The Missouri Nurse Practice Act, Statute 335.066, item 12 states that violation of any professional trust or confidence is reason for disciplinary measure on a nurses license. The primary nurse caring for Mr. E clearly violated this patient’s trust and confidence by not relaying the fact that the patient had an advanced directive that stated he did not wish to be intubated to his brother, Mr. Y and by discussing this patient and his medical information with the other nurse’s in the cafeteria.
As I reviewed the Code of Ethics from the American Nurses’s Association I found several Provisions that applied, and were violated, to this scenario. Provison 1.3-The nature of health problems states that the nurse respects the worth, dignity and rights of all human beings irrespective of the nature of the health problem. It goes on to state that the worth of the person is not affected by disease, disability, functional status, or proximity to death.
This affects my actions as the nurse in that despite Mr. E’s developmental disability and other comorbidities I can not neglect my duty to him as my patient. Mr. E’s worth is not less than another patient’s that does not have a develomental disability. I owe him the same rights and respect that I owe all my patient’s.
By placing this patient on a ventilator against his wishes as determined not only by his advanced directive but by his own statement of “No” I am violating his right to self-determination outlined in Provision 1.4 of the ANA Code of Ethics; Patient’s have the moral and legal right to determine what will be done with their own person. While the physician did not believe that, at the time of treatment, the patient was competent to make this decision, the patient had an advanced directive that clearly stated that he did not wish to be intubated.
Provision 2.1 of the ANA Code of Ethics also directs that the nurses primary concern is always for the patient and the best interest of the patient while Provisions...