Assignment: Standardized Nursing Language: What Does It Mean for Nursing Practice?

Assignment: Standardized Nursing Language: What Does It Mean for Nursing Practice
Assignment: Standardized Nursing Language: What Does It Mean for Nursing Practice
To Prepare:
Review the concepts of informatics as presented in the Resources, particularly Rutherford, M. (2008) Standardized Nursing Language: What Does It Mean for Nursing Practice?
Reflect on the role of a nurse leader as a knowledge worker.
Consider how knowledge may be informed by data that is collected/accessed.
The Assignment:
In a 2- to 3-page paper (not including title page and references), address the following:
Explain how you would inform this nurse (and others) of the importance of standardized nursing terminologies.
Describe the benefits and challenges of implementing standardized nursing terminologies in nursing practice. Be specific and provide examples.
example, if the decision to withdraw treatment is carried out and death is thereby hastened,
would this action violate the ethical principal of non-maleficence which demands that
actions taken must prevent harm to the patient? Nevertheless, it has also been argued that it
is permissible to withhold or withdraw treatment and allow the disease process to progress
to a natural death for the patient (Kinsella and Booth 2007). However, any decision to
withhold or withdraw treatment should be based upon the expectation that the patient can
no longer benefit from that treatment, it is medically futile and the doctor’s intention when
doing so must be to relieve the patient of the burdens associated with that treatment
(Kinsella and Booth 2007).
J Relig Health (2016) 55:119–134 123
123
Withdrawing medical treatment has always been seen as acceptable as there is a clear
distinction between positive acts and omissions. According to the acts–omissions dis-
tinction, ‘‘in certain contexts, failure to perform an act, with foreseen bad consequences of
that failure, is morally less bad than to perform a different act which has the identical
foreseen consequences. It is worse to kill someone than to let them die’’ (Glover 1977).
Thus, acting to kill a patient even for good reasons may seem wrong, whereas omitting to
act by withholding life-saving treatment may seem right in certain compelling circum-
stances. It follows that permitting an illness to progress naturally, as opposed to making
something happen by acting intentionally, appears to be more acceptable legally and
ethically (Glover 1977; McLachlan 2008).
Medical Futility
Medical futility is described as an intervention that will not be able to reach the intended
goal of the intervention (Cavalieri 2001). This usually occurs during assessments on
whether to forego or withdraw life-sustaining treatments (Centre for Bioethics 2005). The
determination of medical futility raises ethical concerns, particularly, on the reasons for
considering the treatment as futile. The fact that such decision rests solely in the hands of
the healthcare providers may lead to possibilities of the discretion being exercised arbi-
trarily. For instance, medical treatment may be discontinued not only because it no longer
benefits the patient, but such continuation may be considered futile in order to save cost
(Centre for Bioethics 2005; Zahedi et al. 2007). Further, discontinuation of life-sustaining
treatments particularly artificial nutrition and hydration causes a great deal of ethical
tension and emotional burden, especially to the family members of a dying patient (al-
Shahri and Al-Khenaizan 2005; Bu?low et al. 2008). Food and water are considered to be
the basic sustenance of human survival, and denying them to a patient may be viewed by
family members as starving their loved one to death (Noah 2006).
However, medical opinions vary on this issue. Some argue that continuing artificial
nutrition and hydration prevents suffering to a certain extent, while others claim that it is an
unnecessary burden with no clear symptom benefit (Olsen et al. 2010). There are also those
that hold the view that nutrition and hydration treatments are palliative care that fulfil a
basic human need and should not be denied at the end of life (Centre for Bioethics 2005;
Zahedi et al. 2007). However, in some circumstances, the continuous supply of nutrition
and hydration may not be beneficial to a dying patient and may in fact be distressing as the
patient’s gastrointestinal function deteriorates (Kahn et al. 2003). It is therefore suggested
that the principle of proportionality be applied with regard to life-sustaining treatments at
end-of-life care. Nutrition and hydration may thus be ethically withheld or discontinued if
the dying patient suffers burdens that outweigh the life-prolonging benefit, irrespective of
whether death will be the result (Centre for Bioethics 2005).
Pain Management/Terminal Sedation
Terminal sedation is used in end-of-life care to relieve severe suffering. It refers to the use
of medications to induce decreased or absent consciousness to the extent that the patient
will no longer feel pain, air hunger or other forms of distress (Kahn et al. 2003; Olsen et al.
2010). In the practice of euthanasia, a lethal injection is administered in an amount that is
certain to bring about and ultimately intended to cause the death of the patient, while
terminal sedation differs from euthanasia in that the dose of medication is maintained
rather than increased once sedation is achieved; the intent being not to hasten death but to
124 J Relig Health (2016) 55:119–134