HERE to HELP! - L`Hôpital d`Ottawa

VOL. 13 NO. 1 |WINTER 2011
KUDOs
I would like to recognize not only
my own coworkers in the PACU
at the General Campus, but also
all of the nursing staff involved
in the launch and success of the
SIMS program.
brought to you by
HERE to HELP!
The
IS Training & Complex Support (TACS) team is Here to Help.
Since its implementation in 1996, OACIS has become increasingly more complex. In addition to clinical
results, we now have scanned documents, electronic discharge summaries (eDS), MS Word and voice
integration documents, and emergency department patient tracking summaries (EDTS).
Over the next few years, OACIS will become even more complex with the implementation of several corporate
initiatives, such as computerized provider order entry (CPOE), positive patient identification involving the
use of bar codes or RFID technology, closed-loop medication management for ordering, administering,
documentation, medication reconciliation, vital signs documentation, clinical device integration, and many
more.
With each initiative, there is the potential to impact 10,000 clinicians. There are also ongoing training
requirements for new hires, transfers, and with each system upgrade.
The TACS team was established earlier this year to augment the training & ongoing support available to
stakeholders.
TACS Objectives
To achieve short- and long-term transformational goals, including change management, training and support
for all stakeholders impacted by the electronic health record.
In February 2010, the General
Campus PACU and SDCU staff
went live with the launch of
electronic documentation or
charting, also known as SIMS
which stands for the Surgical
Information Management
System.
Additionally, over the past year
all of the perioperative nursing
units at The Ottawa Hospital,
including the PAU, SDCU and
PACUs went live and have made
a smooth transition into the
electronic world.
We should all be proud of the
great teamwork and dedication
of all team members, which has
contributed to this success...
from the development phase
through to the implementation of
the SIMS program in our units.
Respectfully submitted,
Sue Ellen McClure R.N.
(SIMS seconded user) PACU
General Campus
TACS tactics: short-term goals
•
•
•
•
•
•
Weekly Library drop-in sessions: 11 a.m. to 1 p.m.
Civic Campus: Wednesdays and Thursdays
General Campus: Tuesdays and Wednesdays
Rounding on the at all campuses to promote the use of OACIS, offer tips & tricks, address any identified
issues with devices including PCs, monitors, printers, etc.
Develop self-directed computer-based training programs to increase OACIS training and OACIS online
help.
Develop an improved toolkit for clinical educators to use in training new hires and transfers.
Provide demonstrations to units and departments about OACIS as requested. To request a
demonstration, e-mail us at [email protected].
Improve support processes. We have a dedicated full-time team member to provide weekday support for
OACIS functional issues, that have been referred to us from the HelpDesk. Off-hours support provided
by a rotating team.
TACS tactics: Long-term goals
•
Work with the IS project teams to develop efficient and effective training and support for future initiatives.
Help us help you!
Take advantage of the TACS team rounding to have your questions answered and learn more about OACIS
and its advanced navigation features.
NPP Admin Team • Teams to be proud of • Hand Hygiene
TOH Flow Symposium • How does my mouse work? • Get the info on InfoNet
Nursing News
Edited and Coordinated by the
Nursing Communication Work
Group
The Nursing News is a quarterly
corporate newsletter written by
nurses for nurses at The Ottawa
Hospital to:
• inform nurses of new programs
and processes, upcoming
events, and new trends in
Nursing in regards to patient
care, education and research
• recognize individual nurses or
groups of nurses for specific
accomplishments including
quality improvement initiatives,
research projects, educational
achievements, publications
as well as presentations
at internal and external
conferences
• promote camaraderie amongst
nurses throughout The Ottawa
Hospital
• provide a venue for feedback on
issues as appropriate.
For information
contact
Co-Chairs
Barb Kyd-Strickland, ext. 73431
Sue Eggleton, ext. 71546
Nursing News Editor
Sue Eggleton, ext. 71546
Members
Cathy Adamson
Jennifer Mascarinas
Iman Mousa
Gillian Reid-McDonald
adriana villa-coady
Thank you to
ChrisSIE DeCurtis,
Communications
Layout & Design
graphics, tOH Printing Services
Printing
TOH Printing Services
Distribution
TOH Volunteer Services
2
NURSING NEWS VOL. 13 NO. 1
From the desk of the
Senior Vice-President, Professional Practice,
and Chief Nursing Executive
concept received the Minister of Health
of Ontario Award of Excellence. TOH has
been identified as an RNAO Best Practice
Spotlight Organization. These examples
are only a few of the amazing
contributions you, our nurses, are
Ginette L. Rodger
Senior Vice-President,
making to patient care, TOH, and
Professional Practice,
and Chief Nursing Executive
the nursing profession.
The theme of this edition of
Nursing News, Looking to the future
while recognizing our past, allows our
colleagues from the Communication
Workgroup to reminisce and get excited
about what is next.
Already 10 years has passed since I joined
TOH nursing team. I have never stayed in
one position this long before. It is due to
all of you!
After the merger of TOH, improvement
of the nursing professional practice
environment presented many challenges.
We have worked as a team of dedicated,
committed nurses to modify our
environment. There is still work to do.
Last year, we decreased our vacancy rate
from 13% to 2.9%, decreased our turnover
from 10 to 12% to 5.7%, and saw a 14%
increase in satisfaction of nurses with
their professional practice environment!
There is a lot to recognize in our past. You
have created some important innovations
such as clinical pathways, medical
directives, and TOH Model of Nursing
Clinical Practice (MoNCP). The MoNCP
is now being implemented by 11 partners
in four provinces, and is recognized by
the Canadian Council on Health Services
Accreditation as a national leading
practice. Last year, the Clinical Expert
Today we have a vibrant nursing
community at TOH. Dedicated,
knowledgeable nurses in all domains of
practice and over 30 workgroups and
reflective groups work every day to help
“Today we have
a vibrant nursing
community at
TOH. Dedicated,
knowledgeable
nurses in all domains
of practice.”
us face challenges such as workload,
staffing and continuing education.
Every year these groups are pursuing
approximately 110 objectives!
The future is bright because of your
leadership in all of your domains. I would
like to take this opportunity to commend
all the teams for making the experience at
TOH better for both nurses and patients.
Professionally yours,
Dr. Ginette Lemire Rodger, RN
Senior Vice-President,
Professional Practice, and
Chief Nursing Executive
If you could meet with our Senior
Vice-President Professional
Practice and Chief Nursing
Executive, Dr. Ginette Rodger,
and ask her anything, what
would you like to ask her?
What
are your hopes/dreams for the future of nursing at TOH?
When I joined TOH nursing team 10 years ago I asked groups of nurses in all domains
of practice what was their expectation of the Chief Nursing Executive The message was
load and clear: “help us develop a vision of nursing at TOH, and get us there.”
We then embarked on a journey to determine what would be an excellent nursing
professional practice environment in an academic hospital. We identified 36 different
elements that should be in place, including communication, organization of delivery of
care, standard of practice, educational support, research to name a few. Ten years later in
2010 we have completed that list. We now have a solid foundation and are ready to build.
After consulting with over 500 nurses, we have selected our goals for the next three to
five years:
1 to become a top 10% performer in North America in nursing quality and safety
2 to ensure the integrity of TOH Model of Nursing Clinical Practice as the base for all our
partners in Canada. This will be TOH nurses’ legacy: the first model created by nurses
and patients in Canada
3 to implement a proactive, modern educational strategy
4 to foster an environment where nursing research flourishes
5 to be the best in Canada in recruitment and retention of nurses
6 to develop a national centre for nursing expertise in specialty areas
Nursing
Work Groups
and Contacts
Model of Nursing Clinical Practice
Work Group
Ginette Rodger – [email protected]
Communication Work Group
Barb Kyd-Strickland – ext. 73431
Sue Eggleton – ext. 71546
Nursing Quality AND Best Practices
Chantal Backman – ext. 71366
Marlene Ghattas – ext. 16979
Nursing Informatics Reflective
Group
Peggy Guilbeault – ext. 78651
Kathy Momtahan – ext. 16035
Nursing Research
Kathy Momtahan – ext. 16035
Viola Plomeno
– [email protected]
Policy, Procedure and Protocol
Susan Madden – ext. 72690
Nursing Professional Practice
Committee
Ginette Rodger, Senior VP
and Chief Nursing Executive –
[email protected]
Nursing Week
Ginette Rodger – [email protected]
Frances Smith (ONA)
ONA / NPP
Ginette Rodger – [email protected]
Frances Smith – 731-1314 ext. 260
Corporate Nursing Clinical
Practice Committee
Evelyn Kerr – ext. 16060
Joanne Abma
Recruitment, Retention, Recognition
Cheryl-Anne Smith – ext. 17894
Robyn Devey – ext. 19897
Education
Nancy Frazer – ext. 16097
Joanne Gauthier – ext. 75641
Management Work Group
Kerry Cook – ext. 82311
Jennifer Smylie – ext. 74305
Advanced Practice Nurses
Laura Wilding – ext. 17086
Kirsti Weekes – ext. 79304
Clinical Pathways
Barb D’Entremont – ext. 71898
IS/IT Nursing Advisory
Julie Latrielle – ext. 78405
Pam Bush – ext. 78719
Nursing Clinical Documentation
Heather Sherrard – ext. 14826
Evelyn Kerr – ext. 16060
Nursing Knowledge Translation
Pam Tkach – ext. 16897
Margaret Quirie – ext. 16910
Do you enjoy the Nursing News?
Want to get involved in its creation?
Join our team!
Contact us: Sue Eggleton ext. 71546
Barb Kyd-Strickland
Internationally Educated Nurses
Workgroup
Riek van den Berg – ext. 78439
Debbie Kaye – ext. 16349
ext. 73431
NURSING NEWS VOL. 13 NO. 1
3
Nursing Professional
Practice Department
(NPPD)
2 Main Offices:
General Campus, Rm 1351
613-737-8899 – ext. 78760
Civic Campus, 1st floor
Paterson building
613-798-5555 – ext. 14976
Senior VP, Professional Practice,
AND Chief Nursing Executive
Dr. Ginette Rodger – ext. 78749
Executive Secretary
Karen Johnston – ext. 78749
Director, Nursing Clinical Practice
Evelyn Kerr – ext. 16060
Administrative Information Assistant
Lellina Palanza – ext. 14976
Corporate Coordinators
Clinical Pathways
Barbara d’Entremont – ext. 71898
Nursing Education
Riek van den Berg – ext. 78439
Nursing Enhancement
Robin Devey – ext. 19897
Nursing Quality AnD Best Practices
Chantal Backman – ext. 71366
Nursing Research and Associate
Clinical Investigator
Kathryn Momtahan, RN, PhD – ext. 16035
Nursing Recruitment, Retention AND
Recognition
Cheryl-Anne Smith – ext. 17894
Corporate Associate
Coordinators
Nursing Clinical Practice
Vacant – ext. 19970
Nursing Education
Nancy Frazer – ext. 16097
Nursing Quality AND Best Practices
Marlene Ghattas – ext. 16979
Learning Resources Consultant,
Centres for Nursing Excellence
Pam Tkach – ext. 16897 or 73204 or 82409
Informatics Administrative Assistant
Louise Klaassen – 613-737-8899, ext. 78760
Clerk Training Officer
Sue Eggleton – ext. 71546
Manager, TOH Models of Nursing and
Inter-Professional Patient Care
Salma Debs-Ival – ext. 73105
MoNCP Research Coordinator
Debra Kaye – 613-798-5555, ext. 16349
Research Data Entry Clerk
Hugo Fortin – ext. 19922
Update regarding the status
of the Hand Hygiene Phase
3 roll out in Ambulatory Care
and Diagnostic Imaging
Linda Hunter
Over
the past two years, hand
hygiene auditing results from all inpatient
units at TOH have been publicly reported to
the Ministry of Health and Long-Term Care
(MOHLTC), as well as internally at TOH.
There are three corporate hand hygiene
trainers: Marney Cooper, Marie-Andrea
Bruneau, and Jenn Johnston. They have been
trained by the MOHLTC to help launch this
reporting process in all areas at TOH. They
will continue to help with the implementation
of this process, and the Hand Hygiene
Steering Committee will keep meeting until
next year to guide the roll out of phase 3 in
ambulatory care and diagnostic imaging
(DI) areas.
Phase 3 in
Ambulatory Care
and DI update
• We have completed over 80% of the
environmental scans in ambulatory care
and DI areas to identify the placement
of alcohol gel at point-of-care (POC) to
ensure successful hand hygiene.
• Alcohol foam product with the necessary
70% concentration, which was not
available in phase 1 and 2, has become
available.
• Foam product trials
were conducted
on two units
in July, one
at the Civic
Campus
and one at
the General
Campus.
• The results of the
product trial were
collected and submitted
for a final decision.
• Facilities Management are aware
of all POC placements and are waiting
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NURSING NEWS VOL. 13 NO. 1
on the product evaluation decision in
order to start the installations.
Pending
•
Training overview for managers and
educators in the affected areas started
in September.
• Over the next few months we will
implement the education plan in the
appropriate areas.
• We will also present to individual
groups and stakeholders as requested.
Goals and
Expectations
•
The hand hygiene program and all
of its components was reviewed at
a corporate operations meeting in
September.
• Hand hygiene champions and auditors
will be chosen by managers, and given
training by the Corporate Trainers noted
above.
• We expect baseline audits to begin taking
place starting in December.
Education, training and support will continue
to move forward.
Pamela’s Computer Corner
How does my mouse work?
Left mouse button
This is the most familiar button. It allows
you to make selections on the screen. One
click will allow you to open a program or
application, choose a file, or select text. If you
hold down the button and move the mouse,
you can select one or more words. Two fast
clicks will open files and applications.
Right mouse button
This button is extremely useful, and you can
do no harm by pushing it. The right mouse
button brings up a shorter version of the
menus you will find at the top of your screen.
The menu may include things such at as cut,
copy, paste, save or properties. It is simply a
shorter way to choose the tasks you use most
frequently. Once you select a menu item, click
the left button to make it happen.
Scroll wheel
Between the left and right mouse buttons is
a wheel. This wheel is a quick way to move
or scroll up or down through your screen.
It functions in the same way as the bar and
arrows found on the right side of applications
like MS Word.
If you have a computer question, send it to me
and I will answer it in the next Nursing News.
Pamela Tkach RN, MScN(c)
Learning Resources Consultant, Centre for
Nursing Excellence
Nursing Professional Practice Department,
The Ottawa Hospital
Civic Campus ext. 16897
General Campus ext. 73204
Riverside Campus ext. 82409
Internal Mail:Box 305, General Campus
[email protected]
TOH Flow
Symposium
September 8 and
9 at the Riverside
Campus
by Nicki Bayfield-Ash, Tracey Carroll, Cheryl
Geymonat, Ginette Letourneau, Jackie Mace,
Aline Mayer, Joselyn Mugford, Yvonne Wilson
Patient flow and occupancy rates affect all patients
and staff of The Ottawa Hospital. The main goal of
this symposium was to engage TOH team members
by sharing positive impacts as well as patient flow
challenges.
Speakers reviewed the need for awareness of TOH
flow, team responsibilities, and provided education
topics that broadened our views about patient flow.
Through brainstorming sessions, new ideas were
gathered for improvements to share with the larger
group.
There were 100 participants at the symposium
from all three campuses. Other topics covered were
occupancy, flow impacts, and best practices
Stay tuned more detailed information, including
feedback from evaluations and brainstorming ideas
in next issue of Nursing News!
Get the info
on InfoNet
• Nursing News
• Policies and Procedures
• Nursing Professional Practice
Department
9 Who is the VP of Nursing
9 Clinical Practice
9 Recruitment/Retention/
Recognition
9 Student Placement
9 Nursing Education
9 Clinical Pathways
9 Quality
9 Model of Nursing Clinical Practice
• TOH Education
9 Upcoming events
9 Nursing education
– Nursing education workshops
–Funding
– Self-directed learning resources
9 ALL TOH users
– Learning and Development
offerings
– e-testing/e-surveys, etc.
• Job Opportunities
• Discounts and Services
• Classified Ads
Check it out!
NURSING NEWS VOL. 13 NO. 1
5
Teams to be proud of!
Canadian Association of
Medical-Surgical Nurses
(CAMSN)
Catherine Ford and Prudy Menard
Medical-surgical nurses are the single largest group
of nurses in the country. CAMSN sought designation
for the purpose of establishing national certification
for medical-surgical nurses through an exam. This
past April, nurses across the country had their first
opportunity to confirm their competence by writing
the exam.
At the General Campus of TOH, a group of nurses
planning to write the medical-surgical certification
exam organized a bi-weekly study group under the
leadership of Prudy Menard, nurse educator for
5NE, 5NW, and the AMA.
Medical-surgical nursing is unique in that it is not
limited to one disease or body system. Consequently,
the list of required competencies is extensive.
While there were mentors available through the
Canadian Nurses’ Association, there were none with
experience in this particular exam.
Despite these hurdles, we forged ahead. Initially,
Prudy presented teaching materials in PowerPoint
format. This arrangement quickly evolved and soon
group members began sharing the responsibility of
preparing and presenting materials. Guest speakers
were invited to share tips and advice on writing
exams. In addition to participating in the study
group, most of us devoted several hours a week to
independent study.
We wrote the exam on the morning of April 17 and
celebrated together afterward
Upon reflection, we agreed that being involved in a
study group was a valuable and positive experience.
There was a high success rate in our group. We were
able to discuss rationales and learn from each other.
There was a lot of mutual support, from the day
we first met until the moment we wrote the exam.
We also agreed that going through the certification
process has proven useful to our practice, and that
we would not hesitate to recommend it to our fellow
medical-surgical nurses.
To celebrate and encourage this valuable process,
a plaque with the names of newly certified nurses
will hang on the wall between 5NE and 5NW. The
names of future certified nurses will be added to it
for years to come.
What do you know about NOA?
Rhandall Tydd-Whiting and Susan Bremner
Welcome to the Neurological Observation Area (NOA)! Our twelve-bed unit is located on E2 at the Civic
Campus. NOA is classified as a step-down unit with a nurse-patient ratio of 1:2.
Our 42 dedicated nurses have specialized training in providing exceptional, expert care for the neurologically
impaired patient requiring frequent observation and clinical intervention. There are specific admission criteria for NOA. Patients admitted to NOA must have a primary neurosurgical or
neurological diagnosis with other co-morbidities. NOA accepts patients who are hemodynamically stable, able
to protect their airway and require cardiac and advanced monitoring; including arterial lines and intracranial
pressure monitoring. NOA patients may require seizure monitoring, post-operative care, have ruptured or
unstable aneurysm, have a ventriculostomy (EVD), require monitoring post TPA or have a nervous system
infection. Patients that are not appropriate for NOA include those with a GCS <8, those requiring palliative
care or aggressive hemodynamic management unrelated to brain perfusion.
On September 8, NOA began a new level of care. NOA is now providing care to inpatients who have suffered a
CVA on another unit. When a Stroke Code is called on an inpatient unit within the Civic Campus, the patient
will be assessed by the Stroke Code team and be transferred to NOA if it is confirmed that they require the
administration of Altepase, also known as TPA, the clot-busting drug. Patients will be acutely monitored
during administration and post-TPA.
NOA is a small, cohesive unit. We are dedicated to
our patients and their families during the stress of
hospitalization, treatment and surgical intervention.
Many staff members hold the CNA certification in
neuroscience nursing, and our staff members are active
in self-directed learning. Our unit council is active, and
team-building is important.
Hopefully, this article has put you “in the know”
about NOA!
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NURSING NEWS VOL. 13 NO. 1
Karen
Johnston
Role in the Nursing
Professional Practice
Department
Karen Johnston is
the Coordinator,
Administrative
Staff and
Executive Offices.
Key
elements of
my position
I am responsible
for providing
efficient and
confidential administrative support to
Dr. Ginette Rodger. I coordinate and manage
the day-to-day operations of the office. For
example, I am responsible for:
• matrix supervision of administrative staff
• acting as liaison with other departments
• coordinating all HR and payroll issues for
department
• participating in recruitment, selection and
retention activities of the departmental
administrative and clerical staff
• acting as liaison between my VP and other
members of our staff at all levels, as well
as external stakeholders
• designing presentations
• receiving correspondence and preparing
responses where appropriate
• providing departmental resources for
various computer-related issues
• recording minutes for various committees
• coordinating meeting schedules and
disseminating packages for 14 internal
committees as well as ad hoc committees
• working on special projects such as semiannual nursing retreat and Nursing Week.
My role is demanding and challenging, but
I thrive in a busy environment.
What does my role mean
for TOH nurses?
I am your main link to Dr. Ginette Rodger.
As well, if you would like to discuss something
with a member of the Nursing Professional
Practice team, but are not sure to whom you
should speak, I would be pleased to direct
you accordingly.
Contact information
ext. 78749
[email protected]
Lellina
Palanza
Louise Klaassen
Role in the Nursing Professional
Practice Department
Role in the
Nursing
Professional
Practice
Department
Louise Klaassen is the Informatics Administration
Assistant in NPPD and she supports Nursing Education.
Key elements of my position
Processing requests for professional leave and funding,
and cheque reimbursements. Coordinating nursing
education days, facilitating learning experiences
workshops and corporate nursing orientation with
internal and external stakeholders. Assisting with
nursing skills fair and education fairs. Updating InfoNet with nursing education
program information. Collecting, documenting and tracking data on education days
and nursing orientation for attendance, survey responses, educational day revenue.
Supporting the office of the VP of nursing as requested. Assisting with the student
placement program through HSPNet. Assisting with bursary, tuition assistance
and specialty certification reimbursement process.
What does my role mean for TOH nurses?
Providing an information focal point for Nursing Education requests. Ensuring there
is awareness of nursing education programs offered and financial assistance programs,
thereby facilitating learning. Providing timely processing of requests to ensure
needs are met.
Contact information
ext. 78760
[email protected]
Naomi Garneau
Role in the Nursing Professional
Practice Department
Naomi Garneau is the Secretary for NPPD and provides
administrative support for the Models of Nursing and
Inter-Professional Care portfolios. She also provides
administrative support to the office of the VP.
Key elements of my position
Lellina Palanza is the Administrative Information
Assistant for NPPD.
Key elements of my position
Support to Clinical Practice, NSG RRR, NSG QI, NSG
Research & NSG Education.
What does my role mean for
TOH nurses?
Sharing of information requested and assisting
with inquiries about NPPD.
Contact information
ext. 14976
[email protected]
Hugo
Fortin
Role in the
Nursing
Professional
Practice
Department
Hugo Fortin is the Data
Entry Clerk and Research Assistant for NPP.
Providing administrative support to Salma Debs-Ivall,
Manager of TOH Models of Nursing and Inter-Professional Patient Care. Providing
support to TOH Models team, including IPMPC facilitators, education consultants,
and the research team. Providing additional administrative support to the office of
the VP partly by assisting Karen Johnston, Coordinator of Administrative Staff and
Executive Offices as well as by acting as relief secretary for both the office of Dr. Rodger
and NPPD as a whole.
Key elements of my position
What does my role mean for TOH nurses?
Contact information
I can help them by supporting the Models team and the office of the VP by assisting
in the implementation of efficient models of care and an organized and accessible
NPP department.
I prepare the kits and enter the data into a database for
MoNCP. I’m also data entry clerk for NPPD with their
different projects. I enter data, so the researchers can
analyze them. The information helps to improve and
facilitate TOH nursing environment.
ext. 19922
[email protected]
Contact information
ext. 72238
[email protected]
NURSING NEWS VOL. 13 NO. 1
7
Relaxation and sleep
Guided imagery resources
for patients and families
Does your patient have anxiety about an
upcoming medical test and can’t sleep? Do
visiting family members want to know more
about relaxation techniques? The Patient and
Family Library has been building a collection
of resources on topics such as stress relief
and relaxation techniques for over ten years.
Our collection includes DVDs, like Guided
imagery for Sleep, CDs such as Preparing for
Surgery: Guided imagery Exercises and books,
like the Relaxation and Stress Reduction
Workbook. Patients and their families can
borrow materials for three weeks at a time. So
the next time your patient is suffering from
anxiety and needs help sleeping, remember to
tell them about the library and our resources.
For more information:
Civic Campus ext. 13315
General Campus ext. 70107
Irving Greenberg Family Cancer Centre
25258
Or visit our website! www.ottawahospital.
on.ca/patient/visit/chlib/index-e.asp
It’s ethics day every day
Mike Kekewich, Ethics Coordinator
Just as we don’t really think about the air we
breathe until we have trouble with it, we don’t
normally think of ethics until things become
morally difficult. The dynamics of ethics are
in play just as much when things go right as
when they go wrong. Think about how many
times a day you wonder what the right thing to
do is for a given situation, which is what ethics
is all about. The bottom line is that ethical
decision making happens, whether you notice
its effects or not.
To get a sense of this, think of the following
situation and the different ways it could
play out for you as a nurse: Your patient is
capable of making decisions, and says they
don’t want to be a full code. You respect this
patient’s decision, and you act ethically. In
other words, even though you may not feel
it, you are fulfilling an ethical obligation by
respecting the patient’s autonomy. The same
thing happens, albeit in reverse, when trying
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NURSING NEWS VOL. 13 NO. 1
to act ethically doesn’t go so smoothly. In
the same example, the patient’s family could
very aggressively demand that the patient be
made a full code, despite the patient’s wishes.
Although we know intellectually that the right
decision would be to respect the patient’s
capable wishes, the process might feel more
difficult than that. You might feel conflicted,
as though you’re forced to profoundly
dissatisfy somebody no matter what you do. In
this case, you’re feeling as though you are in a
dilemma. Your attention is drawn to questions
about what you should do, and the answers
may not seem so obvious.
The Department of Clinical and
Organizational Ethics at The Ottawa Hospital
can help you identify ethical issues in your
work through education and consultation.
Ethical issues and dilemmas can lead to moral
distress and other negative outcomes, which
can create an unwanted sense of burden. Even
if you are unsure whether the problem you are
encountering is specifically ethical in nature,
you can always call the Ethics Consultation
Service to talk about it. We are also available
to provide in-services, orientations, and
other targeted ethics education to meet any
specific needs you might have. By using these
resources, you can provide better care, and
can more effectively identify ethical issues as
they arise.
613-722-7000
(ask for the Ethics Consultation Service)
[email protected]
www.cna-aiic.ca/CNA/practice/ethics/
code/default_e.aspx