Paper Example on Personal Decision Making Model

Introduction

Effective decision-making is a process that serves nurses throughout their profession. It's vital for the nursing practitioners to decide how to think and the consequences of their decisions to the patients as well as the hospital environment at large. Effective decision making is a skill that will serve nurses for the rest of their lives. Decision making is a step-by-step process that helps to build a strong foundation for personal values that are influenced by the family, friends and peers, societal mores and life experiences. Values are one's own choice, and they boil down to the individual's decision. A seven step framework helps to establish a basis for effective decision making (Lunenburg, 2010). It involves identification of the core personal values, recognition and identification of the situation that demands the decision, brainstorming of the possible ideas or solutions, gathering facts and information, thinking and planning, making choices and acting on them and evaluating the decision to measure its viability.

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Personal Decision-Making Model

The reflective equilibrium model involves establishing a state of coherence or balance among a set of beliefs that are achieved through a process of deliberative mutual adjustment among a set of general principles and specific judgements (Yilmaz, Franko-watkins & Kroecker, 2016). As a practicing nurse, I can make use of the processes of reflective equilibrium to establish a balance of my moral convictions and background beliefs together with well-established principles and moral theories to come up with sound moral judgements. It is a model that is more dominant with moral justification in both applied and normative ethics. It lies on the ambition to ensure moral objectivity without bearing the controversial and metaphysical burdens of moral justification, rational intuitionism and claims of moral beliefs that can somehow be identified as non-inferential (Daniels, 2016).

In this method, I check on the moral beliefs held in the nursing field, the moral judgements made concerning the particular situation or issue at hand and the moral beliefs across a myriad of similar issues. The results of the above would enable me to establish a common thread in line with the moral beliefs in nursing in a bid to come up with solutions to the problem. In this model, the concept of reflective equilibrium helps to establish a process by which I can figure out how a situation can be handled using morally right procedures and how it can be identified as a morally right or wrong decision by the medical procedures. It also helps to identify whether the nursing beliefs are moral and consistent.

The model involves simple strategies put in place to achieve the desired decisions. It provides an account of what I am doing as a psychiatric nurse when I engage in moral deliberation. The major activities involved in the model include:

• Establishing clear intuitions/judgmental considerations.
• Determining the principles that would help to explain why the actions are right or wrong.
• Self-evidence can alternatively be rejected when all the moral judgments are supported by other non-stipulated beliefs that have to be considered or all the reflection of what is proper occurs within a framework of some other reasons.
• The final judgment can be justified by establishing a balance in the judgments of individual cases and the general moral beliefs to establish a 'reflective equilibrium.'

Elements of the Reflective Equilibrium

Judgments

This element can either be specific in general in scope. It provides a primary subject of the equilibrium. Examples include racial discrimination of patients when the nursing ethics provide equal moral worth of all the patients.

Principles

This is a general element to the model. It is also a primary subject of the equilibrium. Examples include the use of the difference principle and equal worth principle among others when handling the patients at the hospital.

Direct Arguments

These are specific elements that provide argumentation to the model. Examples include the leveling down objection and the Rawls's intuitive argument (Mikhail, 2011).

Devices of Representation

These are general elements that also act as argumentations in the model. Examples include the original positioning of the practitioner as well as the ideal observer.

Background Theories

These are general elements of the paper that also play a major role are argumentations in the model. Examples include the social theories and the theories of the practitioner among others.

Application of Theories and Principles of Nursing and Healthcare Ethics

The theories and principles of nursing were appropriately applied in the development of the personal decision making model. As indicated in the elements of the model, principles are a general scope and form a primary subject of the equilibrium. Being a nursing paper, it makes use of the nursing principles that are by the ethical considerations in healthcare. The model makes use of the four principles of healthcare ethics as developed by James Childress and Tom Beauchamp in the 1985 principles of biomedical ethics that provide the medical practitioners with guidelines on how to make decisions when caught in complicated situations that involve patients. These principles are part of a major element in the decision making model. They include beneficence, autonomy, justice, and non-maleficence (Shroeder-back, Duncan, Sherlaw, Ball & Czabanowska, 2014).

Non-Maleficence

This means "to not harm." It intends to be the end goal for all nursing practitioner decisions. In developing the model, I had to consider whether the patient, other people or the society at large could be harmed by the decision taken even if it benefits the individual patient. The definition of "harm" in a clinical care setting is also put into consideration as that which worsens the condition of the patient as well as the environment around the patient. We can also justify harm basing on the natural law theory of double effect because of an expected greater good.

Beneficence

Using and applying this principle to the model ensures that I as the nursing practitioner has to do all I can to benefit the patient in each situation and decision made. It ensures that all the treatment procedures that have been set are with the intention of providing the most good for the patient. It involves development and maintenance of high levels of skills and knowledge, undergoing training on the current and best practices in the specific medical fields and proper consideration of the patient's individual circumstances since what is proper for one patient might not be the same for another.

Autonomy

This principle stands for the right of the patient to retain control over what happens to his/her body. As much as I would provide a suggestion of advice, any actions that would try to coerce of persuading the patient into making a decision would be a violation of this principle. The patient should be allowed to make his/her decisions irrespective of whether the medical provider believes them to be in the patient's best interests of not. The medical practitioner should act independently of his or her personal beliefs and values.

Justice

This principle addresses the elements of fairness in the medical decisions made. This includes fairness in the decisions that burden and benefit as well as those that involve the uniform distribution of scarce resources and new treatment platforms to enable medical practitioners to uphold the required legislation when coming up with choices. The justice is classified into procedural and distributive. Procedural justice involves setting up fair procedures and ensuring that they are followed to the later while distributive justice is involved with the proper and equal allocation of resources.

Proportionality

This is a normative principle that demands that in balancing and weighing the individual patient freedom against the wider social good, concerns should be made properly. In this case, it is essential that the benefits of public health should outweigh the infringed and general moral considerations.

Other Ethical Decision-Making Models that helped to develop my Decision-Making Model.

Various models were used to help establish the model and in one way or another play a part in the decision making process. These decision models include the Vroom-Yetton-Jago decision models and the recognition-primed decision model.

The Vroom-Yetton-Jago Decision Model

The model bases on the fact that not all ethical decisions are equal. Some decisions in the nursing profession are extremely vital and would require input from many other stakeholders within the health institution while other decisions can be made in an easy and fast manner as they would not provide any long-lasting effect on the patient's health conditions. An understanding of this basic concept is vital since as a psychiatric nurse, I would not be able to use the same decision-making process for all the choices that I make. This model, therefore, helps to customize the approaches used for decision making basing on the existing situation. It makes use of three basic factors that help to analyze the decision that should be made. These factors include:

Decision quality

Here the decision maker thinks about how vital it is to come up with the most appropriate decision. One always wants to make the right decision, but some circumstances arise that are more critical than others in the medical context.

Subordinate commitment

Some of the decisions that I'm going to make have strong impact on the patients as well as the hospital's operations while others would slightly affect them. Therefore, this step involves thinking about each decision and its associated effects on the individual patient and others within and around the medical center. It also ensures that as a nursing practitioner, I 'buy in' from the patient, doctors, and other stakeholders and incorporate them in the decision making process, especially when making critical decisions.

Time constraints

The timelines to implement a decision would highly impact the process that would be taken to select a given decision. If the decision has no urgent timelines, there would be plenty of time to make the appropriate decision, and this would provide room for inclusion of other stakeholders such as the doctors, other nurses and the management at large. However, a time sensitive hospital situation would not warrant the involvement of all the stakeholders in the decision making the process as the patient's life is also at stake. It is therefore vital to establish a clear timeline for your decision and decide whether you would have time for input from other stakeholders to help make vital personal decisions.

The light offered by these three factors provides a clearer picture of the path that should be followed to make a quality decision. It provides the options of consultation, autocracy, and collaboration in decision making in the nursing profession.

The Recognition-Primed Decision Model

In the medical field, there would not always be a lot of time to make quality decisions. It would be awesome to sit down and take time to think of the various options at your disposal before making a choice. However, that might not be how things work in reality. There come situations where one has to act quickly based on the information present.

The model presents three steps that should be taken to facilitate decision making and contribute significantly to the equilibrium reflective model. They include experiencing the situation, analysis of the situation and the implementation of the decision.

Experiencing the situation involves 'taking in' as much as possible the situation that r...