A Case Study on Leg Amputation for John

Introduction

Decision making in healthcare is being demonstrated in this paper. This decision making is regarding the amputation regarding John's legs. Two types of decision making are being demonstrated in this paper and those are ethical and the shared decision making. John is having several injuries in legs and is even unable to walk properly. He was suffering from diabetes and due to his poor condition of diabetes and to treat his legs, two options were provided. The first decision given was to improve the condition of diabetes by the help of a nurse and with the risk of sepsis, while the other option was to amputate the right leg's toe. Finally after a few discussions regarding the available options, the decision of amputation was selected by John.

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Background information and the Decision

Decision making is essential and can be said that it's highly necessary in the medical practices and healthcare policy. The healthcare decisions are vital as it will be affecting the patients till their last breath. Thus taking those decisions with the help of teams and also asking the patients for their approval is a required one for the decision making to be successful? A wide regional variation is available for the shared decisions to be taken between the patients and the providers. These decisions can be helpful in making certain solutions regarding the problems and for improving one's health and conditions of patients (Légaré, 2018). Decision making is a kind of care that is required to be provided instead of complex behaviors that occur. The errors in these decision makings can be leading to poor patient outcomes. It can be said that since past few years these decision makings have grown a lot in nursing and patients have seen a positive aspect regarding this one. From nineteen century until now great changes could be seen in this decision making in the nursing field. A conceptualized movement from the nineteenth century can be seen over here in this case easily. A practical model is being demonstrated for the decision making in the field of nursing in this case.

Decision-making in healthcare

Utilization of professional practice models are helpful for nurses in guiding the professional identity, encouragement in healthcare mission and an improved quality of patients life. These are a part of decision making so that proper decisions regarding the healthcare of patients can be taken and treated properly. The key factors such as uncontrollable, changeable, time limited and pressured environment can be easily managed here in the case of decision making of healthcares. A case of John who is aged 86 is suffering from diabetes and with foot problems. Earlier he had been through various surgeries and is not able to walk on his own. A scenario is raised in front of him, in which he has two choices, either to wait and get cured under the provisions of the nurse or rather attenuate his right leg's big toe so that he can get some relief (Dakin, 2018). John chose to amputate his legs and get relief. This decision was proceeded under the decisions and help of the team members and by the nurses also. Two decision makings are being seen in this paper and that is shared and the ethical decision making technique.

Literature view of healthcare decisions

According to Ankolekar, 2018, benefits and challenges regarding the patient's decision aids are being talked about by the author here. The shared and the patient’s decisions are highly vital in the participation of decision making procedures in nursing. Due to an increasing number of complexities the risk can be seen for the decision to be approved by the patients here. An easily understood method is being provided in this case so that benefit in the trade of for the patients can be overcome easily. Patients care and data of clinical reports are being presented so that limitations and challenges regarding the decision making can be evaluated easily. Many of the patients face lack of future seeing skills and thus they couldn't guess the proper decision that will be beneficial for their life and thus team members in healthcare are helpful for them to adopt the best decision for them. A shared decision is being discussed by the author that could be beneficial for the survival of patients. Patients' decisions are certain aids so that is required for the clear interaction in the clinical field to be proceeded properly for the patient's life. Patients' decision aids are being discussed and challenges regarding those decisions are also described by the author clearly.

By Antwi,2017, evolution of certain techniques regarding healthcare and decision makings are presented by the author clearly. A clear path to reduce the decision making headaches can be understood with the help of this author's decision. A crowd widoin technique is being discussed here so that an ethical decision making can be processed easily. Ethical and moral issues related to the decision making tool is also being discussed in this paper. The physicians and nurses readily acknowledge when encountering the patients that trigger legal and ethical issues in healthcare. These ethical and moral issues are only effective in raising the pervasive cases or the criminal cases that can be worth the decision making in healthcare. This is an ethical way in deciding the imperative way of healthcares and also for the policy makers so that they can understand the conflicts that arise due to legal and clinical judgments (Academia.edu, 2019)

According to Ruppert, S., 2017, a patient education is vital criteria before proceeding for any kind of decision making in the healthcare industry. Various experiences are available to describe the thoracic surgeries that can be providing an opportunity for the patients and their family so that they can undergo certain information raging the effect of those surgeries in future. The author is able to describe the multidisciplinary support and use the resources available for getting proper results. Ethical decision making is being processed by the author here. A life saving and withdrawal of life therapy is possible in this case by understanding the ethical decision making technique. Dignity and moral values regarding human life is being provided by the help of this decision making technique. In this decision making technique the involvement of nurses and the whole team members are required so that ethical decision making can be successfully initiated here in this case.

According to Hsu, 2016, a decision making process is being seen in the case of various tests and diagnostics that are applied to the patients. Cloud based systems are being defined here in this case for the management of diseases. This is an experimental case where 2 diabetic patients are being analyzed upon and the better decision making could be evaluated by the best decision among the two patients. Insulin is the first step provided and then the effective treatment is provided so that cure can be preceded easily in this scenario. Using new technologies have become a better option to understand the status of diabetic person by the help of these real time operated tools and technologies. Cognitive apprenticeship and leadership theories are available in the case for selecting the procedure regarding the treatment. An active participation in learning theory is also an effective one for the decision making in healthcare industries. Moreover tools and technologies are utilized in this case for the proper decision making procedure in healthcare environments.

Collaborative decision in clinical practice using 4p

A team or shared clinical practice can be useful for the proper decision making in healthcare. A similar scenario for collaborative decision making is generally seen in the various surgical cases. According to NMC code of conduct the prioritized patients are reflected in this case. A collaborative situation was seen when a diabetic patient suddenly had a heart attack. A sudden action was taken with the sudden decisions of physicians, nurses and team members. All the team members got involved in their work properly so that they could save the life of a patient (Power, 2017). Finally with certain therapy and with the collaborative work they were able to save patients' lives.

Decision making process

The decision making process in the case of John being selected is ethical and also helpful for him in this scenario. John was suffering from diabetes and his toe was also in great pain. In such a scenario there are only two decisions available for John and both 0of them can be seen to be ethical one to be chosen. The first option was to proceed and improve his condition under the supervision of nu8rse or to get surgery of his toes so that a proper relief could be gained for lifetime. Both these decisions are important as per the scenario and must be proceeded only under the recommendation of physicians (Slade, M., 2017). The first decision of choosing medication under nurse is not a sure case that relief could be gained and moreover the interval of time required is also not properly seen in this case. As there were none except his wife in the family so proceeding with the first option could be the wrong decision here. The second decision of surgery might be better because John may be get proper relief after that one. According to the decision of nurses and team collaboration they recommended surgery for John and thus proceeding with such a decision can be more helpful than the first one (Dbjournal.ro, 2020).

two models selected and preferred discussion

There are two decision models that are presented in the Johns treatment and those are shared decision and ethical decision making. In the shared decision making process the patients have full right to participate in the decisions that are being made for their healthcare. They are to be informed in every situation regarding their health. A shared idea by the nurses in setting goals, assessing risk and supporting is seen to be involved in this shared decision making. The other model described is ethical decision making. This decision making process describes the best options regarding the alternatives present in healthcare (Joseph-Williams, 2017). In case of harm or good the decisions required to be made by the nurses that the aptness could be saved or lead to a great life properly. There are five different levels of selecting the ethical decision making process. The both have a similarity that decisions can be accepted by the patient and can be beneficial for the patients. But still the difference occurs such as in shared one the patients or minority patients so agree to the physicians. The issue of money can also be occurring as a challenging part in shared decision making. But in case of ethical decision making the patients are made aware of the decision of nurses that are presented by them. Decisions of patients are respected by the nurses and collaborative help is provided to them. Thus ethical decision making is selected one in this scenario (Journals.lww, 2020).

ability of the team for patients survival

Leadership quality is highly recognizable for the collaborative team work to be proceeded proley. In the case of healthcare decision making the leadership quality is vital one so that proper and effective decisions could be made properly. In case of any emergency the leadership quality can only help in proceeding with proper steps and in a successful manner only. Due to leadership qualities circumstances can be built so that patients' goals and requirements can be met easily. The leadership quality is required in every aspect of life and including the decision making in nursing also. In the case of John the collaborative and teamwork can be easily seen (Lacourciere, 2019). The collaborative ideas and recommendation of nurses is helpful for John to make the right decision regarding his diabetes and for future life. The leadership plays an ethical role in making proper decisions that could save the life of patients in any harsh condition.

management issues for healthcare decision

In decision making the ethical issues also arise so that can be overcome by proper decision making in nursing. The decision making can be failure if the time is less and the decision is required to be taken within minutes. The other issues that can occur in decision making are conflicting views regarding the patient's healthcare. This disagreement in such cases can be harmful one for the patient as well as for the nursing team available. An improper treatment with poor prognosis and disharmony in the team can be seen that led to challenging for the decision to be made. A less education regarding the treatment can be insufficient for proceeding with the right decision at the right time in the scenario for the patient's health. Moreover, lack of technological usage in treatment can also become a conflicting point for the nurses to make proper decisions for treating the patients as seen as possible (Ginter, 2018). Thus management of these ethical issues are required to be followed properly so that decisions can be made and successfully processed in healthcare. The first thing required is to manage the team of nurses and work collaboratively in any condition so that patients can revive easily. The decisions are required to be made by help of proper leadership qualities so that no harm can be seen for the patients. In this case John is getting collaborative help from nurses so that he will get a better future in life (Healthaffairs.org, 2019).

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Conclusion

Thus it can be conscious that the decision making is an important task that is required to be process in the healthcare industry. The physicians, nurse and the team members are an important part of proper cure and patient healthcare. An ethical decision is highly required so that patients' lives could be saved or could be properly proceeding in future. Certain authors are also stated in this paper that is successful in describing the decision making techniques and its requirement for the patient's better future. Managerial and ethical issues are being described in this paper so that decision making can be preceded easily in the healthcares. A collaborative team work regarding saving the life of a patient is also described with a case in this paper. The participative part from the 4Ps is also defined in this paper so that the collaborative work regarding the decision making is understood properly in the case of nursing and healthcare.

Reference List

Books

Ginter, P.M., Duncan, W.J. and Swayne, L.E., 2018. The strategic management of health care organizations. John Wiley & Sons.

Journals

Lacourciere, A., Kumar, O. and Apold, S., 2019. Implementing an OR contact precautions decision algorithm to promote interprofessional teamwork for infection prevention. AORN journal, 109(5), pp.597-611.

Slade, M., 2017. Implementing shared decision making in routine mental health care. World psychiatry, 16(2), pp.146-153.

Ankolekar, A., Dekker, A., Fijten, R. and Berlanga, A., 2018. The benefits and challenges of using patient decision aids to support shared decision making in health care. JCO clinical cancer informatics, 2, pp.1-10.

Ruppert, S., 2017. NU02. 03 Ethical Decision Making. Journal of Thoracic Oncology, 12(1), pp.S199-S201.

Hsu, W.C., Lau, K.H.K., Huang, R., Ghiloni, S., Le, H., Gilroy, S., Abrahamson, M. and Moore, J., 2016. Utilization of a cloud-based diabetes management program for insulin initiation and titration enables collaborative decision making between healthcare providers and patients. Diabetes technology & therapeutics, 18(2), pp.59-67.

Légaré, F., Adekpedjou, R., Stacey, D., Turcotte, S., Kryworuchko, J., Graham, I.D., Lyddiatt, A., Politi, M.C., Thomson, R., Elwyn, G. and Donner‐Banzhoff, N., 2018. Interventions for increasing the use of shared decision making by healthcare professionals. Cochrane Database of Systematic Reviews, (7).

Dakin, H. and Gray, A., 2018. Decision Making for Healthcare Resource Allocation: Joint v. Separate Decisions on Interacting Interventions. Medical Decision Making, 38(4), pp.476-486.

Power, A. and Ridge, J., 2017. What does studying research methods have to do with practice? Views of student midwives and nurses. British Journal of Midwifery, 25(1), pp.59-61.

Joseph-Williams, N., Lloyd, A., Edwards, A., Stobbart, L., Tomson, D., Macphail, S., Dodd, C., Brain, K., Elwyn, G. and Thomson, R., 2017. Implementing shared decision making in the NHS: lessons from the MAGIC programme. Bmj, 357, p.j1744.

Online Article

Academia.edu, 2019, Evolution and Application of Crowd Wisdom Techniques in Healthcare Decision Making : An Overview of Ethical and Moral Implications Available at:

Journals.lww, 2020,Ethical decision making Available at:

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