Advanced practice nurses face ethical issues in their day to day work life on varying degrees. How they address these issues is dependent on the specific matter and the morals surrounding it. It hence their work to ensure that they maintain high levels of ethical standards and consult if faced with dilemmas they cannot solve on their own. Mr. Green is an end life prostate cancer patient receiving treatment in Brisbane, QLD, Australia. The patient has expressed suicidal thoughts to one of the nurses and asked that the nurse keeps the same a secret ( Jie, 2015) . The ethical issue faced by this nurse is both on the autonomy of the patient and proper care of an end life patient. The main concern in this case scenario is whether or not the nurse should inform other nurses and medical team members of the patient’s suicide thoughts without the consent of the patient.
Health care decisions at the end of life of patients often depend on ensuring that the patient's quality of life is maintained. Nurses should be aware of terminal illness, especially at an individual's end of life phase causes pain, anxiety, and distress to both the patient and the family. As such, it is their role to ensure they support the patient in a wholesome manner by promoting comfort, both physically and emotionally, offering support to their families through proper communication, therapy and creating a therapeutic relationship with the patient and their families to understand their beliefs, values, culture and their approach to life. By so doing, nurses and other health care practitioners can tailor the best treatment approach. Issues around the cost of treatment should be discussed with the patient, and in possible cases, the option of palliative care can be considered ( Dumanovsky, Augustin, Rogers, Lettang, Meier & Morrison, 2016) . Palliative care units have become common in caring for terminally ill patients since they allow the patient to receive affordable health care in a unit that is not a hospital.
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Before deciding on an advanced practice nurse, it important to understand the ethical implications of all decisions that can be made, the ethical principles as well as the nursing code of ethics governing nurses in the specific state. The nursing code of ethics requires that nurses and other health care providers do not share a patient's information without the consent of the patient and/or the family. Sharing information with other nurses and health care practitioners would be against the patient's privacy. Advanced nursing practice nurses often find themselves in situations where a patient chooses to trust them. Sharing out the information would hence betray the trust the patient has in this particular nurse. The implications of not sharing out the information with other nurses would possibly lead to more adverse effects if the patient went ahead with his plan.
It is hence prudent that the nurse informs other nurses of the patient's suicide thoughts so that they know how to advance their care towards him. Suicide thought is common among many ed life patients. All health care practitioners must be aware of the patient's thoughts so that they know the kind of relationship to establish with the patient. Mr. Green may also need therapy to help him proceed with his treatment without suicidal thoughts. A second approach would be to also inform the family members about Mr. Green's suicide thoughts and get consent from them on whether to inform other members of the medical team or not. The nurse informing the family members of Mr. Green's suicide thoughts must explain to them all the possible case scenarios, including the fact that Mr. Green may proceed with his suicidal thoughts without the knowledge of the people taking care of him. Informing the medical team would make them more alert about Mr. Green's actions hence preventing him from committing suicide.
Advanced practice nurses have the opportunity of creating a therapeutic relationship with patients and their families. The third approach to this dilemma would be to bring up the conversation on end of life to both the patient and his family. This is largely dependent on the patient's beliefs, desires, values, and the patient's fears as well as those of his family members. In Australia' for example, suicide is a crime. But patients have a right to autonomy. Nurses also have the responsibility of being beneficent and doing what is good for the patient. As such, a patient who is nearing the end of life has the option of ending their life or choosing to continue with treatment depending on their beliefs and what they find most suitable. This decision should also be respected.
In conclusion, the best ethical decision in this case scenario is for the nurse to share the information with other health care practitioners. By so doing, the nursing team follows a self-harm and suicide protocol when dealing with the patient. They ensure that they maintain communication with the patient, identify any factors and items around the patient that could be used for suicide. Once these actions were taken, the patient was well protected from causing harm to himself. Later on, he was transferred to a palliative care unit where he stayed without any signs of self-harm or suicide. Mr. Green passed on at 76 years in the company of his family and pastor. The decision to inform other health care practitioners was hence based on a proper analysis of the specific case, the state health laws and regulations, and the intention of being beneficent to the patient and the family.
References
Dumanovsky, T., Augustin, R., Rogers, M., Lettang, K., Meier, D., & Morrison, R. (2016). The
Growth of Palliative Care in U.S. Hospitals: A Status Report. Journal Of Palliative Medicine , 19 (1), 8-15. https://doi.org/10.1089/jpm.2015.0351
Jie, L. (2015). The patient suicide attempt – An ethical dilemma case study. International Journal Of Nursing Sciences , 2 (4), 408-413. https://doi.org/10.1016/j.ijnss.2015.01
