chapter 2 contemporary canadian challenges in nursing ethics.docx

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University of Toronto Scarborough
Biological Sciences
Danillo Viana

Chapter: 2: Contemporary Canadian Challenges in Nursing Ethics 1 - Nurses face increasingly complex health problems on the parts of patients, families, and communities; and they must do their work in climate of continuing cost constraints measures The lived Experiences of Nurses Today - Susan’s Story o I am becoming the person I never wanted to be o Feeling quite distraught—for giving six-year old boy w/ cancer who kept crying!!! Sedative [to shut him up] - Jacque’s Story o The waiting room is full—see Mrs. Le Blanc who fractured her hip after and her son o This could be my parent. Can I keep working under these conditions? - Sandeep’s Story o MS pt—needs more help with ADL, parents cant afford agencies that can provide additional hours—pts second options to live in a long-term care facility, that can provide her the care she needs—pt and family refuse this options o I feel powerless - What were the problems in creating a quality practice environments? - What were the constraints that did not allow Susan, Jacques and Sandeep to do what they thought was ethically correct? Some Historical Background - Susan, Jacques, and Sandeep—and their patients and their patient’s family members are dealing with ethical issues at the individual (micro) level 1. History of Funding Changes o The Canada Health Act articulates the principles underlying Canadian health care, including matters of public administration, comprehensiveness, accessibility, universality and portability o In response to the proliferation of biotechnology, the aging of the population, increase in chronic illness and other challenges, proviniclal and territorial gov’t ways of reducing their health care spending  FG=reduce transfer payments of health care and other servicesreduce deficits  Cutting back on their health care budgets in several wayus o Shortened the list of services covered by the publicity funded health care system  Refugees and foreign students were not eligible for health care provided by the publicly funded system Chapter: 2: Contemporary Canadian Challenges in Nursing Ethics 2 2. Impact on Patient/family/Community Care and Nursing Practice o Patients who are forced to navigate a system that is complex and unfriendly mystery in order to find the right specialist, the nearest facility and the best treatment o The goals of community care are laudable:  Promoting health  Maintaining independent and fostering quality of life o Underfunding of community care had undermined those goals o The vulnerable –people such as those with mental illness or people in aboriginal communities are particularly at risk Health Care Reform Response - Health care reform is a general rubric used for discussing major health policy creation or changes—for the most part, governmental policy that affects health care delivery in a given place. - Patient and consumer groups and nursing professional organizations lobbied gov’ts and informed the public that standards of care were being undermined - The challenges for the Canadian health care system became a question of whether to reform the publicly funded system or introduce major changes that would involve a greater role for private health care - Three important reports examined the problems of the health services sector in depth and suggested different ways of responding to the problem o 1. A Framework for Reform: Report of the Premier’s Advisory Council on Health (2001)  The report called for delisting medical services, initiating user fees, setting higher health care insurance premiums and fostering a greater contribution from private health care o 2. Health of Canadians: The Federal Role (2002)  The key recommendation included guarantee of care in a timely manner, a cap on individual’s pharmaceutical bills, a post-acute care home-care programs funded fifty-fifty by the federal and provincial governments and the establishment of an independent health care commissioner to monitor reforms and changes in payment plans for physicians o 3. Romanow Report (2002)  This third study had been initiated by Prime Minster Jean Chretien, who recommended that the Privy Council establish a commission with the mandate to recommend ways of maintaining the long-term availability of a universally accessible, publicly funded health systems providing high quality care Chapter: 2: Contemporary Canadian Cha
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