What can the nurse contribute to the decision making process?

Monteverde, Settimio (2015). What can the nurse contribute to the decision making process? Oncology Research and Treatment, 38(suppl), pp. 33-34. 10.1159/000439070

As in other domains of medical and nursing practice, also in oncology the goal of collaborative decision making is the patient's health and wellbeing. This is achieved by means of the integration of patient preferences, available scientific evidence and a sensitivity for the relationship between burden and benefit. Patients are encouraged and requested to exercise their right to self-determination and give their consent to the oncological treatment that best fits their values as well as the medical condition. Nevertheless, evidence shows that the threat of the disease and the uncertainties and risks inherent to the medical treatment render the patient and the family particularly vulnerable. Patients and families have multiple needs of information, counseling, assistance and encouragement in making meaningful treatment decisions. These needs are best met when each of the professions involved in the delivery of oncological care plays an active role within the process of shared decision making. Therefore, interprofessional collaboration between doctors and nurses not only covers medical treatment, monitoring and reporting, but also decision making. Due to their continuous presence and proximity to the patients and families, nurses play a crucial role in helping patients to make meaningful decisions. This task is germane to the sphere of co-responsibility shared by doctors and of nurses (see for example Swiss Health Insurance Law (KVG, KLV Art. 7). However, communication research within oncology suggests that the perception of patients, doctors and nurses with regard to the quality of communicative interaction, the understanding of the information delivered, the empathic response and the weighting of risks and benefits of a proposed treatment differs significantly. Similarly, doctors and nurses have different perceptions of the degree to which the other profession is involved in decision making processes. Of particular importance are those decisions that involve the redirection of care towards palliation and quality of life when suffering increases and no benefit is seen for the patient in continuing a curative approach. In redirecting care towards palliation and advance care planning, careful communication, clarification of patient values and readiness for interprofessional negotiation are indispensable. Here, clinical ethics tools like case deliberations, ethics consultations or family conferences are important means to identify meaningful goals of care.

Item Type:	Conference or Workshop Item (Speech)
Division/Institute:	School of Health Professions School of Health Professions > G Teaching
Name:	Monteverde, Settimio0000-0002-7041-2663
Subjects:	B Philosophy. Psychology. Religion > BJ Ethics R Medicine > RT Nursing
ISSN:	2296-5270
Language:	German
Submitter:	Settimio Monteverde
Date Deposited:	06 Aug 2020 07:41
Last Modified:	18 Dec 2020 13:30
Publisher DOI:	10.1159/000439070
URI:	https://arbor.bfh.ch/id/eprint/12152