Ethics at Catawba Valley Medical Center
For many years, nurses at every level at Catawba Valley Medical Center are committed to the pursuit of ethical treatment for all patients and the preservation of their rights through policies, procedures, and processes. By working collaboratively with other disciplines, the patients, and their families, nurses are strategically poised to act as the first-line of defense in protecting patients on every front.
The Ethics Advisory Council has evolved from the long standing ethics committee. The council now reports to the Patient Rights committee and is comprised of a multi-disciplinary membership team of professionals and community representatives that gather to consider ethical issues arising in the care of patients. The council is identifying new ways to bring ethics to the bedside.
Ethical consults can be requested by members of the medical team, registered nurses, patients, or their representatives as well as administrative personnel. Although the process of initiating an ethics consult has not changed significantly, the requests are delivered much more expediently. Consult requests are being considered virtually in real-time, allowing an almost instant response. Members of the council who are on site gather and perform a preliminary investigation involving the person/people who initiated the consult request. Depending on the complexity of the situation, this group may be able to make immediate recommendations. For situations where it is appropriate, the group sets in motion the process required to convene the full council.
Ethics Advisory Council Annual Report 2010
The Ethics Advisory Council has had a very productive year 2010. The Council has a new reporting structure through the Patient Rights Council chaired by Greg Billings, Administrator Psychiatry Services. Council meetings have been used as teaching opportunities with the following programs being presented:
- Ethics 101 – Mary Caldwell, Ethicist Mission Hospitals
- Capacity vs. Competence – Megan Lee, RN, JD, CPHRM, & Dr. Cathleen LaFave
- Healthcare Ethics for Psychologists: a Casebook – Dr. Cappelletty
The council had as one of its goals the ability to mobilize a team within 30 minutes of a consult being ordered. To accomplish this goal the council has set up a call list through CVMC’s reverse 911 system. Members of the council are immediately alerted through this process and call in with their availability to attend. This has facilitated a very prompt response to ethics consults which typically represent issues of immediacy.
Five ethics consults were convened in 2010 dealing with a variety of issues:
- Ventilated patient in a vegetative state that has no family, no POA or other documentation indicating his end-of-life wishes.
- Staff concerns related to a patient’s emotional reaction to being sent to a nursing home after a complicated stay postoperatively.
- Nurse being asked by MD to perform a diagnostic test that requires patient consent despite patient refusal.
- A psychiatric patient in the Emergency Department in the custody of the Police Department became very agitated and physically assaulted the police officer that had just arrived for his shift by striking him in the face several times.
- Staff nurses growing concern about a patient that has had multiple ED and inpatient stays. The staff felt uneasy about patient’s safety after discharge related to concerns about suspected abuse in the home.
Current membership of the Ethics Advisory Council includes:
Adina Andreu RN, Chair
Dr. Al Osbahr
Alayne Gaston CNM
Amy Squire RN
Anita Penland RN
Ann Brooks RN
Anne Walker RN
Brenda Howell RN
Cheryl Goossens RN
Eddie Beard RN
Erica Page RN
Dr. Gordon Cappelletty
Greg Billings RN
Pastor Jeff Brown
Chaplain John Robbins
Larry Johnson JD
Michael Funk Deckard PhD
Michelle Tomlin RN
Patty Tucker RN,
Rebecca Lenoir RN
Sabrina Williams RN
Sherry Hardee RN