Assignment: Patient Preferences And Decision Making

Assignment: Patient Preferences And Decision Making

A profound situation that sticks out to me was when I was a surgical nurse. We had an oncology patient come in for tumor excision. Prior to the surgery I ran her urine POCT, and she was pregnant. She refused the surgery, understandably. The doctors discussed with her that chemo and radiation were her best option, however ultrasound had showed the baby was just into the second trimester. This was an impossible situation for me to imagine and still is. The mom decided to decline all treatments until after the baby was born. Just under a year later she was back, with the baby! We did the treatments as we originally planned, but the cancer had progressed and she did end up leaving on Hospice with CMO orders. Even so, she was absolutely at peace with this decision and thrilled that she had a healthy baby.

It is always important to consider patient preferences. The patient retains the right to choose. It is important that the patient can provide sound informed consent and agree to proceed with the procedure (Olejarczyk, 2022). The best way to approach situations like these is with shared decision making. Shared decision making includes establishing a trusting relationship with the patient; providing emotional support; assessing patients’ understanding of the situation; explaining the patient’s condition and prognosis; highlighting that there are options to choose from; explaining principles of surrogate decision-making; explaining treatment options; eliciting patient’s values, goals, and preferences; deliberating together; and making a decision (Kon et al., 2016).

There are decision aids for cancer. There are decision aids for each type of cancer. There are decision aids for pregnancy. Decision aids are a useful tool that help to easily organize the treatment options (McAlpine at al., 2018). It may be helpful to utilize decision aids in my future practice when patients need them. Ultimately, however this woman made her choice from love for her child, which no aid can help navigate.

 

References

Kon, A. A., Davidson, Judy, Morrison, W., M.D., Danis, M., M.D., & White, Douglas B,M.D., M.A.S. (2016). Shared decision-making in intensive care units: Executive summary of the american college of critical care medicine and american thoracic society policy statement. American Journal of Respiratory and Critical Care Medicine, 193(12), 1334-1336. Retrieved from https://www.proquest.com/scholarly-journals/shared-decision-making-intensive-care-units/docview/1797885427/se-2

McAlpine, K., Lewis, K. B., Trevena, L. J., & Stacey, D. (2018). What Is the Effectiveness of Patient Decision Aids for Cancer-Related Decisions? A Systematic Review Subanalysis. JCO clinical cancer informatics, 2, 1–13. https://doi.org/10.1200/CCI.17.00148

Olejarczyk, Jacob. (2022). Patient Rights And Ethics. https://www.ncbi.nlm.nih.gov/books/NBK538279/

Assignment: Patient Preferences And Decision Making

Changes in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex.

What has your experience been with patient involvement in treatment or healthcare decisions?

In this Discussion, you will share your experiences and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.

To Prepare:

• Review the Resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan.
• Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at https://decisionaid.ohri.ca/.
  • Choose “For Specific Conditions,” then Browse an alphabetical listing of decision aids by health topic.
• NOTE: To ensure compliance with HIPAA rules, please DO NOT use the patient’s real name or any information that might identify the patient or organization/practice.
•  Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life.
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