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Related Concept Videos

Therapeutic Communication01:30

Therapeutic Communication

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Communication is a lifelong learning process. Through therapeutic communication, nurses can collect relevant assessment data, provide education and counseling, and interact during nursing interventions. Sending and receiving messages occur through verbal and nonverbal communication techniques and can happen separately or simultaneously.
Verbal communication depends on language or a prescribed way of using words so that people can share information effectively. The critical aspects of verbal...
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Techniques of Therapeutic Communication II: Focusing, Paraphrasing, and Summarizing01:23

Techniques of Therapeutic Communication II: Focusing, Paraphrasing, and Summarizing

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Focusing involves centering a conversation on a message's critical elements or concepts. Focusing is valuable if the talk is vague or patients begin to repeat themselves. Sometimes, when patients are asked about their symptoms, they may go off-topic and try to tell their entire life story. Respectfully, the nurse should bring the conversation back into focus.
This therapeutic technique can also be used when a patient brings up pertinent information during a health-related conversation. The...
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Ending Relationships01:28

Ending Relationships

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The dissolution of intimate relationships presents complex emotional and psychological challenges, particularly when emotional bonds are strong, the relationship is long-standing, and perceived alternatives are limited. This distress often intensifies in romantic breakups, where the initiator may experience greater turmoil than the rejected partner. Contributing factors include residual attachment, guilt over causing pain, and uncertainty about how to manage the situation. The stress is further...
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Leaving Groups02:14

Leaving Groups

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The nature of leaving groups strongly influences the outcome of a nucleophilic substitution reaction.
In general, in a nucleophilic substitution reaction, a nucleophile displaces a functional group, called the leaving group, from the substrate to give a substituted product. A leaving group departs the substrate molecule through heterolytic cleavage, taking the pair of electrons with it to become a relatively stable weak base in the form of an anion or a neutral molecule.  
In a...
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Contact-dependent Signaling01:19

Contact-dependent Signaling

48.3K
Contact-dependent signaling, as the name suggests, requires that communicating cells be in direct contact with each other. This is achieved either through receptor-ligand interactions or by specialized cytoplasmic channels that allow the flow of small molecules between cells. In animal cells, channels called gap junctions facilitate contact-dependent signaling in certain tissues, whereas, plasmodesmata perform a similar function in plants.
Gap Junctions
In animal cells, gap junctions are formed...
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Barriers to Effective Communication I01:30

Barriers to Effective Communication I

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A communication barrier is any distortion or interruption during a conversation, resulting in miscommunication of the message. A good communicator should know these barriers and continuously check for the listener's understanding by obtaining feedback.
Communication barriers include the following:
Physiological barriers: They are limitations caused by a person's health condition or disability, such as hearing loss, poor eyesight, illness, or unconsciousness. An example to overcome this...
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"I am not interested in talking with you.".

Adam Peña, Trevor Bibler

    The Hastings Center Report
    |July 16, 2016
    PubMed
    Summary

    A surrogate decision-maker refused ethics consultations for a patient with congestive heart failure exacerbation, raising questions about the surrogate's authority and the next steps for healthcare providers.

    Area of Science:

    • Medical Ethics
    • Clinical Decision-Making
    • Patient Rights

    Background:

    • An 85-year-old patient presented with multiple critical conditions including congestive heart failure exacerbation, pneumonia, altered mental status, and sepsis.
    • The patient was deemed to lack capacity, with his daughter, Celia, appointed as the surrogate decision-maker via medical power of attorney.

    Purpose of the Study:

    • To explore the ethical dilemma arising when a surrogate decision-maker refuses a clinical ethics consultation.
    • To determine the extent of a surrogate's authority in refusing consultations.
    • To identify appropriate next steps for healthcare providers in such complex situations.

    Main Methods:

    • Case study analysis of a clinical scenario involving a surrogate decision-maker's refusal of ethics consultation.

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  • Review of medical ethics principles and legal frameworks governing surrogate decision-making.
  • Exploration of the role and limitations of clinical ethicists in resolving healthcare conflicts.

    • Main Results:

    • The surrogate decision-maker, Celia, consistently refused to engage with the clinical ethicist.
    • The healthcare team perceived Celia's decisions regarding the patient's care, particularly insulin therapy, as potentially not in the patient's best interest.
    • The clinical ethicist was uncertain about the surrogate's right to refuse consultation and the subsequent course of action.

    Conclusions:

    • The case highlights a critical conflict between a surrogate's authority and the healthcare team's obligation to provide optimal patient care.
    • Further clarification is needed on whether a surrogate can unilaterally refuse a clinical ethics consultation.
    • The study underscores the importance of clear protocols for managing disagreements between surrogates and healthcare providers to ensure patient well-being.