Ch 4 Winslow Nursing

1,814 views
1,523 views

Published on

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
1,814
On SlideShare
0
From Embeds
0
Number of Embeds
5
Actions
Shares
0
Downloads
14
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide
  • Examples: Disease = enemy
  • Advocacy may be equated with the desire for more authority/money
  • Ch 4 Winslow Nursing

    1. 1. “ From Loyalty to Advocacy: A New Metaphor for Nursing” G. Winslow <ul><li>Two prominent models of ideal nursing practice </li></ul><ul><li>Military Model </li></ul><ul><li>Legal Model (Advocacy Model) </li></ul>
    2. 2. Military Metaphor <ul><li>Dates back to the 1850’s and the Crimean War </li></ul><ul><li>Florence Nightengale was the main proponent of strict military discipline in nursing. </li></ul><ul><li>The military metaphor advocated by Florence Nightengale still exists in medicine generally. </li></ul>
    3. 3. Military Aspects of Nursing <ul><li>Discipline </li></ul><ul><li>Acceptance of the hardships of service </li></ul><ul><li>Suitable respect for those of higher rank* </li></ul><ul><ul><li>Ideal of military obedience to physicians </li></ul></ul><ul><ul><li>Loyalty to physicians (commanding officers) </li></ul></ul><ul><ul><li>Nurse as the “handmaiden” of the physician </li></ul></ul>
    4. 4. Conflicting Duties – Loyalty and the Military Metaphor <ul><li>Incompetent physician – to tell or not to tell? </li></ul><ul><li>Deceptive physician (keeping a patient’s condition from them) – what is the nurse’s duty to the patient? </li></ul><ul><li>“ Private duty nurse” – self-protection/self-preservation </li></ul>
    5. 5. Loyalty Examined <ul><li>Refusal to criticize nursing school </li></ul><ul><li>Refusal to criticize fellow nurses </li></ul><ul><li>Refusal to criticize the physician under which one works </li></ul>
    6. 6. Dealing with the Problems of the Military Metaphor <ul><li>Faithfully obey order of physician </li></ul><ul><li>Gently question the doctor’s orders </li></ul><ul><li>Consult another authority (nurse supervisor) </li></ul><ul><li>Withdraw from the case </li></ul>
    7. 7. The Legal Metaphor (Advocacy Model) <ul><li>Nurse as the protector of patient’s rights </li></ul><ul><li>Right to adequate information about their condition </li></ul><ul><li>Right to information about treatment options </li></ul><ul><li>Right to accept or refuse treatment </li></ul>
    8. 8. Arguments for the Nurse-as-Advocate <ul><li>Nurses have the most contact with the patient </li></ul><ul><li>Nurses tend to be concerned with the whole patient </li></ul><ul><li>Nurses have traditionally educated patients </li></ul><ul><li>Both have suffered neglect in the health care system </li></ul>
    9. 9. Advocacy Model and the Nursing Codes of Ethics: <ul><li>International Council of Nurses (1973) </li></ul><ul><li>American Nurse’s Association (1976) </li></ul><ul><li>Nurse’s primary responsibility is shifted away from the physician to the patient. </li></ul>
    10. 10. Problems with the advocacy model <ul><li>Meaning of advocacy requires clarification </li></ul><ul><li>Laws have not kept up with the models of nursing Tuma case. </li></ul><ul><li>Patients/families are often unprepared to view nurses as advocates. </li></ul>
    11. 11. Problems with the Advocacy Model (cont.) <ul><li>Advocacy is frequently associated with discord </li></ul><ul><ul><li>Are nurses properly prepared to be advocates? </li></ul></ul><ul><ul><li>Does advocacy misconstrue the nature of the doctor-nurse-patient relationship. (Team Model vs. Advocacy Model) </li></ul></ul><ul><li>Push by nurses for adoption of the advocacy model may appear self-interested . </li></ul><ul><li>Conflicting loyalties – patients come and go; doctor’s and nurses stay. </li></ul>

    ×