Ethical Dilemma: Forming Biases and Judgments Towards Patients

As I was doing my patient research for one of my patients who had hepatic encephalopathy, I had found my self forming judgment and biases against my patient. I read that EMS had to transport her from her house because her home care aide reported that she had increased confusion. The EMS report stated that they found empty beer cans in her room and she reeked of alcohol. When I read this, I quickly remembered a discussion I had with a classmate about a doctor who told his patient that "She did it to herself". I couldn't help but agree with how the doctor thought. Here is a person who was terribly sick because of years of abusing alcohol, smoking, and doing street drugs. She is in the hospital occupying a bed and using up so much resources, which could have been better allocated to someone whose illness wasn't self-inflicted.

That would have been my thoughts if I wasn't more aware of the determinants of health and other ethical principles such as not judging a person by pure face value. As I have learned from my past clinical experiences, what is said on the chart is not always 100% accurate and there are other vital information that aren't included and can only be known from the patient themselves. It is very easy to fall into the trap of forming hasty generalizations because of a limited information provided to us. I do not know my patient very well but I am sure that there is a reason behind the self-abuse. Although the information was limited, I have noticed that she has bipolar disorder. From the mental health course that I have taken, I have learned that substance abuse is one way for people to self-medicate. Bipolar disorder is a condition in which people go back and forth between periods of a very good or irritable mood and depression. Mental illness is not something that people chose out of their free will and they deserve the help that they need without the negative attitude that some people would have because of the misconception that "they did it to themselves".

Some would argue that they did have a choice to abuse substances, but again as a health professional, our role is to promote health and help a patient to the best of our resources and abilities. Just like a person who smokes, we cannot change them through force, we have to form a partnership and work with them towards mutually set goals when they are willing and more accepting to learn. It is difficult not to form biases, but we have to wear our nursing caps and leave our personal biases out the door.

These are just my thoughts on this subject.

Thoughts on Dying and Upholding the RN Image

http://www.pbs.org/wgbh/pages/frontline/facing-death/

Watching the Frontline video titled "Facing Death" has brought about questions regarding morality and ethics: How far will you go to sustain the life of someone you love or even your life? Dying is a normal part of the life cycle, but no one wants to die. The program has showcased how modern  medicine can keep a human body functioning for years but the poor quality of life of someone who is on life support sometimes outweighs being alive. Prolonging someone's life could actually be more harm especially if someone is always suffering from excruciating pain or worst, brain dead. But again I always believe that the right to live belongs to everyone, therefore it is also their right to decide what happens to them. This is why I think it is important for everyone to have personal directive, so that one's wishes will be respected during an event that someone loses the ability to choose. The video didn't talk about euthanasia, or assisted death, but this will always be a topic of controversy around end of life care. No one wants to be in excruciating agony, therefore making sure that someone is comfortable during the last hours of their life is important. Again if we look back on the principles of beneficence and non-maleficence, letting people die with dignity and peace seems to be the right thing to do. Also, if treatment will only cause more pain and suffering for a patient with little to no chance of surviving, that treatment plan should be revised or all out discontinued. Morality will always have a grey area and much discussions about this topic should be pursued for improvements in end of life care to occur. I also find it important for a nurse to be aware of the process of grieving (Denial, Anger, Bargaining, Depression, and Acceptance) so that a nurse can find the right timing to talk about options left for the patient.

For the journal that I have read regarding the impressions we leave, I find it important for nurses to always be professional with their interactions with their patients. This is especially true for registered nurses as they now have to prove their contribution to health care as licensed practical nurses are able to do what they do and are paid significantly less. Registered nurses should always let their patients know that they are registered nurses, and by informing their patient's this, nurses should definitely need to leave a good impression. As I have seen in clinical, socializing and chatting at the nursing station should be only done when one has made sure that absolutely everything is done for the patient and that one actually spent time to know the patient so that one will have the necessary information to plan competent and compassionate care. Excellent communication skill is really highlighted as this determines the majority of the patient's first impression for the nurse.

Working as a Male Nurse in a Gender-Biased World

If you’re working as a male nurse, you know the odds are stacked against you. Women, who have been monopolizing this role for decades, may resent you stepping into their employment territory, especially in this economic downturn. The media pokes fun of male nurses, and a lot of older folks don’t trust a male nurse. However, you can shine in your position if you take the following steps:

Show Off Your Strengths

One of your primary strengths is probably exactly that—physical capability. Offer to help other nurses with the physically challenging duties such as moving patients, lifting equipment, and carrying supplies. You may also be one of those men who possess admirable emotional strength, which will come in handy in your position as well. Be ready to step in when tempers flare or drama floods your floor. You can be the source of strength your core group of nurses relies upon.

Overdo Professionalism

You can’t take professionalism too far in this role. It’s too easy for some homophobic old guy to accuse you of inappropriately changing his bedpan or some suspicious woman to accuse you of leaning into her in a sexual way while you moved her from her gurney to her hospital bed. You’ve got to be on your guard at all times to make sure you:

• Treat others with respect, even if the patients (or visitors) are not respectful of you
• Use professional medical language
• Ask permission when appropriate
• Explain what you are doing and why you are doing it before you perform your nursing duties, especially if those actions could possibly be misconstrued
• Get another nurse in the room with you if you have to perform any task on a patient who you suspect might not trust you

Develop a Sense of Humor

Sure, there are going to be guys who take pot shots at you and other nurses who might not give you the respect you’re due until you’ve worked with them awhile. Still, it never helps to be defensive or sour-natured. Come up with a few dismissive lines and learn to laugh off anything that smacks of an insult. Remind yourself that in time, you’ll show both your coworkers and your patients who you are: a strong male nurse who can carry them across the room, handle their breakdowns, and drug ‘em up so they feel better again. What’s not to love?

Bio:

Erinn Stam is the Managing Editor for scholarships for nursing students. She attends Wake Technical Community College and is learning about nursing scholarships for men. She lives in Durham, NC with her lovely 4-year-old daughter and exuberant husband.

23 Years Old

The lake shimmered like a silver mirror, as the full moon casted it's rays upon it. Nostalgia hits me as I remember seeing the same scene not long ago. In my head I told myself, "OMG! I'm as big as the moon!". My emo moment ended right there and I was saddened by the thought that I'm actually outside 10 at night jogging. MLIA.

I then forced myself to think of more serious thoughts and remembered that in a few hours I was going to turn 23 years old... Gawd, I'm this close to being an old man and die.

I then reminisced and thought to myself that my life hasn't been a total waste. It was exciting actually. Although the majority of my life was wasted in pursuit of academic excellence, I did have a taste of social life. Like I met friends, enemies, and people who at one time were special to me. I do not regret my decisions in the past as regretting will not not correct my mistakes or alter the consequences. I do on the other hand relive these mistakes in order for me to learn from them and at least become a better person. I am sorry though for the people I've hurt and offended in the past. No excuse or apology will atone for my crudeness and selfishness. Hopefully in the following years we can learn to forgive and forget and start afresh.

I thank the people who have stayed by my side despite my shortcomings and unpredictability. I hope our friendship and camaraderie will stand the test of time and all other obstacles on the way. To the people on Facebook who took a few moments of their time to greet me, I am honored and thankful. I appreciate it a lot and I am glad to hear from all of you again.

I am now 23 years old... I am a young adult. It's scary how time has passed so quickly. I now start a new chapter in my life. I am excited.

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Photo Credits to Thinaar's Blog

Muslim Are Our Neighbors

With the recent events such as the September 11 attack, many Muslims have become a centre of fear and hate. Many Muslims become victims of stigma; Stigma is defined as an occurrence of labeling, stereotyping, and discrimination. Stigma is usually caused by lack of education or knowledge about the Muslim culture.

This is why My Fellow American is such a wonderful website. It helps people realize that Muslims shouldn't be outed because their culture and religion is a bit different. My Fellow American showcases many stories from real people whose lives were touched by Muslims. Here is a video of how someone helped a Muslim family helped feel more at home in their neighborhood:

Just like with any other group of people, it is unfair to be making generalizations and assumption about someone based on stereotypes. Sure, relying on stereotypes to help us make sense of someone is easier but it's just wrong. Take this for example, you go to a school with a really bad reputation like having really low grade averages. Just because you come from that school doesn't mean you are stupid, because you might actually have a 4.0 GPA (or A).

I have several Muslim friends, and I can honestly vouch that they are very different from stereotypes.