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NRS 433 Topic 1 Discussion Question Two

NRS 433 Topic 1 Discussion Question Two

Topic 1 DQ 2

Nursing research is used to study a dilemma or a problem in nursing. Examine a problem you have seen in nursing. Provide an overview of the problem and discuss how addressing the problem through nursing research can improve patient outcomes. Provide rationale and support for your answer.

Replies to Krishna Turner

Dilemma is often an issue that appears in nursing. Nurses are place in a sometime difficult and uncompromising position. From giving advice to a patient about their health or decision regarding care. (Dilemmas in nursing, 2022) Example: a patient refused having an x-ray done at bedside due to chronic pain. Patient has several decubitus and because the film will need to be placed underneath the patient back it will cause more pain and pressure to the patient. As a nurse we must explain the reason and benefit of having the x-ray done. Patients have a right to refuse treatment or any procedures. Although the patient refuses the x-ray the patient knew that continuing treatment was important regardless of having the diagnostic test. Patient did understand the importance of the test but is also aware that for the providers to further treat the disease or disorder a diagnostic test need to be done.

To address the issues or dilemmas that the patients maybe experiencing is not to have any judgement but to understand their concern. This can be done be letting the patient know that they are being heard. As nurses we need to help figure out an alternative method of helping the patient with their fear and pain to eventually move forward with getting an x-ray done. The patient has lack of control of most treatments done in the hospitals, the question to ask is what can be done to gain more control in the hospital. It will help the patient achieve a better outcome if you negotiate and express what you and the patient both cares about. (Robert A., 2015)





20 common examples of ethical dilemmas in nursing + how to deal with them. 20 Most-Common Examples of Ethical Dilemmas in Nursing. (n.d.). Retrieved July 29, 2022, from https://www.nursingprocess.org/ethical-dilemma-in-nursing-examples.html


What to Do When a Patient Refuses Treatment Robert Arnold MD Download PDF. (2015). What to do when a patient refuses treatment. Palliative Care Network of Wisconsin. Retrieved July 30, 2022, from https://www.mypcnow.org/fast-fact/what-to-do-when-a-patient-refuses-treatment/

Can you identify a specific dilemma you have seen or experienced in your facility or career?

I have experience families having to make a tough decision for their loves ones during a code. The decision was to have the patient continue to be intubated and not being their old self again, or making the decision to take them off life support. Imagine having a 29year old daughter who was pregnant and had 4 other kids, and while in labor she had a seizure. This then warrant for them to take the patient into the OR to have emergency c-section. During the procedure the patient had multiple seizures, was losing a lot of blood and coded on the table 4 times. After the patient received several units of RBC, plasma, and platelet 4 hours later became stable enough to be transferred to the ICU. Once on the unit she coded 3 more times and the mother was present. The last time the patient coded the doctor went and talk to the mother to make a difficult decision. The mother wanted us to continue to work on the patient, although she was asystole. By this time we were in the 6 hour of working on her and the doctor had to call the time of death. It’s hard to make certain calls when the patient does not do advance directives. “Nurses must advocate for the autonomy and rights of patients.” (20 common examples of ethical dilemmas in nursing + how to deal with them) End of life decisions are hard not only for the families but those that have to bring it to the families attention.


20 common examples of ethical dilemmas in nursing + how to deal with them. 20 Most-Common Examples of Ethical Dilemmas in Nursing. (n.d.). Retrieved July 29, 2022, from https://www.nursingprocess.org/ethical-dilemma-in-nursing-examples.html


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Ethical dilemma’s are very common in health care. The ethical dilemma in your post sounds horribly sad because of the age of the young mama and that she had just birthed her 5th child. The ethical dilemma’s commonly seen in the adult ICU in my area are mostly related to elderly patients who are put through painful lifesaving procedures (intubation, CPR, continuous dialysis, etc.) because their families do not know what their wishes are and they do not want to be the one to make the fateful decision. It poses and ethical dilemma for the nurse, then, who is responsible for carrying out each of the physician’s orders and is putting the elderly patient through all of these treatments that they may not have wanted. I have found that due to those sad situations, I ask the difficult questions like “would you like us to do compressions on you if your heart stops? Or, “Would you like a breathing tube if you fail to breath successfully on your own?” If they answer that they would not like any artificial, lifesaving measures, I alert the physician and have them second that important conversation and write the proper orders before anything happens. Arizona has a packet called “Life Care Planning Packet” that includes information about all of the important documents for the patient and their family to fill out (Attorney General AZ, n.d.).


Attorney General AZ (n.d.). Life care planning packet.https://www.azag.gov/sites/default/files/docs/seniors/life-care/2018/Life-Care-Planning-Packet-Complete.pdf

Good post. Evidence-based care refers to the practice of factoring in patients’ specific preferences, as well as the findings of relevant research and clinical studies, when making decisions on their medical treatment. The majority of medical professionals work hard to provide care that is not just effective but also compassionate and suited to the requirements of their patients. Therefore, it is encouraging when there is solid study evidence that tells us what works and what does not work, as well as with whom and where it works best. Evidence from the fields of science and economics, as well as the findings produced by collaborative efforts such as the Cochrane Collaboration, should be utilized to the fullest extent possible (Larsen, et al., 2019). On the other hand, nurses and people who use health care services have a clear need for more evidence, which arises from questions that cannot be stated in scientific or economic terms.


Larsen, C. M., Terkelsen, A. S., Carlsen, A. M. F., & Kristensen, H. K. (2019). Methods for teaching evidence-based practice: a scoping review. BMC Medical Education19(1), 1-33.

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