Topic 5 dq 2 peers responses

Peer #1

Stacey Ludlow

Patient advocacy is the most important aspect of our duty as professional nurses. Patients often present in a condition in which they are unable to advocate for themselves, and it is the nurse’s role to fulfill this need. The Institute of Medicine outlined six factors that influence patient outcomes: safety, effectiveness, patient centered, timely, efficient and equitable (Hilbet, 2018). By consistently incorporating these tenets and utilizing evidence-based care practices, nurses continually improve care.

We must always address our patients’ needs according to their individual and unique needs, taking into account culture, environment, and spiritual diversity. Because we are often faced with broadly diverse views, nurses can find themselves morally and ethically conflicted when addressing individual patient needs (Luca et al., 2021). According to a 2021 study, nurses were found to feel the need to advocate more assertively for patients who were particularly vulnerable. These patients were those who were especially weak or frail, whose families were failing to include the patient in medical decisions, patients who were unable to express their wishes, and also they felt the need to advocate as a team with other disciplines (Luca et al., 2021). While we should certainly maintain sensitivity in practice and advocate for all our patients, we have must always hold ourselves accountable to those who cannot advocate for themselves.

My advocacy story is about a personal experience. Several years ago, my father had a massive stroke that left him with left hemiplegia and cognitive changes. He eventually regained his speech, and was able to live at home with his significant other, but he had several complications which eventually led to the decision to place him on hospice care two years after his stroke. His S.O. was very caring, but had no prior healthcare experience. My sister and I lived in different states and were comfortable with his S.O. making medical decisions, and she and his doctor eventually made the decision to stop tube feedings, and other invasive interventions. I went to see him during this time, and his S.O. was attentive, and concerned about his pain level. She crushed a lortab, mixed it in water and pushed it with a syringe into his mouth. Violent coughing ensued. I gently told her that he should not be taking oral meds, that he was aspirating and it was essentially tortuous. I checked his PEG tube for placement, and it seemed fine, so I contacted the hospice nurse for clarification. She told me that because we had decided to discontinue fluids and nutrition, that the med should be given that way, that even if he didn’t actually swallow the meds, they would be absorbed buccally. When I asked about the use of the PEG tube because he was violently coughing, she told me that if we used it and gave him fluids, we would be “prolonging the inevita