2.50
Hdl Handle:
http://hdl.handle.net/10755/164201
Category:
Abstract
Type:
Presentation
Title:
Ethics, Nurses and the ICU: A CNS-led Intervention to Change the Status Quo
Author(s):
Hill, Kathleen M.
Author Details:
Kathleen M. Hill, MSN, CCNS-CSC, Cleveland Clinic, Cleveland, Ohio, USA, email: nacnsorg@nacns.org
Abstract:
Purpose: This session will demonstrate the impact of a CNS-led intervention to change the culture in a 55-bed cardiac surgical intensive care unit. Significance: The culture of the ICU is fraught with technology and the overwhelming goal of saving lives, with the underlying presumption that patients want everything done. Families are captivated by massive efforts to save their loved one, similar to the heroic dramas played out weekly on the television, where almost everyone lives. In reality, the burden to save a life at all costs is often too great. Complicating the situation is an unspoken taboo against even considering the possibility that a patient may not survive, or will survive with devastating consequences inconsistent with his or her values and preferences. Background/Design: Bedside caregivers identified a need for clinically relevant information and skill building regarding their ability to cope with situations where patients' response to surgery was not as hoped. Methods: The CNS for the ICUs, the medical director, and a CNS with expertise in ethics collaborated to develop a four-part series for nursing and medical staff to address the issues encountered in the ICU setting when surgical interventions did not produce the hoped-for results. The series offered an opportunity for practicing the skills needed to have a caring conversation with patients and families to assess their wishes when the plan and goals of care shift. Findings: This program will provide an overview of the development, implementation and outcomes to date for this project, including examples of behavioral changes that altered patient trajectory at the end of life. Conclusions: Clinical Nurse Specialists are key figures in the development and implementation of change within their practice environment. Implications for Practice: Altering the 'way things have always been done' in regards to patients, families, and their expressed or implied wishes is not as easy as updating a technical procedure. But, if a process must be improved to provide better care to populations, it is the CNS who has the innovative skills and passion to bring about the change.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
CNS Outcomes: Ensuring Safety and Quality
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Phoenix, Arizona, USA
Description:
Conference theme: CNS Outcomes: Ensuring Safety and Quality, held February 28-March 1 in Phoenix, Arizona, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleEthics, Nurses and the ICU: A CNS-led Intervention to Change the Status Quoen_GB
dc.contributor.authorHill, Kathleen M.en_US
dc.author.detailsKathleen M. Hill, MSN, CCNS-CSC, Cleveland Clinic, Cleveland, Ohio, USA, email: nacnsorg@nacns.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/164201-
dc.description.abstractPurpose: This session will demonstrate the impact of a CNS-led intervention to change the culture in a 55-bed cardiac surgical intensive care unit. Significance: The culture of the ICU is fraught with technology and the overwhelming goal of saving lives, with the underlying presumption that patients want everything done. Families are captivated by massive efforts to save their loved one, similar to the heroic dramas played out weekly on the television, where almost everyone lives. In reality, the burden to save a life at all costs is often too great. Complicating the situation is an unspoken taboo against even considering the possibility that a patient may not survive, or will survive with devastating consequences inconsistent with his or her values and preferences. Background/Design: Bedside caregivers identified a need for clinically relevant information and skill building regarding their ability to cope with situations where patients' response to surgery was not as hoped. Methods: The CNS for the ICUs, the medical director, and a CNS with expertise in ethics collaborated to develop a four-part series for nursing and medical staff to address the issues encountered in the ICU setting when surgical interventions did not produce the hoped-for results. The series offered an opportunity for practicing the skills needed to have a caring conversation with patients and families to assess their wishes when the plan and goals of care shift. Findings: This program will provide an overview of the development, implementation and outcomes to date for this project, including examples of behavioral changes that altered patient trajectory at the end of life. Conclusions: Clinical Nurse Specialists are key figures in the development and implementation of change within their practice environment. Implications for Practice: Altering the 'way things have always been done' in regards to patients, families, and their expressed or implied wishes is not as easy as updating a technical procedure. But, if a process must be improved to provide better care to populations, it is the CNS who has the innovative skills and passion to bring about the change.en_GB
dc.date.available2011-10-27T11:43:55Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:43:55Z-
dc.conference.date2007en_US
dc.conference.nameCNS Outcomes: Ensuring Safety and Qualityen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationPhoenix, Arizona, USAen_US
dc.descriptionConference theme: CNS Outcomes: Ensuring Safety and Quality, held February 28-March 1 in Phoenix, Arizona, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_US
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