WHEN TO SHARE
The situation above is an ethical conundrum because values are in conflict. On one hand, transparency is good and patients have a right to know about administrative factors affecting their care. On the other hand, care should stay focused on a patient's problems, not the nurse's.Working through this dilemma requires both analytic and reflective skills. First, the conflict should be analyzed in terms of the relevant ethical principles and rights of the people involved. This sets parameters of ethically permissible action, allows rigorous analysis that can be reviewed by others, and contributes to developing criteria useful to solving future similar cases. However, a decision about the most ethical course of action in this situation cannot be reached without a certain amount of self-reflection as well, including a dispassionate assessment of one's own motives and a clinically savvy assessment of the nurse–patient relationship.Reasons to share information. In order to determine whether or not to tell a patient about staffing levels, one must consider the reasons a clinician might share or withhold certain information from a patient. Sharing information serves several functions that support the provision of ethical care. * Adequate information is needed for patients to give consent or refuse care. * Information about the effect and consequences of treatment can lessen anxiety in situations where patients have little control. * Information that allows patients to accurately anticipate events improves their ability to regulate their reaction and increases their sense of inclusion. * Sharing information shows respect for the patient as a partner in care.Reasons not to share information. Despite the value of information in health care, patients will never have all the information. The information useful to patients is both factual (the clinical details) and experiential (what it's like to have the disease or associated experience). There are several barriers to revealing all the information. * It isn't possible to tell the patient everything nurses know. * If the patient hasn't had a particular experience, she or he may not fully anticipate its realities from a description—this might occur, for example, when patients and caregivers must decide about institutional care versus home care involving difficult medical procedures like ventilation. (Conversely, nurses should remember that patients often have more experiential knowledge, especially about chronic conditions with a waxing and waning course, than clinicians who haven't “been there.”) * It isn't appropriate to tell patients some information. * Some information isn't pertinent to nursing care of patients.In light of the above considerations, any decision about what information to discuss with a patient and what information to leave out will require the nurse's judgment. Information about staffing levels doesn't bear directly on most informed consent decisions for particular treatments, except insofar as this information could influence patients’ decisions about whether or not to remain in treatment at that facility. But telling the patient about staffing levels may in some cases help the patient to understand and anticipate occurrences such as slow response to medication requests or nurses spending less time on psychosocial aspects of care. In addition, sharing this information might help show respect for the patient as a partner in care.Conversely, in some circumstances telling patients about staffing levels constitutes self-serving excuse making, which detracts from good nursing care. Nurses may sometimes wish to tell patients about staffing problems to avoid blame or even to get sympathy from the patient. The ability to give quality nursing care depends on being able to examine one's own motives and understand when telling something to a patient serves the patient.
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เมื่อใช้ร่วมกันThe situation above is an ethical conundrum because values are in conflict. On one hand, transparency is good and patients have a right to know about administrative factors affecting their care. On the other hand, care should stay focused on a patient's problems, not the nurse's.Working through this dilemma requires both analytic and reflective skills. First, the conflict should be analyzed in terms of the relevant ethical principles and rights of the people involved. This sets parameters of ethically permissible action, allows rigorous analysis that can be reviewed by others, and contributes to developing criteria useful to solving future similar cases. However, a decision about the most ethical course of action in this situation cannot be reached without a certain amount of self-reflection as well, including a dispassionate assessment of one's own motives and a clinically savvy assessment of the nurse–patient relationship.Reasons to share information. In order to determine whether or not to tell a patient about staffing levels, one must consider the reasons a clinician might share or withhold certain information from a patient. Sharing information serves several functions that support the provision of ethical care. * Adequate information is needed for patients to give consent or refuse care. * Information about the effect and consequences of treatment can lessen anxiety in situations where patients have little control. * Information that allows patients to accurately anticipate events improves their ability to regulate their reaction and increases their sense of inclusion. * Sharing information shows respect for the patient as a partner in care.Reasons not to share information. Despite the value of information in health care, patients will never have all the information. The information useful to patients is both factual (the clinical details) and experiential (what it's like to have the disease or associated experience). There are several barriers to revealing all the information. * It isn't possible to tell the patient everything nurses know. * If the patient hasn't had a particular experience, she or he may not fully anticipate its realities from a description—this might occur, for example, when patients and caregivers must decide about institutional care versus home care involving difficult medical procedures like ventilation. (Conversely, nurses should remember that patients often have more experiential knowledge, especially about chronic conditions with a waxing and waning course, than clinicians who haven't “been there.”) * It isn't appropriate to tell patients some information. * Some information isn't pertinent to nursing care of patients.In light of the above considerations, any decision about what information to discuss with a patient and what information to leave out will require the nurse's judgment. Information about staffing levels doesn't bear directly on most informed consent decisions for particular treatments, except insofar as this information could influence patients’ decisions about whether or not to remain in treatment at that facility. But telling the patient about staffing levels may in some cases help the patient to understand and anticipate occurrences such as slow response to medication requests or nurses spending less time on psychosocial aspects of care. In addition, sharing this information might help show respect for the patient as a partner in care.Conversely, in some circumstances telling patients about staffing levels constitutes self-serving excuse making, which detracts from good nursing care. Nurses may sometimes wish to tell patients about staffing problems to avoid blame or even to get sympathy from the patient. The ability to give quality nursing care depends on being able to examine one's own motives and understand when telling something to a patient serves the patient.กลับสู่ด้านบน | บทความเค้า
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