Come up with a patient-care situation in which the RN shouldintervene and advocate for the patient (this can be real or made-up situation).An example of such a situation might be when a patient has not been givencomplete informed consent.
YOU MUST ANSWER ALL 12 QUESTIONS
1. What is the dilemma in your patient-care situation story: Use your own words to describe the problem. State it in a way that others can quickly understand your dilemma.Review
2. Identify the medical facts:Describe the facts that are relevant to the dilemma.
3. Remember that the diagnosisand prognosis are medical facts.
4. Identify the non–medical facts (patient and family, external influences):
a. Patient and family facts such asculture, religion, social, economic, the existence of an AdvanceHealthcare Directive, verbalpreferences made by the patient, how the patient lived his/her life.
b. Those that you discuss should be relevantto the situation.
5. External influences include:organizational policies, federaland state laws, practice acts, code ofethics. These should be relevant to the situation.
6. For both step 2 or 3, separate thefacts from the assumptions: Sometimes all healthcare professionals allow assumptions to guide their decision–making. These must be identified so that these assumptions do not interfere with the process.
7. Identify items that need clarification. Your paper shouldidentify facts that you need toclarify. When initially discussing an ethical situation, it is not unusual tonot have all of the answers.
8. Identify the decision makers: Isthe patient an adult competent to make their own choices? Is the patient a child who is old enough to have a say in the decision.If the patient cannot make their own decision, who is the decisionmaker? How was this person selected?
9. Review the underlying ethicalprinciples: Review which ones and why they apply t thisparticular case: beneficence, nonmaleficience, veracity, fidelity, autonomy and justice.
10. Define alternatives: One–Way to proceed may be apparent at this point. However, sometimes there are different choices. They should be addressed identifying the benefits and burdens for doing one thing versus the other.
11. Follow–up: Define the process to be used with the chosen alternative.
12. Conclude with a discussion ofnursing advocacy in the clinical setting and the nurses role as a patientadvocate.
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