Patient Preferences and Decision Making

 

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Patient Preferences and Decision Making

Introduction

Patient preferences and shared decision making contributes to attainment of patient-
centered nursing care and better health outcomes. Specialized nurses are faced with numerous
situations where patient preferences play a key role in determination of the most appropriate
treatment plan that is aligned with unique patient values. As a nurse, I am required to act in the
best interests of each patient and help them make the best judgment regarding their treatment
(Doherty & Doherty, 2005, p 126). As a nurse working in critical care ward, I have encountered
several situations that require consideration of patient preferences and inclusion of patient values
in shared decision making. An example of such situation where I included patient preferences
was during my inpatient shift when a 50 year old Type 2 diabetic male patient, with high
cholesterol levels engaged me on the best treatment plan. The situation offered me critical
experience since I informed the patient about the disease, treatment options, safety issues, and
pressure ulcers. I ensured mutual trust and addressed patient privacy concerns in order to
encourage good relationship with the patient. In this case, the diabetic patient raised a need and
required me to reduce the high levels of bad cholesterol associated with type 2 diabetes, and
consequently minimize the high risk of heart complications. The patient’s preference influenced
the treatment plans whereby the patient preferred subcutaneous injection as opposed to usual
inhaled insulin.
The patient preferences and values were reflected in treatment plan selected since I
focused on enhancing the health outcomes of the patient and reducing harm from the treatment
and care plan for the patient. In this case, the patient outlined that subcutaneous injection had
worked well with his grandfather, and believed it would still work well with him. I obliged with

the patient values and created a treatment plan that included daily subcutaneous injection. The
value of the patient decision aid selected contributed to effective decision making since it
prompted a detailed assessment and the patient offered information on developing kidney
problem which is associated with diabetes. This prompted another care plan for management of
kidney stones as the patient noticed crystal like substance while urinating that morning.
Throughout the interaction, I got to know the patient’s family background, cultural values, and
assumptions regarding type 2 diabetes. The interaction enabled me offer evidence-based care
based on facts rather than generalized assumptions. The decision aid enabled me educate the
patient on proper physical exercise, dietary habits, and medications of managing other
complications associated with type 2 diabetes.
The value of the patient decision aid contributed to shared decision making. Effective
decision making entails working together with the patient to make decisions and select
assessment tests, treatments, and care plans based on available clinical evidence and balance of
attached medical risks and expected health outcomes of the patient. In this case, the situation
reflects shared decision making where patient preferences and values are reflected in treatment
plans administered by the nurse (Ringdal, Chaboyer, Ulin, et al, 2017, p 7).
The decision aid inventory is useful in my professional practice and personal life since it
offered me practical experience of implementing patient-centered care and evidence-based
practice. The decision aid inventory is useful in professional practice since it enabled me gain a
better understanding of the importance of including the unique cultural beliefs and interests of
the patient in selecting the preferred treatment plan (Hertog, 2021, p 1910). In addition, the
decision aid clearly demonstrates the need to build cordial relationships and mutual trust with
patients in order to facilitate patient engagement and allow patients voice their concerns and

interests regarding the available treatment options. The decision aid will be useful in supporting
patient interests and enhancing health care outcomes of my patients in nursing environments.

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