The state regulation that is under focus in this case study is the regulation number 1443.5 which deals with standards of competent performance for nurses (Board of Registered Nursing 2010, p.1). This regulation has a range of guidelines that show what a professionally competent nurse should do in a case such as the one under review. The issues made clear in this regulation include the position of the individual nurse in determining what is best for the client through the evaluation of both his or her mental and physical condition. The regulation also makes it clear that the nurse must take actions that are in the interests and wishes of the patient (Benjamin 1992, pp.16-19).
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The above code of ethics for the nurses forms the basis for all the actions that the nurse undertakes as a professional. For example in the case at hand, the nurse is required to do all that is geared towards the improvement of the health of Mr. This is supposed to be done with a careful diagnosis of the mental and physical condition of the patient; who in this case is Mr. All the positions taken by Mr. such as the refusal of a ventilator are supposed to be considered by the nurse as the advocate to the wellbeing of the patient. However, the nurse is also required to not only make an independent assessment of the patient’s health and come up with the appropriate decision regarding the best course of action but also listen to other health professionals such as thee concerned physician such as Dr. G. who in this case is of the opinion that Mr. is better off on a ventilator.
Besides the above, the case study in question provides a dilemma regarding the decision of putting Mr. on a ventilator. It is very clear that the patient himself is of the opinion that he should not be on a ventilator under any circumstances. Naturally, we are supposed to arrive at the conclusion that the wishes of the patient be met. But we are also informed that Mr. suffers from mild mental problems. This means that he is not in a position to make sound judgments regarding his health. The decision by the doctor to call on the other person who is closely connected to the patient so as to seek his opinion is sound. It is also important to point out that anything that is done for the betterment of the life of the patient is supposed to be supported and this is part and parcel of the nursing code of ethics as pointed out in the starting part of this essay. Therefore, putting Mr.E on a ventilator is an ethically sound decision.
On the ethical standing of the brother’s decision to authorize a ventilator, the position is that the brother has been asked to give an opinion on what is to be done regarding the position and this can be construed to mean that his opinion matters. As the person closest to the patient, he has the grounds for the decision and given that it favors the life of the patient, it is not ethically questionable.
Leaving the above aside, the regulations from the nursing board allow for autonomy of nurses to the extent that all that the nurses do is for the wellbeing of the patients who are under their care. Anything outside this is unacceptable. In the case under consideration, the nurse will be required to report the absence of a written permission for the action taken. This may sound improper but it is professionally needed. Reporting this is obligatory for the nurse given that issues arising from the action will have a background which is the ventilator and if it is not reported that a ventilator was instituted without a written permission, there may be professional problems.
Given the circumstances, the action taken to salvage the life of Mr. is understandable. But the nurse will be under obligation to follow all the professional rules while in the line of duty. The understanding of the mental condition of Mr. E is important as this means that life saving decisions can no longer emanate from the patient but have to come from other sources such as the nurse and other legally and professionally qualified persons.
Benjamin, M., 1992.Ethics ion Nursing. (3rd ed.).New York: Oxford University Press.
Board of Registered Nursing.26th June 20010.California Code of Regulations. Retrieved from Ca.Gov. Board of Registered Nursing. Web.