Implementing advance directives in the clinical setting: The experience of critical care and oncology nurses

2.50
Hdl Handle:
http://hdl.handle.net/10755/166209
Category:
Abstract
Type:
Presentation
Title:
Implementing advance directives in the clinical setting: The experience of critical care and oncology nurses
Author(s):
Artnak, Kathryn
Author Details:
Kathryn Artnak, MSN, University of Texas Health Science Center at San Antonio Department of Nursing, San Antonio, Texas, USA, email: kathryn.artnak@angelo.edu
Abstract:
The Patient Self-Determination Act of 1990 is a federally mandated law that requires health care institutions to make all patients and clients aware of state laws regarding advance directives (e.g., living wills). Conceived to protect individual choice in medical treatment decision making, particularly at the end of life, implementation of this health care policy has become in many places another exercise in institional bureaucracy. This paper presents the findings from focus group discussion sessions designed to elicit the experience of nurses regarding the utility of advance care planning documents in the clinical setting. Two clinical sites were purposely chosen--the intensive care unit and the oncology unit--due to the probability of the presence and subsequent implementation of advance directives (e.g., living wills). Analysis of the data showed that conflict often occurred over the interpretation of these documents between the physicians, the nurses and the families of the patient involved. They describe the effect of an overzealous regard for individualism within the context of health care decision making, often creating complex, difficult situations of an ethical nature where patients and families are often left facing serious illness alone, frightened, and without guidance. Such results are troubling for the proclaimed purposes of advance directives which are to protect the "best interests" of individuals regarding their treatment choices for a time when they are unable to speak for themselves.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
Feb 29 - Mar 2, 1996
Conference Host:
Southern Nursing Research Society
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.titleImplementing advance directives in the clinical setting: The experience of critical care and oncology nursesen_GB
dc.contributor.authorArtnak, Kathrynen_US
dc.author.detailsKathryn Artnak, MSN, University of Texas Health Science Center at San Antonio Department of Nursing, San Antonio, Texas, USA, email: kathryn.artnak@angelo.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/166209-
dc.description.abstractThe Patient Self-Determination Act of 1990 is a federally mandated law that requires health care institutions to make all patients and clients aware of state laws regarding advance directives (e.g., living wills). Conceived to protect individual choice in medical treatment decision making, particularly at the end of life, implementation of this health care policy has become in many places another exercise in institional bureaucracy. This paper presents the findings from focus group discussion sessions designed to elicit the experience of nurses regarding the utility of advance care planning documents in the clinical setting. Two clinical sites were purposely chosen--the intensive care unit and the oncology unit--due to the probability of the presence and subsequent implementation of advance directives (e.g., living wills). Analysis of the data showed that conflict often occurred over the interpretation of these documents between the physicians, the nurses and the families of the patient involved. They describe the effect of an overzealous regard for individualism within the context of health care decision making, often creating complex, difficult situations of an ethical nature where patients and families are often left facing serious illness alone, frightened, and without guidance. Such results are troubling for the proclaimed purposes of advance directives which are to protect the "best interests" of individuals regarding their treatment choices for a time when they are unable to speak for themselves.en_GB
dc.date.available2011-10-27T14:42:30Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T14:42:30Z-
dc.conference.dateFeb 29 - Mar 2, 1996en_US
dc.conference.hostSouthern Nursing Research Societyen_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.-
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