yc2m

All you lovely nurses out there.......please help!!

2nd year essay on legal, ethical & professional issues relating to an elderly patient (who is very independent) wanting to return home after stay in hospital and rehabilitation. Patient's family want him to go into care.

I've been looking at consent, confidentiality, benefinence, non-malefinence, justice record keeping, autonomy etc but am getting really confused as to what falls within each section. Any advice would be most welcome.

I've got information overload and am going round in circles, not knowing what should go where!!:curse:

thanks in advance
yc2m

asher

Informed consent

if he is aware of the risks and feels there won't be a problem unless a psych says he is unfit to make that decision he has to be allowed home to try!

Donna&Neil

Hi I would think there must be a full assessment of risk to determine if allowing this person home is a safe option. If patient is mentally capable, no impaired judgement/risk then family should not be given priority here.

asher

its usual to do a home visit first under supervision to see if there are any problems as well

Yoong

Unclear what was his hospitalisation for?
I would be more precise if I knew what brought
him into hospital.
I would get the family in for an interview with the patient.(if he consents)
Discuss discharge planning assessments for safety with them
before he returns home.
Social Worker to see that all benefits are in place.
Ask the OT to do home assessment and handling of finances.
Try out a few overnight passes to see how he
copes at home on his own.
Follow up care to be arranged according to patient's
needs.
Good luck with your essay.
Yoong

ethan anderson

Try out a few overnight passes to see how he copes at home on his own. Follow up care to be arranged according to patient's needs. Good luck with your essay.




ethan anderson

Zana

Another idea:empowerment, try and find a Thompson 2006 book. NSF for older people has sections you might fing useful.
And also, we have in surrey a thing called 'nip in bed', a max of 14 days allowed after hosp discharge, in a nursing home, hotel like regime, the advantage is that there is a nurse on site.
Hope this helps.
Good luck.
I would probably stress communication problems, as I have met a lot of elderly reluctant to accept help or changes around their homes.

jmd104

Have you considered nurses role as patient advocate???? I've not long finished my diploma and patint advocacy would always be commented on when it was discussed in an essay because so few students remebered to put it in there depite the fact that we all do it when we're working. What is you role in being an advocate for your patient and supporting him in his decision making and his family?

yc2m

Thanks everybody, you've all been very helpful!!
Still got a fair bit to read before i actually start writing, and it's to be in for Monday........so have a guess how my weekend is gonna go, !!

Stitch

What is the actual question and have you been supplied with the marking criteria. This will give you an indication of what is required and will cut down your reading/writing time considerably.

Cheers

Ginny

yc2m

Hey Ginny,

The question states that a very independent elderly patient wishes to return home from hospital after a period of rehabilitation after illness (doesn't specify), and the family wants him to go into care, as they think he is too frail to live on his own. It then ask what are the legal, ethical and professional issues relating to this scenario??:curse:

I have been trying to read about human rights, informed consent, autonomy for ethics. Prefessionally: duty of care, justice, beneficence, non-maleficence, record keeping and legally: ?? ??

thanks
yc2m

mollyb

Hi yc2m
I work as a cpn in older persons service. Have a look at the Mental capacity act 2005 on DOH website. I think this will be relevant to you. In short, there is a two stage test of capacity to make own decisions. 1. There must be an impairment or disturbance in the functioning of the mind or brain. 2. The impairment must be sufficiant that the person lacks the capacity to make that particular decision to go home.

If the person does not have impairment, then they have full capacity to make thir own decisions.
I come accross this quite frequently and our consultant psychiatrist is often asked to assess for capacity. If they have full capacity, all should be done to support the person to remain within their own home as far as possible with the correct level of support. This may include referral to social services to organise home care package. The persons wishes are priority before family, but they would be included in all stages of the process, with the persons cooperation of course.

Hope this will be helpful. I don`t want to add to your info overload!

Lesley

eddie007

Damn, I was just about to add Capacity... well done for getting that in first..

eddie007

You could bring in caring for the carers... supporting family ... understanding their concerns and educating them... So often a families concern is due to either gulit becasue they can't provide the support they would like to or a lack of knoweldge as to services available...

Stitch

Hi,

I would address them in the order the question asks starting with the legal implications. Might want to review the details contained in the mental health acts and vulnerable people. In ethics have you reviewed the Belmont Report which describes the rights of individuals? The three principles identified here
respect for persons ie. human dignity, beneficence and justice provide the standards that all of ethical conduct are based. Also in the protection of human rights self-determination, privacy and dignity, anonymity and confidentiality, fair treatment and protection from discomfort and harm are paramount. This also incorporates infromed consent. You may wish to look up information pertaining to doumentation and the legal responsibilities inherent within nursing. As for professionally you could take this on as what is the role of the nurse in promoting and protecting the rights of a vulnerable patient.

Hope some of this makes sense.

Ginny