Jaclyn Strangie March 20, 2014

NURS 627


Decisional-Analysis Paper

Last semester, during a med-surge rotation, there was a specific patient that forced
me to make a decision that immediately comes to mind when faced with this task.
On this clinical day, I was eager to learn about this individual and how I could use
my skills to best care for him / her. I started the day by hearing a report on the case, along
with the nurse that I was going to be working with that day as well as with my clinical
instructor, regarding this patient. After hearing the report on this patient, XX, I decided to
take a walk by his room and peak in on him. While doing this, I noticed that there were
two police officers sitting in the room beside the patients bed, both officers waved to me
as I walked by.
I thought to myself, what is this all about? I began to wonder why they were there.
I had asked my clinical instructor what the situation was and if it was okay to still care for
this older gentleman. My instructor advised me not to go into this room alone, but that I
was safe to care for him with his assigned nurse and with the police detail in place.
However, this wasnt enough information for me. I needed to get some additional
background details on this man. After asking around and speaking with several nurses, I
found out that this patient has been a prisoner for many years. He committed a crime
against humanity a long time ago, and is still incarcerated and that is the reason why there
had to be several police officers stationed in his room all hours of the day.
I knew in general terms what the crime he was involved in meant and having the
benefit of hearing more specifically what he had done, it prompted me to wonder and ask
myself, should this impact my obligation as a nursing student? Would I be comfortable
caring for this man? Would it feel right?
At that moment I wanted to give up caring for this patient before I had even started.
There was a lot going through my mind. At first this knowledge made me scared and
afraid. It seemed impossible to care for this man knowing what I knew, but I knew I
needed to disregard all the stories about this patient. When self - reflecting in trying to
make a decision, I realized that I was immediately judging this patient from the minute I
walked by his room that morning. I was judging him by the way he looked and the fact
that there were police officers by his side. Unfortunately, I didnt realize I was doing so
initially. It didnt dawn on me how selfish I was being until I took a deep breath and
thought long and hard about this case. I was being selfish in the sense that I cared more
about this patients history, and myself, than I did his current health and the necessary
care he deserved.
It wasnt until moments later when I began to think like a nurse again and fulfill
my duty. As stated in the code of ethics, nurses must make the care of people their first
concern, treating them as individuals and respecting their dignity (Sutcliffe, H. 2011).
Being a nursing student, a nursing assistant, and a future RN, I know the responsibility of
nurses and what we are here for. It doesnt matter the background of this patient, his race,
his religion, his beliefs, etc. He is still a patient and an individual, just like any other, who
deserves the proper care and rights that any other patient deserves.
After self-reflecting and thinking about the quality of this patients outcome, I
made a critical decision and chose to care for this client. I began to view him as a
normal patient, with no criminal background. Despite who he may have been, I knew he
deserved the care and it was my job to make sure he got the care he needed.
It was now 0900, time for XXs pills. I entered XXs room accompanied by my
clinical instructor and his assigned nurse for that shift. He was very lethargic and drowsy
during this time. I introduced myself as Jacki, a nursing student and explained what we
were going to be doing at the time. He had a big abdominal incision, which required a
new dressing and packing. Before doing this I administered Dilaudid so he wouldnt feel
the pain. He was able to verbalize his level of pain and any concerns that he had during
this time.
When looking around the room at my instructor, she continuously gave me a head
nod with a smile, to reassure me that I was okay, and that I was doing a good job
providing efficient care. The more time I spent in XXs room, the more comfortable I
felt. It was awkward, at first, having the police officers watching over me, but the longer I
was in there, the more I forgot they were even there. I felt proud and a sense of
accomplishment as I completed his morning care and administered the appropriate
scheduled medications.
After this encounter I was able to express my thoughts to my instructor. I realized
how important it was for me in that situation to be especially cautious of my non-verbal
communication. In the ANA code of ethics provision 1, it states that the nurse, in all
professional relationships, practices with compassion and respect for the inherent dignity,
worth and uniqueness of every individual, unrestricted by considerations of social or
economic status, personal attributes or the nature of health problems (ANA, 2001, p.7).
Knowing this, it shows how important it is for nurses and members of the health care
team to be aware of how they communicating with patients, no matter whom they are as
an individual.
It was imperative that I made eye contact at all times, made sure I was facing him
and was always listening to what he had to say. My instructor was proud that I was able
to make what I thought was the right decision regarding this case and that the outcome
was what it should have been. I was able to provide appropriate patient-centered care for
XX, as if I never knew he had a criminal background.
If this situation arose again, I feel confident that I wouldnt hesitate to care for a
patient with a criminal background. Im fortunate to have experienced a situation such as
this one, as an undergraduate nursing student and feel as though I would be prepared to
encounter a similar situation in the future. I have learned and am aware that nobody is
perfect. As nurses, we must view each patient as their own individual and provide care in
their best interest, no matter the circumstances. In the future, I will continue to put my
own judgments aside and be aware of my non-verbal actions, when caring for any
individual.
At the end of the day, Im glad I made the decision that I made. It was a learning
experience and something that I will never forget. Its a situation that I can forever look
back on whenever I may feel how I initially felt when learning about XXs case. As
nurses, we face many challenging situations, some we wish we never encountered.
However, its our job to provide evidence-based practice in order to care for our patients
in the best way possible. With that being said, I am relieved I conquered this situation and
was able to make the best decision as a nurse, in the best interest of the patient.

References
American Nurses Association (ANA). (2001). Code of ethics for nurses with
interpretative statements. Siiver Spring, MD: Author.

Sutcliffe, H. (2011). Understanding the NMC code of conduct: a student
perspective. Nursing Standard, 25(52), 35-39.