Experience with a Revised Hospital Policy on Not Offering Cardiopulmonary Resuscitation

Courtwright, Andrew; Rubin, Edward L.; Erler, Kimberly; Bandini, Julia; Zwirner, Mary; Cremens, M. Cornelia; McCoy, Thomas H.; Robinson, Ellen M.

doi:10.1007/s10730-020-09429-1

Cited by 2 publications

(4 citation statements)

References 33 publications

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“…They disseminated their work through publication, influencing other organizations to evaluate their own policies related to code status. 60,66,67 Optimally, nurse ethicists would engage politically, embracing the social justice origins of the profession. 56 Scully 68 suggests a continuum of advocacy and activism for bioethicists, arguing that because bioethicists must make normative claims about certain acts or states being ethically preferable above others-a commitment to "how things should be"-this necessarily means "there cannot be a hard line between scholarly bioethics and being an advocate/activist" (p. 875).…”

Section: Health Policymentioning

confidence: 99%

“…An innovative policy at Massachusetts General Hospital provides an example of how nurse ethicists can continue to uniquely influence policy work. 60,66,67 Informed by experiences of bedside nurses caring for imminently dying patients for whom a full code order was still in place due to surrogate disagreement, the hospital nurse ethicist catalogued data to make the case for Do Not Resuscitate (DNR) order in such situations. In her role as ethics committee co-chair, Robinson and a physician counterpart introduced and guided a policy statement for a “Do No Harm” medical order (DNR) through multiple hospital committees including but not limited to the critical care committee, medical policy committee and office of general counsel to achieve final approval.…”

Section: Health Policymentioning

confidence: 99%

“…They disseminated their work through publication, influencing other organizations to evaluate their own policies related to code status. 60,66,67…”

Section: Health Policymentioning

confidence: 99%

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Operationalizing the role of the nurse ethicist: More than a job

Morley,

Robinson,

Wocial

2023

Nurs Ethics

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The idea of a role in nursing that includes expertise in ethics has been around for more than 30 years. Whether or not one subscribes to the idea that nursing ethics is separate and distinct from bioethics, nursing practice has much to contribute to the ethical practice of healthcare, and with the strong grounding in ethics and aspiration for social justice considerations in nursing, there is no wonder that the specific role of the nurse ethicist has emerged. Nurse ethicists, expert in nursing practice and the application of ethical theories and concepts, are well positioned to guide nurses through complex ethical challenges. However, there is limited discussion within the field regarding the specific job responsibilities that the nurse ethicist ought to have. The recent appearance of job postings with the title “nurse ethicist” suggest that some healthcare institutions have identified the value of a nurse in the practice of ethics and are actively recruiting. Discomfort about the possibility of others defining the role of the nurse ethicist inspired this paper (and special issue). If the nurse ethicist is to be seen as an integral part of addressing ethical dilemmas and ethical conflicts that arise in healthcare, then nurse ethicists ought to be at the forefront of defining this role. In this paper, we draw upon our own experiences as nurse ethicists in large academic healthcare systems to describe the essential elements that ought to be addressed in a job description for a nurse ethicist practicing in a clinical setting linked to academic programs. Drawing upon our experience and the literature, we describe how we perceive the nurse ethicist adds value to healthcare organizations and teams of professional ethicists.

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Section: Health Policymentioning

confidence: 99%

Section: Health Policymentioning

confidence: 99%

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Operationalizing the role of the nurse ethicist: More than a job

Morley,

Robinson,

Wocial

2023

Nurs Ethics

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“…One study found that a provider's personality characteristics such as self-directedness, cooperativeness, and self-transcendence, showed significant relationships with attitudes underlying endof-life decisions [178]. Another study found that physicians were more likely to place a DNR order without consent for imminently dying patients [179]. Nurses may have differing opinions on aspects of a DNR than physicians [180][181][182][183][184].…”

Section: Values What Is Each Team Member's Own Values Towards End-of-...mentioning

confidence: 99%

Managing a Suicidal or Gravely Disabled Patient on an Involuntary Psychiatric Hold and Who Has End-ofLife Orders: Key Factors to Consider in an Emergency Room Setting

Kalapatapu

2023

Curr Res Psychol Behav Sc

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Management of patients who have end-of-life orders may be complicated by the presence of an involuntary psychiatric hold for suicidality or grave disability. Decision-making factors that have been previously described include principles of medical ethics, laws and legal precedent, and examination of the motivations for end-of-life orders. However, management remains difficult, especially in time-limited settings such as the emergency room due to the wide-ranging existence of patient factors, individual ethics, and policies at governmental and hospital levels. We examined existing literature on the topic and created a structured conceptual model of key considerations for end-of-life issues during involuntary psychiatric holds in an emergency room setting, grouped into patient, involuntary psychiatric hold, system, and provider factors. These encompass the range of factors most likely to guide decision making on individual cases that emergency clinicians will face.

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Experience with a Revised Hospital Policy on Not Offering Cardiopulmonary Resuscitation

Cited by 2 publications

References 33 publications

Operationalizing the role of the nurse ethicist: More than a job

Operationalizing the role of the nurse ethicist: More than a job

Managing a Suicidal or Gravely Disabled Patient on an Involuntary Psychiatric Hold and Who Has End-ofLife Orders: Key Factors to Consider in an Emergency Room Setting

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