HOUSTONCancer patients receiving aggressive treatment often
face difficult decisions. Nurses will often help patients and their families
through thembut the nurses may need support themselves, says a nurse who
co-authored a study looking at nurse utilization of hospital ethics rounds.
The study was presented during a poster session of the Oncology Nursing
Society’s 26th Annual Congress in San Diego.
Whereas the physician on medical rounds examines the patient and then
leaves to go on to the next patient, "the nurse is the person who
spends the majority of time at the patient’s bedside," said Joyce
Neumann, RN, MS, AOCN, a clinical nurse specialist and bone marrow
transplantation (BMT) clinical coordinator, Hematology Center, M.D. Anderson
Consequently, she said, "nurses often have privileged information
that the patient gives themtheir fears and concernsand it’s really
up to the nurse to make sure that these concerns are communicated to the
health care team."
Ms. Neumann, with Rebecca Pentz, PhD, and Anne Flamm, JD, surveyed nurses
at her institution who had taken part in ethics rounds. The program was
started 2 years ago in the BMT unit to enhance nurses’ knowledge of
ethical principles, provide a forum for discussion, and encourage nurse
participation in clinical decision-making.
Nearly all (99%) of the nurses who attended the ethics rounds reported
that the experience helped them in their practice; 92% reported that they
had a better understanding of ethical principles; 80% said that they had a
better understanding of advance directives; and 88% reported feeling better
prepared to speak with physicians about ethical issues.
In the survey, the most frequently cited reason nurses gave for not
asking for an ethical consult was fear of conflict with the medical team.