2.50
Hdl Handle:
http://hdl.handle.net/10755/148478
Type:
Presentation
Title:
Ethical decisions in nursing: The do-not-resuscitate decision
Abstract:
Ethical decisions in nursing: The do-not-resuscitate decision
Conference Sponsor:Sigma Theta Tau International
Conference Year:1991
Author:Keffer, M., PhD, APRN, BC
P.I. Institution Name:Indiana University
Title:Assistant Professor
End-of-life decisions, among them the DNR (do-not-resuscitate)

order, are a significant part of contemporary medical practice.

Nurses who are responsible for patients with a DNR order are often

excluded from participation in the DNR decision, yet may be

required to provide care at the time of DNR implementation. The

purpose of the study was to describe and explain how the nurse

understood the DNR decision and bow nurses interpret their role

within the DNR process. The study used grounded theory methodology

to develop an understanding of nurses views and actions regarding

the DNR decision.



Seventy-seven registered nurses employed in the medical-surgical

and critical care units of three midwestern acute-care hospitals

were interviewed using an open-ended question format. A conceptual

model evolved from the data that had as its basic social structural

process accommodation. Analysis indicated that nurses accommodated

to the DNR decision either by active or passive involvement and

consequences of that accommodation were either negative or

positive. The process was seen as a dynamic interaction between

the DNR decision and the nurse with pre-existing determinants and

factors influencing how the nurse found meaning in the decision.

Descriptive statistics are presented to illuminate the categories

and model. Even though nurses were involved at differing levels as

mandated by each hospital policy, the nurses behaved similarly

across hospitals, thus supporting the model of accommodation.

Comparisons of policies and reactions of the subjects are presented

to substantiate the findings.



The recommendations from the study suggest changes toward more

knowledgeable patient care, better communication among nurse,

patient, and physician, and a lessening of ethical tensions which

contribute to inter- and intra-professional conflict. The nursing

profession should support educational programs which will help

consumers understand end-of-life choices. Nursing curriculum

should include content in ethical decision-making. If the nurse

is aware of the patient's rights and his/her own duties to the

patient, is aware of the role of the physician as one of the

decision makers, and is aware of the possibilities of treatment

abatement options, then nursing and nurses will be more effective

advocates for the patient, institution, and society.



Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEthical decisions in nursing: The do-not-resuscitate decisionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/148478-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Ethical decisions in nursing: The do-not-resuscitate decision</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1991</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Keffer, M., PhD, APRN, BC</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Indiana University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jkeffer@attglobal.net</td></tr><tr><td colspan="2" class="item-abstract">End-of-life decisions, among them the DNR (do-not-resuscitate)<br/><br/>order, are a significant part of contemporary medical practice.<br/><br/>Nurses who are responsible for patients with a DNR order are often<br/><br/>excluded from participation in the DNR decision, yet may be<br/><br/>required to provide care at the time of DNR implementation. The<br/><br/>purpose of the study was to describe and explain how the nurse<br/><br/>understood the DNR decision and bow nurses interpret their role<br/><br/>within the DNR process. The study used grounded theory methodology<br/><br/>to develop an understanding of nurses views and actions regarding<br/><br/>the DNR decision.<br/><br/><br/><br/>Seventy-seven registered nurses employed in the medical-surgical<br/><br/>and critical care units of three midwestern acute-care hospitals<br/><br/>were interviewed using an open-ended question format. A conceptual<br/><br/>model evolved from the data that had as its basic social structural<br/><br/>process accommodation. Analysis indicated that nurses accommodated<br/><br/>to the DNR decision either by active or passive involvement and<br/><br/>consequences of that accommodation were either negative or<br/><br/>positive. The process was seen as a dynamic interaction between<br/><br/>the DNR decision and the nurse with pre-existing determinants and<br/><br/>factors influencing how the nurse found meaning in the decision.<br/><br/>Descriptive statistics are presented to illuminate the categories<br/><br/>and model. Even though nurses were involved at differing levels as<br/><br/>mandated by each hospital policy, the nurses behaved similarly<br/><br/>across hospitals, thus supporting the model of accommodation.<br/><br/>Comparisons of policies and reactions of the subjects are presented<br/><br/>to substantiate the findings.<br/><br/><br/><br/>The recommendations from the study suggest changes toward more<br/><br/>knowledgeable patient care, better communication among nurse,<br/><br/>patient, and physician, and a lessening of ethical tensions which<br/><br/>contribute to inter- and intra-professional conflict. The nursing<br/><br/>profession should support educational programs which will help<br/><br/>consumers understand end-of-life choices. Nursing curriculum<br/><br/>should include content in ethical decision-making. If the nurse<br/><br/>is aware of the patient's rights and his/her own duties to the<br/><br/>patient, is aware of the role of the physician as one of the<br/><br/>decision makers, and is aware of the possibilities of treatment<br/><br/>abatement options, then nursing and nurses will be more effective<br/><br/>advocates for the patient, institution, and society.<br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T09:45:45Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T09:45:45Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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