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· You must respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts and supporting your opinion with a reference. Response posts must be at least 150 words. Your response (reply) posts are worth 2 points (1 point per response). Your post will include a salutation, response (150 words), and a reference.

· Quotes “…” cannot be used at a higher learning level for your assignments, so sentences need to be paraphrased and referenced.

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· Acceptable references include scholarly journal articles or primary legal sources (statutes, court opinions), journal articles, and books published in the last five years—no websites or videos to be referenced without prior approval

Responses must be posted in APA format for Canvas to receive full grades. Automatic deduction of 10% if not completed 

· You must respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts and supporting your opinion with a reference. Response posts must be at least 150 words. Your response (reply) posts are worth 2 points (1 point per response). Your post will include a salutation, response (150 words), and a reference.

· Quotes “…” cannot be used at a higher learning level for your assignments, so sentences need to be paraphrased and referenced.

· Acceptable references include scholarly journal articles or primary legal sources (statutes, court opinions), journal articles, and books published in the last five years—no websites or videos to be referenced without prior approval

· Responses must be posted in APA format for Canvas to receive full grades. Automatic deduction of 10% if not completed.

Worldview & Decision-Making

Sejal Patel

St. Thomas University

NUR 421: Nursing Practice in Multicultural Society

Professor Kathleen Price

November 02, 2021

Worldview & Decision-Making

The sudden neurological injury that is not likely to recover puts the person in denial if the person is somewhat conscious. It is hard to accept for even family that sudden change in care given stage. Those patients have physical problems like paralysis of facial muscles or losing sensation in the face, altered sense of smell or taste, loss of vision, swallowing difficulties, dizziness, ringing in the ear, and hearing loss. They also have altered consciousness, intellectual problems, cognitive problems, Executive functioning problems, communication problems, behavioral changes, emotional changes, sensory problems, and degenerative issues.

The majority of persons who have suffered substantial brain damage will need rehabilitation. They may have to relearn basic abilities like walking and to talk. The objective is to increase their ability to carry out everyday tasks. Rehabilitation includes a group of people who master different specialties to help patients maintain living activity. An occupational therapist, who supports the person learning, relearn or improving skills to perform everyday activities—a physical therapist who helps with mobility and relearning movement patterns, balance, and walking. The social worker or case manager facilitates access to service agencies, assists with care decisions and planning, and facilitates communication among various professionals, care providers, and family members. A rehabilitation nurse assists with discharge planning from a hospital or rehabilitation center by providing continuous rehabilitation care and services. Speech and language therapist supports the person to improve communication skills and use assistive communication devices if necessary. A recreational therapist helps the patient with Time management and leisure activities. We can also use music therapy and aroma therapy to relax patients who face incurable health conditions.

Advance directives are an essential part of health care. No one can predict when unanticipated medical complications may occur. In a medical emergency, an Advance Directive can assist loved ones and medical professionals in making critical decisions. If you have an advance directive in place, it implies that your health care wishes will be followed out even if you are unable to express them. The health care proxy form is where you can appoint a health care agent or someone close to you to make health decisions for you when you cannot make them yourself. Another great form to have is the living will; this form explains your health wishes about end-of-life care, such as palliative care. This form states what patients want, and it makes it easier on your loved ones; this way, they do not have to make daunting decisions. A Surrogate is a person close to a family member who makes decisions on your behalf if you cannot do it yourself and have not appointed anyone. Palliative care is an essential part of end-of-life care. This includes lowering suffering for people who are undergoing treatment for incurable diseases. It also entails providing support to family members who bear the pain of witnessing a loved one go through such traumatic events. Physicians can’t forecast patients’ treatment choices, but they can learn about their preferences for surrogate decision-makers from the pre-made advance directive.

References

Kass-Bartelmes, B. L., & Hughes, R. (2004). Advance care planning: preferences for care at the end of life. Journal of pain & palliative care pharmacotherapy, 18(1), 87-109.

Fischer, G. S., Tulsky, J. A., Rose, M. R., Siminoff, L. A., & Arnold, R. M. (1998). Patient knowledge and physician predictions of treatment preferences after discussion of advance directives. Journal of general internal medicine, 13(7), 447-454.

Worldview and Decision-Making

Finance Joseph

St. Thomas University

NUR-421-AP3

Professor Kathleen Price

November 04, 2021

Worldview and Decision-Making

Physicians have a social commitment to sustain life and relieve suffering from patients. However, patients have a big role to play when it comes to deciding on life-sustaining treatment. Sometimes the performance of one duty may conflict with the other, and in that case, the patient’s preferences need to prevail (Kuosmanen, 2021). The principle of patient autonomy expects physicians to respect the patient’s decision to forgo life-sustaining treatment. Individually, I understand this principle, and I know that I have a big role in making the big decision as to why I need to undertake or forgo life-sustaining treatment in the event I develop a medical condition that requires one.

Considering that sometimes a patient receiving life-sustaining treatment could be incompetent and lack the capacity to the capacity to make any decision regarding their condition, the family becomes the surrogate decision-maker. Hence, I believe that it is critical to discuss with close family members about life-sustaining treatment in advance to prepare them to make the right decision in case one develops the condition in the future. An advance directive to close family members is vital and mostly includes aspects such as a patient’s values about life, including how life should be lived, and a patient’s beliefs and values about suffering, sickness, death, and medical procedures. Discussing with close family about my preference regarding the named elements in advance is the first step of preparing them to make the right decision that will suit my beliefs and values, in case I develop a condition that has no cure but can be managed by life-sustaining treatments.

Traumatic Brain Injury is one of the neurological conditions that are managed through life-sustaining treatments. According to Ng & Lee (2019), Traumatic Brain Injury occurs when there is a disruption in the brain’s normal function, which could be caused by a bump, blow, or the head suddenly hitting an object. Any individual can develop traumatic brain injury at any point in their lives, and it is a life-changing situation for most survivors. The treatment for traumatic brain injury includes life-sustaining treatments on most occasions, especially if the patient becomes paralyzed. A brain can be damaged in many ways, and a damaged brain cannot be healed; however, the patent can be given medical treatments that help to prevent further damage and reduce the functional loss from the damage.

Brain injuries often result in disabilities, which are most likely to persist for the rest of a patient’s life, especially if a patient suffers from severe Traumatic Brain Injury (Williamson, Ryser, & Ubel, 2020). These disabilities are usually managed by life-sustaining treatments such as physical therapies. In the most severe cases of traumatic brain injury, patients are left with life-altering events, in which the physicians may need to guide families through the challenging decisions regarding the appropriate decisions or when to discontinue interventions in favor of the patient’s quality of life. Preparing close families on these matters may help them to fulfill my wishes in scenarios where I develop a condition like TBI, which could hinder me to make any decisions regarding my situation.

References

Kuosmanen, L. (2021). Patient participation in shared decision-making in palliative care-an integrative review. https://doi.org/10.1111/jocn.15866

Ng, S. N., & Lee, Y. W. (2019). Traumatic Brain Injuries: Pathophysiology and Potential Therapeutic Targets. https://dx.doi.org/10.3389/fncel.2019.00528

Williamson, T., Ryser, M. D., & Ubel, P. A. (2020). Withdrawal of Life-supporting Treatment in Severe Traumatic Brain Injury. https://doi.org/10.1001/jamasurg.2020.1790

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