Patients Refusal Over Recommended Treatments Case Study

Patients Refusal Over Recommended Treatments Case Study

The ethical and legal principles of healthcare provide patients with the right to refuse medications and other types of treatment (Varkey, 2021). This case of Mr. B refusing to restart his medication after a new diagnosis creates a conflict between the ethical principles of autonomy and beneficence. Therefore, as a health care professional, I must ethically ensure that the patient adheres to their treatment plan. At the same time, I must also ensure that I protect myself and the organization against any liability and claims related to the case of Mr. B. Additionally, in most care settings, although care options are discussed with the patient, care providers tend to overlook the role and preferences of the patient, citing their capacity to make care decisions (Driever et al., 2020).

To responsibly and ethically deal will Mr. B’s refusal to restart his blood pressure medication, the nurse should first seek to understand and address his concerns. Since Mr. B’s concerns arise from his experiences of a recent fall, the nurse should engage him in discussing the new treatment and why he needs to start on the new medication, including the benefits he will gain from taking the new medications. The nurse should also discuss with him the risks that are associated with the new medication he needs to restart. Overall, the nurse should seek to develop a good relationship with the patient. Good nurse-patient relationships create an equal distribution of power and support patient anonymity during care decisions based on professionally provided health advice (Molina-Mula & Gallo-Estrada, 2020). The nurse should then log the details of the incident and report it to their supervisor before administering the new medications to Mr. B.

Some types of medications increase the risk of falls. The health care team would have prevented Mr. B’s fall by collaborating closely with the patient throughout the medication process and educating the patient on the side effects of the medication and the proper use of the medication.

References

Driever, E. M., Stiggelbout, A. M., & Brand, P. L. (2020). Shared decision making: physicians’ preferred role, usual role, and their perception of its key components. Patient education and counseling, 103(1), 77-82. https://doi.org/10.1016/j.pec.2019.08.004

Molina-Mula, J., & Gallo-Estrada, J. (2020). Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making. International journal of environmental research and public health, 17(3), 835. https://doi.org/10.3390/ijerph17030835

Varkey, B. (2021). Principles of Clinical Ethics and Their Application to Practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119

ORDER A PLAGIARISM-FREE PAPER HERE

We’ll write everything from scratch

Module 06 Discussion – What Would You Do?
Discussion Topic

Activity Time:
2 hours; Additional Time for Study, Research, and Reflection: 1 hour

Directions:
Consider the scenario below, then follow the instructions underneath it to complete the discussion. If appropriate, support your position with credible resources/examples/evidence and provide APA references.

Patients Refusal Over Recommended Treatments Case Study

Mr. B
Mr. B, a 70-year-old male client, presented to his primary care physician with complaints of blurred vision and headaches over the last two months. On several visits, Mr. B’s blood pressure was found to be elevated, so the physician started him on hydrochlorothiazide 25 mg by mouth daily. One month later, Mr. B began to have chest pains and shortness of breath, so his primary care provider referred Mr. B to a cardiologist for further evaluation.

The cardiologist ordered an echocardiogram and stress test which revealed heart enlargement and a reduced ejection fraction (volume of blood pumped out of the heart per minute). As a result, the cardiologist started Mr. B on a beta-blocker (metoprolol 25 mg by mouth daily).

A few days after taking the new medication (in addition to the hydrochlorothiazide ordered by the primary physician), Mr. B suffered a fall at home. Upon arrival at the emergency room, Mr. B’s blood pressure was 80/50. The emergency room physician suspected the cause of Mr. B’s fall was hypotension secondary to the medications he was taking. The ER physician recommended that Mr. B follow up with his primary care physician and cardiologist, but hold the medication until seen by them.

As recommended, Mr. B visits his primary care physician for a follow-up. During the visit, Mr. B’s blood pressure is found to be elevated (160/90), so his physician tells Mr. B to restart taking his blood pressure medication.

Imagine that you are the nurse attending to Mr. B and that he indicates that he’s afraid to restart the medication because of his recent fall.

What considerations/actions should the nurse make regarding the client’s refusal to restart his blood pressure medication?
What considerations/actions would have helped the healthcare team to prevent the client’s fall?

Review the posts made by your classmates and reply to someone expanding on their idea or offering an alternative for consideration.

Please make your initial post by midweek, and respond to at least one other student’s post by the end of the week. Please check the Course Calendar for specific due dates.