Ethical Dilemma
Disruptive innovation changes existing trend or create new ones by promoting simple practices. According to Thompson (2016), advanced practiced nurses are regarded as disruptive innovators in healthcare settings. The increase in availability of primary care providers as nurse practitioners is also seen as disruptive innovation as it increases the access to the health care in the under-privileged communities. In the documentary, the nurse practitioner came across many challenges while taking care of homebound patients. The nurse acted as a disruptive innovator by providing care to the patients at their home by home visits.
According to the US Department of Health & Human Services (2005), the voluntary consent of the human subject is absolutely essential. It is also health care provider’s duty to get informed consent from patients. I would also help patients answer the questions they would have regarding their care so they can make informed decision. In the movie, for example, DNR order drew my attention. In our practice, we may come up with a situation as mentioned in the movie “The invisible patients”, where patients do not have or do not want to sign the DNR order. As a caring nurse, we do see that some of these patients have very low chances of survival even after resuscitations. Patients might have to go through the pain and suffering while maintaining resuscitation order. Sometimes we feel emotionally disturbed and we feel dilemma in this type of situation like the nurse felt in the documentary. In this type of situation, I would inform patients and their care givers about patients’ health status and condition so they can make informed decision. My role as a Nurse Practitioner would be to provide patients with enough information for them to make their own decision regarding their care. According to Hamrick et al. (2019), the ethical barriers felt by NPs in these types of situations are: not enough knowledge about ethics, lack of confidence in resolving, lack of communication skills, and powerlessness. Some other barriers are inter-professional barriers, patient-provider barriers, and organization and environmental barriers. (Hamrick et al., 2019). Identification of the ethical issues guide NPs to develop plans and strategies that can decrease the conflict.
Although the cost of changing these barriers can be very high and can require some time to make the change, according to Hamrick et al. (2019), NPs can navigate to low-cost health environment by demonstrating their distinct contribution to patient care. NPs can become patient advocates and healthcare leaders to promote social justice in the healthcare delivery system.
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