I live in Los Angeles, California, so this is where I obtained my Advances Health Care Directive. The latter may be identified as “a legal document that states a person’s wishes about receiving medical care if that person is no longer able to make medical decisions because of a serious illness or injury” (National Cancer Institute, n.d., para. 1). In California, its compliance with the law is achieved if the following conditions are implemented.
In the case one’s capacity to act independently is lost, the Directive safeguards their right to refuse unwanted medical care or to request preferred treatment. Depending on one’s advance planning needs, one can accomplish any or all of the first four parts of the form; however, part five must be completed. The first part is a Health Care Power of Attorney. This section allows one to appoint somebody (an agent) to handle healthcare choices on their behalf (National Resource Center, n.d.) Unless otherwise specified in an advance directive, a healthcare power of attorney comes into effect when the main physician finds that one lacks the capability to grasp the character and implications of their healthcare decisions, as well as the capacity to make and express such decisions.
Individual Instructions are included in the second part of the form. It is the living will of one’s state. This provides one with the opportunity to express desires in terms of healthcare in case they are unable to communicate. Then, it allows one to restrict the particular instructions to only enter into force if a certain circumstance occurs. The third part gives one the possibility to declare their desire for organ donation. The fourth part allows one to appoint a primary care doctor to be in charge of their healthcare. The signing and witnessing provisions are included in the fifth part to ensure that the document is valid. It should be noted that this form contains no mention of mental illness (National Resource Center, n.d.). If one wants to create advance care arrangements for mental illness, one can talk to their doctor and an attorney about creating an advance directive that is suited to new requirements.
It should be admitted that while completing the Directive, I had no substantial difficulties during the process, given that the form is simple and clear. However, there were some issues related rather to my socio-emotional background. It was not completely comfortable for me to complete this form because it was necessary to think about the end of life – this problem has been identified by the scholarly dimension as well (Cogo et al., 2016). Then, I had to think a lot about who would be my agent, as many potential persons could possibly lack experience or education in this vein. Such an issue has also been explored by scholars (Cogo et al., 2016). Nevertheless, the Directive seems an essential document that will inevitably be needed in the future.
POLST (Portable Medical Orders) is known by several names in various states. POLST is the term given to it within the national scope. Similar to a medication prescription, portable signifies that the order is enforceable outside a hospital or physician’s office. POLST stands for a variety of things, such as the following. First, it is a procedure – a component of advanced care planning which enables one to live the best life. Second, it is a conversation – a thorough discussion with a healthcare practitioner about one’s medical condition, treatment choices, and goals. Third, it may be considered a travel-friendly medical order form.
Then, it should be stressed that it is entirely optional to complete a POLST. However, one should not submit the form until they have had a thorough discussion with their physician or another qualified medical practitioner. They can clarify the medical words and alternatives, as well as how they apply to one’s present medical state. The important point is that POLST is not appropriate for everyone. People with chronic health issues, as well as those who are considerably ill or medically weak, should fill out the POLST form (UCLA Health, n.d.). POLST is most effective for those who prefer less harsh medical therapy. The POLST can only be completed by a patient’s physician. The POLST form is only legitimate if a person (or their authorized decisionmaker) and their physician or another healthcare professional both sign it.
A POLST form is not an advance directive and should not be used in place of one. When utilized properly, advance directives and POLST forms are both useful in improving healthcare planning papers for conveying patient intentions. An advance directive can be viewed as a document in which one names a person or people to make medical choices for them and provides direction for making such decisions, usually in end-of-life scenarios (UCLA Health, n.d.). An advance directive cannot be considered as a medical order; it is rather a request from the patient. A POLST form, in contrast, is a set of medical instructions that apply to a small group of patients and address a tiny percentage of crucial medical choices. The form is meant to be used in conjunction with advance directives as a translational instrument and guarantee of care continuity.
The final point that should be mentioned is the importance of an RN’s role in assuring the patient’s right to autonomy in choosing the healthcare interventions the patient does or does not want. RNs, as authorized healthcare providers, can sign the POLST form with a patient. Moreover, they can be the ones with who patients can discuss the necessity of POLST in general or its particular provisions. This is a crucial step in deciding whether POLST is needed.
References
Caring Info. (2021).California advance directive.
Cogo, S. B., Lunardi, V. L., Quintana, A. M., Girardon-Perlini, N. M. O., & Silveira, R., S. (2016). Challenges to implementation of advance directives of will in hospital practice. Revista Brasileira Enfermagem, 69(6), 969–976.
National Cancer Institute. (n.d.). Advance directive.
National Resource Center on Psychiatric Advance Directives. (n.d.). California codes: Probate code (sections 4600 – 4643).
UCLA Health. (n.d.). What is POLST?