Nurse Advocacy and Patient Autonomy Essay

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.....nurse assigned to care for this patient, I would strongly advocate on behalf of the patient's autonomy. The clash between patient autonomy and the healthcare system and its representatives like nurses can only be resolved by being honest in this situation. The patient is under a high degree of stress, not only because of his health condition and the fear that brings out in him, but due to other stressful life events including his financial situation. He was also supposed to get married immediately before the bypass surgery was scheduled, and this is bound to add to his level of stress. The primary issue here is providing what the patient needs to keep him safe during the procedure, and if he insists on using his own pump, which he has successfully used for the thirty years he has lived with the disease of diabetes, then he should use his own pump. There is no need for the nurses on duty to be concerned about this issue, or to coerce the patient into purchasing a new pump that he not only cannot afford, but does not want. Perhaps the new pump would not be effective in his case, anyway. The nurse manager is in the wrong, and I would tell her as much, while advocating on behalf of the patient.

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When confronted with the ethical issue of patient autonomy, many nurses perceive that they respect patients more than patients perceive they are being respected by nurses (Rahmani, 2010). Sometimes nurses forget that what is convenient for them (such as using the pump the nurse manager was familiar with already) is not best practice for the patient.



The standard post-op orders are not a rigid rule. They are guidelines, designed to be flexible to allow for any extenuating circumstances or issues like this. Unless the nurse can definitively prove that post-op, the patient's pump will be insufficient for keeping his blood insulin levels at equilibrium, then the nurse manager has no business telling the patient to buy a new pump. The patient's safety needs to be assessed more in relation to the stress of the bypass surgery, which is a totally separate issue. If the patient does need to adjust the settings on his pump temporarily, then there are better ways of framing the issue other than coercion and paternalism. The patient has been managing his disease for a….....

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References


Rahmani, A., et al. (2010). Respecting to patients' autonomy in viewpoint of nurses and patients in medical-surgical wards. Iranian Journal of Nursing and Midwifery Research 15(1): 14-19.

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