Trinity University of AsiaCathedral Heights, Quezon CityGraduate School

Assessing the Ethical Decision Making of Staff nurse in End-of-Life Care: Towards Initial to Culture Change

This tool is designed to describe the self-assessment of the staff nurse in their ethical decision making skills in end of life care.

PART I: PROFILE VARIABLES

Direction: Kindly put a check mark on the blank before each item that applies to you.

1. Age_____________

2. Years in the current Unit_____________

3. Area of Assignment General Nursing Unit Special Nursing Unit Ancillary Nursing Unit

4. Numbers of Training in End-of-Life Care None 1-2 3-5 6 or more

5. Religion Roman Catholic Muslim Protestant Others Specify ______

6. Ethnicity Cebuano Ilocano Pangasinense Kapampangan Tagalog Bicolano Waray Zamboangeno Ilonggo Others Specify _____

7. Educational Attainment BSN Masters Degree Doctorate Level Others Specify ______

PART II: SURVEY PROPER

Direction: Please put a check mark () on the space provided that best describes your judgment on the frequency of ethical dilemma that you encountered based on the following scale:

Always7 or more timesOften5-6 timesModerate3-4 timesSometimes1-2 timesNone0

Frequency of Ethical Dilemma encountered by the staff nurse in the following dimensions:

I. Autonomy vs. VeracityALWAYS OFTEN MODERATE SOMETIMES NONE

Administering a placebo to a patient in pain.

Continuously managing the CPR even if the patient has no chance of surviving.

Not disclosing the doctor's poor prognosis to the patient as per the family's request.

Not divulging the information to the patient regarding the chemotherapy and its side effects as per the family's request

II. Beneficence vs. Non MaleficenceALWAYS OFTEN MODERATE SOMETIMES NONE

Following the family's request to stop all medication and nutritional therapy of the patient.

Following the family's request for the patient not to undergo necessary medical treatment.

Following the instruction of the patient's relative, who is in the medical field, to increase the narcotic dose of the patient.

Following the familys request against the minors wish to continue providing life sustaining measure even though the minor patient is experiencing chronic pain.

III. Veracity vs. Non MaleficenceALWAYS OFTEN MODERATE SOMETIMES NONE

Not disclosing the condition of an HIV/Aids positive patient to his family as per his request.

Not revealing the patient's deteriorating condition to his relatives as per his request.

Not informing the patient regarding a relatives death or ill condition as per the family's request.

IV. Autonomy vs. BeneficenceALWAYS OFTEN MODERATE SOMETIMES NONE

Conforming the lifesaving treatments to the patient's religious perspectives and cultural beliefs.

Continuing the patient's medical treatment despite his refusal but in accordance to the family's consent.

Following the patient's request not to be put in a mechanical ventilator even if the need arises.

V. Fidelity versus BeneficenceALWAYS OFTEN MODERATE SOMETIMES NONE

Informing the patient/relative that a treatment will soon be stopped as evidenced by an improving recovery parameters but due to a sudden deterioration of condition, the treatment needs to be continue.

Promising a pediatric patient that has difficulties taking medication that his or her condition will improve if he or she takes the medication.

Promising the patient that she/he will be discharged soon as prescribed by the physician but due to an abrupt decline in vital parameters , the discharge order is put on hold/cancelled.

PART III: survey proper

Direction: Please put a check mark () on the space provided that best describes your opinion on the identified factors that enabled you to assess your decision making skills based on the following scale:

5- Strongly Agree (Provision /Condition is present and facilitated (highly) in self-assessment)4- Agree (Provision /Condition is present and facilitated (moderately) in self-assessment)3- Neither agree nor disagree (Provision /Condition is present and facilitated (Fairly) in self-assessment)2- Disagree (Provision /Condition is present and facilitated (Poorly) in self-assessment)1- Strongly Disagree (Provision /Condition is present and (Never) facilitated in self-assessment)

A: Self-Assessment of the Nurse on their Ethical Decision Making Skills in End of Life Care.

I. Recognition of Ethical Dilemma54321

1. The nurse acknowledge that there is an issue that deserve nurses attention.

2. The nurse assess the values and beliefs of everyone involve.

3. The nurse identify the guidelines pertaining to end of life care.

4. The nurse consider how her behavior affect the situation.

II. Analyze the Ethical Dilemma54321

1.The nurse genuinely want to do the right thing.

2. The nurse want to determine the possible relationship between the types of ethical dilemma.

3. The nurse evaluate the level of moral intensity represent in the ethical dilemma encounter in end of life care.

III. Selection of Ethical Principle54321

1. The nurse determine what kind of ethical principle is best applied to the situation.

2. The nurse decide what is good for the patient.

3. The nurse focus ethical principle.

4. The nurse base the choices on widely accepted ethical guidelines.

IV. Decision Making54321

1. The nurse are concerned on how goals are reached

2. The nurse conclude the importance of each potential approach.

3. The nurse evaluate alternative course of action.