The director of nursing (DON) of a hospital is concerned about ...

[awywial]

The director of nursing (DON) of a hospital is concerned about communication problems among different professionals that seem to lead to patient care problems. What action by the DON would be most appropriate?
 
  a. Call a meeting of the managers from all the professional areas.
  b. Develop a task force to encourage better communication.
  c. Host informal sessions where professionals can clarify their roles.
  d. Institute formal communication channels between groups.

Question 2

A nurse admits a patient with end-stage cancer who is very obviously in pain yet refuses pain medication because of the desire to remain aware of family members who are present.
 
  The best example of the nurse acting under the ethical principle of beneficence is to
  a. assess the patient and pain thoroughly and discuss the patient's wishes.
  b. call the doctor and get orders for around-the-clock pain medication anyway.
  c. tell the patient and family that the patient has the right to refuse treatment.
  d. try convincing the patient that the family does not want her to be in pain.

[hanadaa]

Answer to Question 1

C
Lack of interprofessional understanding is cited as a significant impediment to communication. The DON can best approach this by hosting sessions in which different professional clarify their roles within the health care system. Calling a meeting of managers may or may not produce beneficial results. Developing better communication is vague. Formal communication channels are not likely to reduce the lack of intraprofessional understanding.

Answer to Question 2

A
The heart of ethical nursing practice is a therapeutic nursepatient relationship in which the nurse's actions are influenced by each patient's unique situation. To follow the principle of beneficence, the nurse needs to promote good understanding of the patient's wishes. After obtaining this information, the nurse can move on to a plan to manage the patient's pain that is acceptable to the patient (possibly nonpharmacological therapies). But without having this information first, the nurse cannot treat the patient's pain in a beneficent manner.
One option might be to call the doctor and get pain medication ordered so it will be available should the patient change her mind. But first, the nurse needs to understand the patient's wishes and desires in order to assist the physician in ordering the most appropriate medication. It is not beneficent to merely get pain medication ordered anyway.
The patient does have the right to refuse any treatment (if the patient is able to make reasoned judgments), but this corresponds to the principle of autonomy.
Trying to convince the patient to act in accordance with the wishes of others is not promoting beneficence.