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 Cancer Center.
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.