521 week 7 replies

Due Date 08/20/2020

APA and references.

Discussion 1

Discuss the elements of informed consent and provide a clinical example about what can happen when some elements are not adhered to.

Informed consent is the granted permission of the patient in the acknowledgement of the possible consequences of the procedure/treatment sought.  Informed consent should include the rendering of treatment with full knowledge of the possible risks, benefits and also, the alternatives.

What are the 4 principles of informed consent as per the literature?

What is informed consent and what does it mean?

What are the three elements of informed consent?

Why is informed consent such an important aspect of the work we do?


Reply 1 Maria K

Informed consent refers to the permission granted by a patient to a medical practitioner in complete awareness and understanding of the possible risks and benefits of a treatment procedure. Informed consent is essential when more than one treatment option exists or when there is symbolic danger involved. The process has three elements. The patient has to be fully enlightened about the procedure. Secondly, the patient or the patient’s surrogate has to be in a state of mental stability to make a conscious decision (McEwen & Willis, 2017). Finally, the patient should be allowed to make a voluntary decision upon receiving a detailed explanation and understanding the nature of the treatment.


When a doctor proceeds with a procedure before getting approval from a patient, the act is considered malpractice, and the doctor is liable for consequences. A patient can sue the medical practitioner for malpractice or seek compensation in injuries during a medical procedure (McEwen & Willis, 2017). For nurses working with chronically ill patients, the working environment is critical in determining these workers’ ethical practices. The organization should have mechanisms and structures that enable the nurses to offer standard quality services. Family members and social networks should support the nurses in providing comprehensive care to the patients (Le Berrre et al., 2017).


Reply 2 Kristine

The essential elements of informed consent as per the FDA regulations are research statement, confidentiality, Compensation/ Treatment for injury, information of the participants, and voluntary participation of all individuals. The informed consent also includes a statement of the expected health outcomes through the trial such as benefits and foreseeable risks (Koonrungsesomboon, 2015).Among the above-mentioned elements, the review board pays close attention to the voluntariness of participants in the form of written consent. This element ensures that the participants are free to decline their participation or may discontinue their participation at any course of therapy without any penalty or loss of benefits. Also, failure to participate does not stop the medical treatment being provided to them. This is of importance whenever a research study is conducted by force, for an instance in a prison where the prisoners are vulnerable and under the influence of the authorities to participate.The confidentiality of data is often an issue. The participants are provided with the procedure that will be protecting their private information which can be identifiable. When the extent of confidentiality is not maintained in a clinical setting, a lack of privacy may lead to participant dropout from the research.

Discussion 2

Describe an organizational environment that would facilitate the ethical practice of nurses caring for chronically ill patients.  As you read about patient rights, describe one patient right that is often not fully implemented in the patient care environment. Identify specific strategies to help ensure that this right is supported within the patient care environment. Explain how the registered nurse can assist in protecting patient rights.

Reply 1 McKell

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An environment in which chronically ill patients would be ethically cared for by nurses would consist of nurses andphysicians, as well as upper management that truly at their core believe in patient autonomy and enforce it, and fight for it.They support and respect their patients and their wishes, as well as provide compassionate care to them. A right thatpatients have as identified by the American Medical Association (AMA) that is not always fully implemented is the right “tomake decisions about the care the physician recommends and to have those decisions respected” (AMA, 2016, p. 1). Thisright has to simply be given to patients. There should be no push back. More education to nurses, ancillary staff, andphysicians needs to be given to ensure this right is given. Many of the patient rights can easily be violated, as a nurse it isone’s duty to ensure they are not, to do so a nurse can read the patient rights and when feeling doubtful if a situation isokay or not they can refer back to the list.

Reply 2 Hannie

In chronically ill patients, it is very important to respect their right for “reasonable continuity of care, and to be informed by physicians and other caregivers of available and realistic patient care options, when hospital care is no longer appropriate” (American Hospital Association [AHA], 2017). They need to be informed of their prognosis at all times, and they should be provided with available resources that could help them achieve a lifestyle of dignity and freedom of pain.

Long-term care is meant to help provide chronically ill patients support. Many of these facilities do just that. After many years working in the ED, I will tell you; I have come across many patients who were never given the right to refuse care. Now how do you determine this? Often when elderly patients stop eating the healthcare system rushes to place feeding tubes. Additionally, many older are fed diets that are consistent with the medical problems they have but may not be the food they want to eat. Also, families influence the patient’s ability to refuse care. At times, these situations are extended due to lack of planning and having an advanced health care directive on file.

I have often wondered if patients who have feeding tubes are merely trying to tell their families they do not want to receive feedings any longer, or if the tube is just removed accidentally. I can only imagine how upsetting it could be to be confined, unable to speak and yet still kept alive without a way to express your wishes. Thankfully most of the time patients received the care that they request.  Nurses can help to protect patients, by ensuring there are POLSTs and advanced healthcare directives on file. Family involvement is key as well. Additionally, if something doesn’t seem right then it probably isn’t. Also, by thinking twice when a patient says they do not wish to receive a specific test or treatment make sure they are given the right to refuse. Often health care providers hope to help everyone as much as possible. With some patients, the best help might be allowing them to refuse and honoring that wish.