The end-of-life concept identified in this movie was assistance with end-of-life decision-making. The nurse in this movie Wit was the first one to initiate the discussion with the patient about her options if something were to happen during her treatment if her heart stopped beating (Bosanquet & Nichols, 2001). The patient did become aware that her treatment plan would not cure her, but because of her uncertainty about the treatment she had not come to the realization that she had options in the event of her death (Bosanquet et al. 2001). Potter, Perry, Hall, and Stockert (2017) discussed that some patients may not know their options when it comes to end-of-life care and members of the healthcare team should be available to discuss these issues with the patient and their families to help alleviate any uncertainties that they may have. Even though the patient in the movie did request a do not resuscitate order (DNR), her ethical rights were still violated when the physician decided to act against them (Bosanquet et al. 2001). This not only violated her rights, but she was not able to maintain dignity in her death.
The therapeutic technique used in this movie was sharing humor. The patient had developed a relationship with the nurse and was able to laugh at a joke that reminded her of her childhood when she learned that literature would be her passion in life (Bosanquet et al. 2001). The nurse could have become defensive and aggregated by the joke but instead, she embraced it and was able to help the patient laugh for the time since she had been hospitalized (Bosanquet et al. 2001). According to Potter et al. (2017), humor can be used between a nurse and a patient to build a trusting relationship and help the patient relax in a stressful situation. However, nurses should be cautious when they use humor and make sure they are aware that many cultures may not share the same humor, and be cautious not to offend the patient or the family (Potter et al. 2017). The nontherapeutic technique identified was automatic responses. The doctors mostly replied in this manner with minimal to no acknowledgment of the patient (Bosanquet et al. 2001). When the patient expressed any concern about her mental status or pain she was only reassured that the treatment was working the way it should and that she would be able to handle it (Bosanquet et al. 2001). Potter et al.(2017) explain that when these types of techniques are being used with a patient they begin to feel that they are not being treated like a human and that their needs are not being understood.
The ethical issue discussed in this movie was autonomy. After the patient was admitted to the hospital she was not involved in many of the decisions that were being made on her behalf and in many cases did not understand the procedures or what they were talking about (Bosanquet et al. 2001). She knew what she was supposed to be doing but had little clarification as to why they were being done. She recognized after being admitted to the hospital that she should have asked more questions before signing the consent form, but her provider should have explained in detail her treatment and all the possible side effects that could happen (Bosanquet et al. 2001). Every procedure that the patient went through should have also been explained and should have been included in the decision-making process, not by the providers alone (Potter et al. 2017). Potter et al.(2017) explain that providers should have respect for the patient and be included in making decisions in their treatment, even though the patient signed a consent form they are responsible for making sure the patient completely understands what they are signing before starting any treatment or procedure.
The legal issue discussed was standards of care. The standards of care for this patient in the movie were not being held up by the members of the healthcare team, they could even be classified as negligence or malpractice (Bosanquet et al. 2001). When the patient arrived at the hospital she was only given the minimal amount of information needed to sign the consent form and was not fully informed of the information about the treatment or the side effects (Bosanquet et al. 2001). The members of the healthcare team did not respect her privacy and undermined her dignity as a person (Bosanquet et al. 2001). She would often have to look up medical definitions because she did not understand what they were talking about when she was being evaluated (Bosanquet et al. 2001). After she began to experience intense pain she was only given enough drugs to reduce her pain because they still wanted to use her for research purposes (Bosanquet et al. 2001). The nurse should have recognized the need to consult with her supervisors and discuss the inhumane actions being taken against the patient (Bosanquet et al. 2001). Potter et al. (2017) discuss the implications of a nurse not taking the appropriate actions and being held accountable for not seeking out the appropriate measures to ensure a patient’s safety.
Watson’s caritive factor that was discussed in the movie was the development of a helping-trusting, human-caring relationship. The nurse demonstrated this behavior by connecting to the patient and taking the time to build a trusting relationship (Bosanquet et al. 2001). She realized that the patient did not have any visitors, no one there to look after her, and no one to talk to her about her illness (Bosanquet et al. 2001). After seeing how she was being ignored by the other members of the team she took the time to sit and talk with her about the treatment and talk to her like a person instead of a patient (Bosanquet et al. 2001). Potter et al. (2017) explain that Watson’s caring theory is to treat the patient as a whole and to be able to connect with the patient to promote a healing environment.
This movie has made me realize that I need to be more self-conscious about how the patient is feeling and how my actions can affect the way they feel. Being able to hear a patient’s point of view during their time in the hospital made me realize the impact that nurses can have on someone, especially when others treat them more like a patient than an actual person. I also realized that not everyone who works in a healthcare setting may take the time to help a patient who may be depressed or lonely and just need someone to talk to about their illness. I will also advocate for my patient and make sure that if I feel like someone is not being treated with the standard of care they deserve that I need to speak up because I may be the only one who does.
References
Bosanquet, S. (Producer), & Nichols, M. (Director). (2001). Wit [ Motion Picture]. United States: HBO Video.
Potter, P. A., Perry, A. G., Hall, A., & Stockert, P. A. (2017). Fundamentals of nursing. St. Louis, MO: Mosby Elsevier.