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Life Crisis

Part 1: Introduction and Life Crisis event (500 words)

You must not include any identifying information in the reflected event related to a patient or organisation.

The example is based on managing care of a 10-year-old patient. The patient name was Andy. Andy was a little girl that was admitted for the purpose of managing care for her end stage leukemia. The parents of the patient were a disciple of Jehovah’s witness. The family of the patient was duly informed regarding the condition of their daughter. The patient use to visit the outpatient department in every two days a week. The nurses took close consideration for the cultural believes of the family and thus, Andy was being managed only with the help of oral medication. The patient’s condition was however, deteriorating with each passing day. The treatment option of blood transfusion was explained to the parents. The consent for the same was however, never given by the parents, given the fact that they were a believer of Jehovah’s witness. Their religion prohibits them to take any kind of infusion therapy, be it medication, fluid or blood transfusion (Chojnowski 2016, pp.2438-2442). The parents were well aware of the repercussions of not following the defined treatment protocol. One day Andy was admitted to the emergency care department with breathing difficulty and unstable vitals.

On blood examination the patient was found to be severely anemic and it was a life-threatening situation for her. However, before implementing any interventional procedure, the consent of the patient or their family is necessary, but in the given care scenario, nurse was also bound by her ethical duties of doing what is best for her patient. The nurse assigned to Andy’s care provided the patient with blood transfusion, overlooking the patient’s cultural and religious preference. The condition of the patient was improved within three hours of receiving blood transfusion. The parents were informed about the transfusion, after the condition stabilized. The parents were very furious for not taking their consent for the treatment and for informing them late regarding the same. This created a very difficult situation to deal with as there was a big ethical dilemma created with the situation. The social justice principle of equity was followed, however, in the process of prioritizing the needs of the patient, the principle of participation was overlooked significantly. The patient condition improved by the means of critical and apt thinking and decision-making process of the nurse assigned to the patient care. However, the decision-making process was not based on the perception of the family in managing the care of Andy.

Part 2: Citations and annotations (1500 words)

Citation 1: Rooddehghan, Z., ParsaYekta, Z. and Nasrabadi, A.N. 2019. Equity in nursing care: A grounded theory study. Nursing Ethics26(2), pp.598-610.

Related Social Justice Principle: Social justice of equity

Annotation: The study was conducted to evaluate for the equity in practice of nursing care. The study was a qualitative study which made use of Glaser’s approach to grounded theory. Convenience sampling was observed for the purpose of data collection. A total of 27 participants were taken into consideration. The finding reflected that the equity in nursing care is mainly related to the nurse practioners approach towards the patients. These nursing approaches were also correlated with six C’s of nursing are as well. the main limitation of the study was reflected as the variance between the attitudes of nursing practioners and their individual perspective of managing care for the patient.

Relevance to your professional clinical practice: The nurses that are having a greater amount of experience can help in providing equity of care to the patients. A fair care should be provided to the patients while managing their care in order to avoid any conflict. 

Citation 2: Lor, M., Crooks, N. and Tluczek, A.. 2016. A proposed model of person-, family-, and culture-centered nursing care. Nursing Outlook64(4), pp.352-366.

Related Social Justice Principle: Social justice of equity

Annotation: The study was conducted to compare four main conceptual care models of nursing care. These models were person, patient, family-centered and culturally competent care model. The study was based on comparative concept analysis based on Roger’s evolutionary concept analysis. The study made use of collective analysis of 32 nursing research articles that were inclusive of 12 attributes. The elements were inclusive of collaborative relationship, effective communication, respectful care, holistic perspective, individualized care, inter-personal coordination, self-awareness, empowerment, family as unit if care, interpersonal relationships, cultural knowledge and cultural skills. Results reflected upon the improved quality of care and improved healthcare outcomes in patients. The study also helped in surfacing various healthcare inequalities. The disparities in the health care services mainly leads to social injustice in nursing are and management of the patients. There were no limitations of the study.

Relevance to your professional clinical practice: Findings also reflected on embracing the conceptual framework in nursing care model inclusive of social justice equity to the patients.

Citation 3: Valderama‐Wallace, C.P. 2017. Critical discourse analysis of social justice in nursing's foundational documents. Public Health Nursing34(4), pp.363-369.

Related Social Justice Principle: Social justice of equity

Annotation: The study was conducted to shed light on the social inequality prevailing in the healthcare system in global aspect. The study was also conducted to evaluate for the limitations that can be pondered upon the nursing practice, if they are not conducted in congruence with social justice. The study was based on a critical discourse design that helped in determining the dynamics related to the power, language and inequality within the nursing care practice. The study highlighted upon the ongoing inconsistencies in the conceptualization of the social justice framework and its application in the clinical practice. The code of ethics of professionalism were found to be far related to the cultural, social or economic aspect. The study was a review and there were no limitations highlighted in the study.

Relevance to your professional clinical practice: The study reflected on the fact that a greater consistency will be able to help the nurses in having a much clearer direction in continuously working to minimize the inequality in social justice of care. The study will also be beneficial in having a more profound approach for professional practices in nursing care.

Citation 4:. Wathen, C.N., Varcoe, C., Herbert, C., Jackson, B.E., Lavoie, J.G., Pauly, B., Perrin, N.A., Smye, V., Wallace, B. and Wong, S.T. 2018. How equity‐oriented health care affects health: key mechanisms and implications for primary health care practice and policy. The Milbank Quarterly96(4), pp.635-671.

Related Social Justice Principle: Social justice of equity

Annotation: The study was conducted to examine the importance of equity-oriented healthcare and how it effects upon the key mechanism and implications for the primary healthcare services and policy making. The study was aimed at defining the capacity of the equity-oriented healthcare approach for the purpose of improving healthcare outcomes in individuals. The study was a qualitative research for which 395 patients were recruited from 4 primary healthcare clinics. The data was collected on the basis of 4 structured interviews conducted over a period of 2 years. The findings included that over a period of 24-month time, higher level of EOHC, was able to fetch improved healthcare outcomes in the individuals. The outcomes were also considerably improved in challenging clinical scenarios like, depression, chronic pain, PTSD and so on.

Relevance to your professional clinical practice: The study can be helpful for the healthcare professionals in attaining improved healthcare outcomes from the patients. these improved outcomes can be effectively managed within a limited time-frame of correct application of interventions strategies are opted for providing healthcare services at a primary care level.

Citation 5: Rozendo, C.A., Salas, A.S. and Cameron, B. 2017. A critical review of social and health inequalities in the nursing curriculum. Nurse Education Today50, pp.62-71.

Related Social Justice Principle: Social justice of equity

Annotation: The study reflected on an important topic of social and health related inequalities that are globally occurring phenomenon. It is also one of the biggest challenges for nurses to carry out healthcare facilities in their full capacity. The study was based on a critical literature review of various research articles. Various data bases were searched for the study purpose. These databases included ERIC, CINAHL, Web of Science, MEDLINE for the time period of 2000 to 2015. A total of 20 articles were taken into consideration for the study purpose. There was a limited approach reflected in terms of experience in implementing educational strategies in nursing curriculum. The study however, failed to examine the existing conceptual framework in terms of inequalities in the healthcare system, in detail.

Relevance to your professional clinical practice: The nurses can help with improving on the educative initiatives in nursing curriculum, in order to highlight on the disparities in the healthcare system.

Citation 6: Thandi, M.K.G. and Browne, A.J. 2019. The social context of substance use among older adults: Implications for nursing practice. Nursing Open6(4), pp.1299-1306.

Related Social Justice Principle: Social justice of participation

Annotation: The study was based on implication of nursing practice in social context of substance use among older adults. The study was based on highlighting the problematic issues related with substance abuse in adult population. The study was a discussion paper. The analysis was mainly based on theoretical explanation regarding the social injustice in the promoting equality of healthcare services mainly for older population. The key issue that was identified in this process was the stigma and discrimination associated with managing care in patients suffering from substance abuse. Healthcare providers can help in mitigating the care to the patients by ensuring equal participation of the patients in the process of healthcare services promotion.

Relevance to your professional clinical practice: The study will provide with a framework for ensuing the equal participation of the patient in the decision-making process. This can be helpful in attaining improved healthcare outcomes in the patients.

Citation 7: Juujärvi, S., Ronkainen, K. and Silvennoinen, P. 2019. The ethics of care and justice in primary nursing of older patients. Clinical Ethics14(4), pp.187-194.

Related Social Justice Principle: Social justice of participation

Annotation: The study was based on finding out the importance of ethical decision-making process in nursing care process. The study was based on qualitative analysis. The study was also based on examining the patient-nurse relationship. For the purpose of the study, seven nurses and one physical therapist from a geriatric ward were considered. Data was collected with the help of group interview method and the data collected was them qualitatively examined. The findings reflected that the nurses were generally empathetic towards their patients and were also keen on building strong and robust relations with the patient and their families. The study however, had limitation in terms of data group that was considered for the study purpose.

Relevance to your professional clinical practice: The clinical practices should be comprised of ethical decision making and also be keeping a close consideration for the patients and its family views.

Citation 8: Kankkunen, P., Kreuter, M. and Pietila, A.M. 2018. Participation in primary healthcare–using a finnish version of the patient participation in rehabilitation questionnaire. International Journal of Caring Sciences11(3), pp.1423-1437.

Related Social Justice Principle: Social justice of participation

Annotation: The study was conducted to evaluate the patient’s participation in the primary healthcare as a crucial part of rehabilitation process. The main aim of the study was to research upon the client’s perception and their opinion about the primary healthcare services and looking themselves as an integral part of the decision-making process. The study was based on descriptive statistical method. For the purpose of data collection, use of Finnish version of Swedish Participation in Rehabilitation questionnaire was used. The participants considered their involvement as an integral part of the process. The study however, failed to reflect upon significant findings from the study. The study also failed to compare between the elements taken into consideration for the study purpose.

Relevance to your professional clinical practice: It can be effective to consider the patient participation in the decision-making process. This can be helpful in gaining improved healthcare outcomes from the patients.

Citation 9: Olding, M., McMillan, S.E., Reeves, S., Schmitt, M.H., Puntillo, K. and Kitto, S. 2016. Patient and family involvement in adult critical and intensive care settings: a scoping review. Health Expectations19(6), pp.1183-1202.

Related Social Justice Principle: Social justice of participation

Annotation: The study was conducted to evaluate the importance of patient and family involvement, in managing the care of patients in critical intensive care unit. The study was aimed at examining the future gaps in the topic. Study was a scoping review, which was conducted with the help of various databases search. The data bases that were considered were inclusive of MEDLINE, CINHAL, PsycINFO and so on. The articles from the year range of 2003-2014 was included in the study. A total 829 articles were used in the study. Significant gap was noted in terms of patient and its family involvement in the critical care management of the patient. The study however, failed to acknowledge for all of the underlying elements that can be a barrier in managing care for the patient.

Relevance to your professional clinical practice: Identifying the gaps can be helpful in nursing care practices. These gaps can also form a foundation for drafting improved treatment interventions for the patients.

Citation 10: Hernández-Marrero, P., Fradique, E. and Pereira, S.M. 2019. Palliative care nursing involvement in end-of-life decision-making: Qualitative secondary analysis. Nursing Ethics26(6), pp.1680-1695.

Related Social Justice Principle: Social justice of participation

Annotation: The study was conducted to evaluate the role of patient participation in managing end-of-life decision making in managing palliative nursing care. The study was also inclusive of analyzing the ethical principles in nursing care and management. The study was based on qualitative secondary analysis. Three qualitative data sets including 32 interviews from previous studies in palliative care conducted in Portugal were taken into consideration for analysis purpose. The study revealed that the principle of autonomy is very helpful in decision-making process is very crucial for ensuring smooth facilitation of healthcare services as a part of palliative care model. The study highlighted upon the limitation of communication in the process of facilitation of the clinical services.

Relevance to your professional clinical practice: The process of effective communication between the patient and the healthcare provider is of crucial importance. This approach of patient-participation can be helpful in refined decision-making for attaining improved healthcare outcomes in patients recovering in palliative care.

Reference List for Life Crisis

Hernández-Marrero, P., Fradique, E. and Pereira, S.M. 2019. Palliative care nursing involvement in end-of-life decision-making: Qualitative secondary analysis. Nursing Ethics26(6), pp.1680-1695.

Chojnowski, K., Janus, A., Bliźniewska, K., Robak, M. and Treliński, J. 2016. Long‐lasting extreme anemia during the therapy of acute lymphoblastic leukemia in a Jehovah's Witness patient. Transfusion56(10), pp.2438-2442.

Juujärvi, S., Ronkainen, K. and Silvennoinen, P. 2019. The ethics of care and justice in primary nursing of older patients. Clinical Ethics14(4), pp.187-194.

Kankkunen, P., Kreuter, M. and Pietila, A.M. 2018. Participation in primary healthcare–using a finnish version of the patient participation in rehabilitation questionnaire. International Journal of Caring Sciences11(3), pp.1423-1437.

Lor, M., Crooks, N. and Tluczek, A.. 2016. A proposed model of person-, family-, and culture-centered nursing care. Nursing Outlook64(4), pp.352-366.

Olding, M., McMillan, S.E., Reeves, S., Schmitt, M.H., Puntillo, K. and Kitto, S. 2016. Patient and family involvement in adult critical and intensive care settings: a scoping review. Health Expectations19(6), pp.1183-1202.

Rooddehghan, Z., ParsaYekta, Z. and Nasrabadi, A.N. 2019. Equity in nursing care: A grounded theory study. Nursing Ethics26(2), pp.598-610.

Rozendo, C.A., Salas, A.S. and Cameron, B. 2017. A critical review of social and health inequalities in the nursing curriculum. Nurse Education Today50, pp.62-71.

Thandi, M.K.G. and Browne, A.J. 2019. The social context of substance use among older adults: Implications for nursing practice. Nursing Open6(4), pp.1299-1306.

Valderama‐Wallace, C.P. 2017. Critical discourse analysis of social justice in nursing's foundational documents. Public Health Nursing34(4), pp.363-369.

Wathen, C.N., Varcoe, C., Herbert, C., Jackson, B.E., Lavoie, J.G., Pauly, B., Perrin, N.A., Smye, V., Wallace, B. and Wong, S.T. 2018. How equity‐oriented health care affects health: key mechanisms and implications for primary health care practice and policy. The Milbank Quarterly96(4), pp.635-671.

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Nursing Assignment Help

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