This scenario is professionally challenging because it requires balancing the ethical imperative to advance nursing practice through research and innovation with the paramount duty to protect patient privacy and ensure data integrity. Home health and community nurses often collect sensitive personal health information, and the responsible use of this data for translational research and registry development demands strict adherence to ethical principles and relevant data protection regulations. Careful judgment is required to navigate the complexities of data anonymization, informed consent, and secure data management. The best approach involves establishing a robust, multi-faceted translational research framework that prioritizes patient consent and data security from the outset. This includes developing clear protocols for data collection, anonymization, and secure storage, ensuring that all research activities are reviewed and approved by an institutional review board or ethics committee. Furthermore, actively engaging patients in the research process through transparent communication about data usage and providing opt-out mechanisms fosters trust and upholds ethical standards. This approach aligns with the principles of beneficence and non-maleficence, ensuring that research benefits patients and the community without causing harm, and respects patient autonomy. It also adheres to the spirit of innovation by creating a sustainable pathway for evidence-based practice improvement. An incorrect approach would be to proceed with data aggregation for a registry without first obtaining explicit, informed consent from patients for the secondary use of their de-identified data in research. This failure to secure consent violates patient autonomy and potentially breaches data protection regulations, which mandate patient rights regarding their personal health information. Another incorrect approach would be to rely solely on de-identification techniques without a comprehensive data governance plan that includes ongoing security measures and access controls. While de-identification is crucial, it is not foolproof, and a lack of robust security protocols can still lead to privacy breaches, undermining patient trust and violating ethical obligations to protect confidentiality. A further incorrect approach would be to prioritize the speed of innovation and data collection over rigorous ethical review and patient engagement. This utilitarian perspective, which focuses solely on the potential future benefits of research without adequately addressing present ethical concerns and patient rights, is professionally unacceptable and can lead to significant legal and reputational damage. Professionals should employ a decision-making framework that begins with identifying the ethical and regulatory landscape governing health data and research. This involves consulting relevant professional codes of conduct, institutional policies, and national data protection laws. The next step is to assess the potential risks and benefits of any proposed research or innovation, with a particular focus on patient privacy and data security. Prioritizing patient autonomy through informed consent and transparent communication is essential. Finally, seeking guidance from ethics committees and legal counsel ensures that all initiatives are conducted ethically and in compliance with all applicable regulations, fostering a culture of responsible innovation.

This scenario presents a professional challenge due to the critical need for accurate and timely diagnostic interpretation in a vulnerable patient population, where delayed or incorrect assessment can have significant health consequences. The nurse must navigate the complexities of integrating subjective patient reports with objective findings and diagnostic data, while adhering to established professional standards and ethical obligations. The best approach involves a systematic and comprehensive assessment that integrates all available data. This includes a thorough review of the patient’s current symptoms, medical history, and any recent diagnostic test results. The nurse should then correlate these findings with established diagnostic criteria and clinical guidelines relevant to the patient’s age and presenting condition. This approach ensures that the diagnostic impression is evidence-based and considers the full spectrum of potential causes, leading to appropriate monitoring and intervention plans. This aligns with the professional duty of care to provide competent and evidence-based nursing practice, as mandated by nursing regulatory bodies that emphasize accurate assessment and diagnostic reasoning as foundational to safe patient care. An incorrect approach would be to rely solely on the patient’s self-reported symptoms without corroborating objective data or diagnostic information. This fails to acknowledge the potential for misinterpretation of symptoms or the presence of underlying conditions not immediately apparent to the patient, thereby compromising the accuracy of the diagnostic process and potentially leading to delayed or inappropriate care. This deviates from the professional standard of comprehensive assessment. Another incorrect approach would be to immediately initiate a treatment plan based on a preliminary, unconfirmed diagnosis without further diagnostic investigation or consultation. This bypasses the crucial step of establishing a definitive diagnosis, risking the administration of ineffective or even harmful treatments. It also neglects the ethical imperative to practice within the scope of one’s expertise and to seek appropriate consultation when necessary. Finally, an incorrect approach would be to dismiss the patient’s concerns due to a perceived lack of objective findings, without conducting a thorough differential diagnosis. This demonstrates a failure to adequately investigate the patient’s condition and could lead to overlooking serious underlying pathology, violating the ethical principle of beneficence and the professional responsibility to advocate for the patient’s well-being. Professionals should employ a decision-making framework that prioritizes a systematic, evidence-based approach to assessment and diagnosis. This involves active listening, critical thinking, data integration, and adherence to established clinical protocols and ethical guidelines. When faced with uncertainty, seeking consultation with colleagues or supervisors is a crucial step in ensuring patient safety and optimal outcomes.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the immediate needs of a vulnerable patient with the legal and ethical obligations of the healthcare provider. The patient’s expressed desire to remain at home, coupled with the family’s concerns about safety and the potential for deterioration, creates a complex ethical dilemma. Navigating this requires a deep understanding of patient autonomy, beneficence, and the regulatory framework governing home health services in the Caribbean. Careful judgment is required to ensure the patient’s well-being is prioritized while respecting their wishes and involving all relevant parties in decision-making. Correct Approach Analysis: The best professional practice involves a comprehensive assessment of the patient’s home environment, their functional capacity, and the family’s ability to provide support, while simultaneously engaging in open and honest communication with the patient and their family about the risks and benefits of remaining at home. This approach aligns with the principles of patient-centered care and the ethical imperative to promote autonomy and well-being. It also adheres to regulatory guidelines that mandate thorough patient assessments and the development of individualized care plans in collaboration with the patient and their caregivers. This ensures that decisions are informed and that appropriate resources are mobilized to support the patient’s safety and quality of life at home, or to facilitate a transition to a more appropriate care setting if necessary. Incorrect Approaches Analysis: One incorrect approach involves immediately discharging the patient to their home without a thorough assessment of the home environment and the family’s capacity to provide care. This fails to uphold the principle of beneficence, as it potentially places the patient at risk of harm due to an inadequatenvironment or insufficient support. It also disregards regulatory requirements for comprehensive patient assessments and care planning, which are designed to ensure patient safety and optimal outcomes. Another incorrect approach is to override the patient’s expressed wishes and unilaterally decide to transfer them to an institutional setting based solely on the family’s concerns, without adequate exploration of the patient’s perspective or potential home-based solutions. This violates the principle of patient autonomy and can lead to distress and a loss of trust. Regulatory frameworks emphasize shared decision-making and respecting patient preferences whenever possible and safe. A third incorrect approach is to delay necessary interventions or care planning, hoping the situation will resolve itself. This passive stance neglects the professional responsibility to actively manage patient care and address potential risks. It can lead to patient deterioration and increased healthcare costs, and is contrary to the proactive and responsive care expected within the regulatory framework. Professional Reasoning: Professionals should employ a systematic decision-making process that begins with a thorough assessment of the patient’s physical, cognitive, and psychosocial status, as well as their home environment and available support systems. This should be followed by open communication with the patient and their family to understand their goals, preferences, and concerns. Based on this comprehensive understanding, professionals should collaboratively develop a care plan that prioritizes patient safety and well-being while respecting autonomy. This plan should be regularly reviewed and updated as the patient’s condition or circumstances change. If significant risks are identified that cannot be mitigated in the home setting, a transparent discussion about alternative care options should occur, always involving the patient in the decision-making process to the greatest extent possible.

Scenario Analysis: This scenario is professionally challenging because it requires the nurse to balance immediate patient needs with long-term health management, considering the patient’s underlying pathophysiology and potential for exacerbation. The patient’s history of chronic obstructive pulmonary disease (COPD) and recent exacerbation, coupled with the new onset of symptoms suggestive of pneumonia, necessitates a nuanced approach that avoids oversimplification and prioritizes evidence-based interventions. The pressure to provide immediate relief must be weighed against the risk of masking underlying issues or initiating inappropriate treatment, which could lead to adverse outcomes or delayed diagnosis of a more serious condition. Careful judgment is required to differentiate between symptoms, assess their severity, and determine the most effective and safe course of action within the scope of advanced practice nursing and relevant health regulations. Correct Approach Analysis: The best professional practice involves a comprehensive assessment that integrates the patient’s current symptoms with their known pathophysiology. This approach begins with a thorough physical examination, including vital signs, lung auscultation, and assessment for signs of respiratory distress. It then proceeds to gather a detailed history of the current symptoms, their onset, duration, and any associated factors, while also reviewing the patient’s baseline COPD status and recent exacerbation management. Crucially, this approach advocates for diagnostic testing, such as a chest X-ray and sputum culture, to confirm or rule out pneumonia and identify the causative pathogen. Based on these findings, a targeted treatment plan, including appropriate antibiotics and respiratory support, can be developed. This aligns with the ethical imperative to provide patient-centered care, grounded in evidence and best practices, and adheres to regulatory guidelines that mandate accurate diagnosis and appropriate treatment for respiratory infections in individuals with chronic lung disease. Incorrect Approaches Analysis: One incorrect approach involves solely focusing on symptomatic relief of the cough and shortness of breath without investigating the underlying cause. This fails to acknowledge the potential for a serious infection like pneumonia, which requires specific antimicrobial treatment. Ethically, this approach neglects the duty to diagnose and treat, potentially leading to a worsening infection and adverse patient outcomes. Regulatory frameworks emphasize accurate diagnosis and evidence-based treatment, which this approach bypasses. Another incorrect approach is to immediately administer broad-spectrum antibiotics based solely on the reported symptoms, without confirming the diagnosis or identifying the specific pathogen. While seemingly proactive, this can lead to antibiotic resistance, unnecessary side effects, and may not be the most effective treatment if the symptoms are not due to a bacterial infection. This approach deviates from the principle of judicious antibiotic use and can contravene guidelines on antimicrobial stewardship. A third incorrect approach is to assume the symptoms are merely a continuation of the patient’s COPD exacerbation and to adjust their existing COPD management plan without further investigation. While COPD exacerbations can present with similar symptoms, the new onset and potential severity warrant a differential diagnosis. This approach risks mismanaging a concurrent or superimposed infection, delaying appropriate treatment for pneumonia, and potentially leading to severe complications. Professional Reasoning: Professionals should employ a systematic decision-making process that begins with a thorough patient assessment, integrating subjective and objective data. This includes a comprehensive history, physical examination, and review of the patient’s medical record. The next step involves formulating differential diagnoses based on the presenting symptoms and the patient’s underlying pathophysiology. Evidence-based guidelines and current research should then inform the selection of appropriate diagnostic tests to confirm or refute these diagnoses. Finally, a personalized, evidence-based treatment plan should be developed, continuously monitored, and adjusted as needed, always prioritizing patient safety and optimal outcomes. This process ensures that clinical decisions are informed, ethical, and compliant with all relevant professional standards and regulations.

Scenario Analysis: This scenario is professionally challenging because it requires the nurse to navigate the complex and often stressful process of understanding and adhering to the board’s certification requirements, specifically concerning blueprint weighting, scoring, and retake policies. Misinterpreting these policies can lead to significant personal and professional setbacks, including wasted time, financial loss, and delayed career progression. Careful judgment is required to ensure accurate understanding and compliance. Correct Approach Analysis: The best professional approach involves proactively and thoroughly reviewing the official Advanced Caribbean Home Health and Community Nursing Board Certification Candidate Handbook. This handbook is the definitive source for all policies, including the detailed breakdown of the examination blueprint, how scores are calculated, and the specific conditions and procedures for retaking the exam. Adhering to the information provided in this official document ensures the nurse is working with the most accurate and up-to-date requirements, thereby minimizing the risk of errors or misunderstandings. This aligns with the ethical obligation of professional competence and due diligence in maintaining licensure and certification. Incorrect Approaches Analysis: Relying solely on anecdotal information from colleagues, even experienced ones, is professionally unacceptable. While colleagues may offer helpful insights, their understanding of policies can be outdated, incomplete, or misremembered, leading to misinformation. This approach bypasses the official, authoritative source and risks non-compliance. Assuming that the retake policy is the same as for previous certifications without verification is also a significant professional failure. Certification bodies frequently update their policies, and assuming continuity without checking the current guidelines can lead to incorrect assumptions about eligibility, waiting periods, or required steps for retaking the exam. This demonstrates a lack of diligence and adherence to current standards. Waiting until after failing the exam to inquire about retake policies is a reactive and unprofessional approach. This demonstrates poor planning and a failure to proactively understand critical requirements that could impact the candidate’s preparation and subsequent actions. It places the nurse in a reactive, rather than proactive, position, potentially leading to rushed decisions or missed opportunities. Professional Reasoning: Professionals should always prioritize official documentation from certifying bodies when understanding examination requirements. A systematic approach involves: 1) Identifying the official source of information (e.g., candidate handbook, board website). 2) Thoroughly reading and understanding all relevant sections, particularly those pertaining to the exam blueprint, scoring, and retake policies. 3) Seeking clarification from the board directly if any aspect remains unclear. 4) Developing a personal study plan that aligns with the blueprint weighting. 5) Understanding the retake process *before* taking the exam to be prepared for any outcome.

Scenario Analysis: This scenario is professionally challenging because it requires the candidate to balance the need for comprehensive preparation with the realities of limited time and resources. The pressure to pass a certification exam, especially one as critical as the Advanced Caribbean Home Health and Community Nursing Board Certification, can lead to anxiety and potentially inefficient study habits. Effective preparation requires strategic planning, not just exhaustive memorization, and adherence to professional standards of practice and ethical conduct. Correct Approach Analysis: The best professional practice involves a structured, evidence-based approach to preparation. This includes identifying key learning domains outlined by the certifying body, utilizing recommended study materials that align with current best practices in Caribbean home health and community nursing, and creating a realistic study schedule that incorporates regular review and practice assessments. This approach is correct because it directly addresses the requirements of the certification, promotes efficient learning, and ensures that preparation is grounded in the specific context and regulations relevant to nursing practice in the Caribbean region. It prioritizes understanding and application over rote memorization, which is essential for competent nursing practice. Incorrect Approaches Analysis: One incorrect approach involves relying solely on outdated textbooks and anecdotal advice from colleagues without verifying their relevance to current Caribbean nursing standards or the specific exam content. This fails to acknowledge the dynamic nature of healthcare and the importance of up-to-date knowledge, potentially leading to preparation based on inaccurate or superseded information. It also neglects the official guidance provided by the certifying board. Another incorrect approach is to cram extensively in the week leading up to the exam, neglecting consistent study and review throughout the preparation period. This method is often ineffective for long-term retention and deep understanding, increasing the likelihood of burnout and poor performance. It does not allow for the assimilation of complex concepts or the development of critical thinking skills necessary for the exam. A third incorrect approach is to focus exclusively on memorizing facts and figures without engaging with case studies or practical application scenarios. While factual knowledge is important, nursing certification exams typically assess the ability to apply knowledge in real-world clinical situations. This approach fails to develop the critical thinking and problem-solving skills that are central to effective home health and community nursing. Professional Reasoning: Professionals should approach certification preparation with the same diligence and strategic planning they apply to patient care. This involves first understanding the scope of practice and the specific competencies assessed by the certifying board. Next, they should identify reliable and current resources, prioritizing those recommended by the board or recognized professional organizations. Developing a personalized study plan that includes regular self-assessment and practice questions is crucial. Finally, maintaining a healthy lifestyle and managing stress are integral to effective learning and optimal performance.

The investigation demonstrates a complex scenario involving a vulnerable patient, potential medication errors, and the need for clear communication and adherence to prescribing support protocols. The professional challenge lies in balancing patient advocacy, ensuring safe medication practices, and respecting the roles and responsibilities within the healthcare team, all while operating within the specific regulatory framework of the Caribbean region for home health and community nursing. Careful judgment is required to navigate potential conflicts and ensure patient well-being. The best approach involves a direct, respectful, and documented conversation with the prescribing physician. This approach prioritizes patient safety by addressing the observed discrepancy immediately. It involves clearly articulating the concern regarding the medication dosage, referencing the patient’s current clinical status and any relevant guidelines or evidence that support the concern. This direct communication allows for clarification, potential correction of the prescription, and reinforces the nurse’s role in medication safety oversight. This aligns with professional nursing standards and ethical obligations to advocate for patients and ensure safe medication administration, as well as the principles of collaborative practice expected within the healthcare system. An incorrect approach would be to administer the medication as prescribed without seeking clarification. This fails to uphold the nurse’s responsibility to question potentially unsafe orders and could lead to patient harm due to an inappropriate dosage. It bypasses essential safety checks and demonstrates a lack of critical assessment of the medication order in relation to the patient’s needs. Another incorrect approach would be to discuss the concern with a colleague without directly addressing it with the prescribing physician. While peer consultation can be valuable, it delays direct intervention and does not resolve the immediate prescribing issue. This approach risks further delay in correcting a potentially harmful error and does not fulfill the professional obligation to ensure the safety of the prescribed medication. Finally, an incorrect approach would be to document the concern in the patient’s chart without any attempt at immediate communication with the physician. While documentation is crucial, it is a secondary measure to immediate intervention when patient safety is at risk. Relying solely on documentation without proactive communication fails to address the immediate threat and leaves the patient vulnerable to the incorrect dosage. Professionals should employ a decision-making framework that prioritizes patient safety. This involves a systematic assessment of the situation, identification of potential risks, and a clear understanding of professional responsibilities and regulatory expectations. When a discrepancy or potential error is identified, the immediate step should be direct, respectful communication with the prescriber. If direct communication does not resolve the issue, escalation through established channels within the healthcare facility or system should be considered, always with the patient’s best interest as the primary driver.

This scenario presents a professionally challenging situation due to the inherent complexities of leadership within a home health setting, specifically concerning delegation and interprofessional communication. The registered nurse (RN) must balance patient care needs with the scope of practice of other team members, while also ensuring clear, timely, and accurate communication across disciplines to maintain patient safety and continuity of care. Careful judgment is required to navigate potential conflicts, ensure adherence to regulatory standards, and uphold ethical principles. The best professional approach involves the RN directly engaging with the physician to clarify the order, document the conversation, and then communicate the clarified plan to the licensed practical nurse (LPN). This approach is correct because it prioritizes patient safety by ensuring the order is understood and appropriate before delegation. The RN retains accountability for the initial assessment and the decision to delegate, as per established nursing practice standards and the regulatory framework governing nursing scope of practice in the Caribbean. Direct communication with the physician is crucial for resolving ambiguity and preventing errors. Documenting the conversation provides a clear record of the decision-making process and ensures transparency. Subsequently, communicating the clarified plan to the LPN ensures that the delegated task is understood within its appropriate scope. This aligns with principles of effective leadership, responsible delegation, and robust interprofessional communication, all vital for quality patient care. An incorrect approach would be to delegate the task to the LPN based on the RN’s initial interpretation without seeking clarification from the physician. This is professionally unacceptable because it bypasses a critical step in ensuring the order’s accuracy and appropriateness, potentially leading to patient harm if the interpretation was incorrect. It demonstrates a failure in leadership by not proactively addressing ambiguity and a breakdown in interprofessional communication by not closing the loop with the ordering physician. Another incorrect approach would be to ignore the physician’s order and proceed with the patient’s usual care plan without any communication. This is professionally unacceptable as it disregards a direct medical order, potentially jeopardizing the patient’s well-being and failing to adhere to the physician’s clinical judgment. It represents a significant lapse in leadership, delegation, and interprofessional communication, undermining the collaborative nature of healthcare. A further incorrect approach would be to delegate the task to the LPN and ask the LPN to contact the physician for clarification. This is professionally unacceptable because it shifts the primary responsibility for clarifying a physician’s order from the RN to the LPN. While LPNs can communicate with physicians, the initial responsibility for interpreting and ensuring the appropriateness of a physician’s order before delegation rests with the RN. This approach demonstrates a failure in leadership and delegation by not taking direct ownership of the clarification process. The professional decision-making process for similar situations should involve a systematic approach: 1) Identify the ambiguity or concern in the order. 2) Prioritize patient safety and the need for clarification. 3) Initiate direct communication with the ordering physician to resolve the ambiguity. 4) Document the clarification and the decision-making process. 5) Delegate the task to the appropriate team member (e.g., LPN) with clear instructions, ensuring they understand the task and its context. 6) Follow up to ensure the task is completed correctly and the patient’s needs are met. This framework emphasizes accountability, clear communication, and adherence to professional standards.

This scenario presents a professional challenge due to the inherent conflict between a client’s expressed wishes and the nurse’s professional judgment regarding their safety and well-being. The nurse must navigate the principles of client autonomy while upholding their duty of care, adhering to the ethical guidelines and professional standards of the Advanced Caribbean Home Health and Community Nursing Board. The complexity arises from balancing the client’s right to self-determination with the responsibility to prevent harm, especially when the client’s decision-making capacity may be compromised or influenced by factors not immediately apparent. The best approach involves a comprehensive assessment of the client’s understanding and capacity to make the decision, coupled with open and empathetic communication. This approach prioritizes understanding the client’s rationale, exploring their concerns, and collaboratively developing a plan that respects their autonomy as much as possible while ensuring their safety. This aligns with the ethical principles of beneficence (acting in the client’s best interest) and respect for autonomy, as well as professional nursing standards that mandate thorough client assessment and client-centered care planning. It also implicitly addresses the need to document all assessments and discussions, which is a regulatory requirement. An approach that immediately overrides the client’s wishes without a thorough assessment of their capacity or understanding is ethically problematic. It disrespects client autonomy and can erode trust, potentially leading to non-compliance with future care recommendations. This fails to meet the professional standard of client-centered care and may violate the principle of informed consent if the client’s capacity is not properly evaluated. Another incorrect approach is to proceed with the client’s request without adequately exploring the underlying reasons or potential risks. This could be seen as a failure of the nurse’s duty of care and beneficence, as it may lead to a situation where the client is exposed to preventable harm. It neglects the professional responsibility to advocate for the client’s safety and well-being. Finally, an approach that involves solely consulting with family members without direct engagement with the client about their wishes and understanding is also flawed. While family input can be valuable, the primary focus must remain on the client’s autonomy and capacity. Over-reliance on family can undermine the client’s rights and may not accurately reflect the client’s true desires or decision-making capabilities. Professionals should employ a decision-making process that begins with a thorough, non-judgmental assessment of the client’s situation, including their physical, cognitive, and psychosocial status. This should be followed by open communication, active listening, and exploration of the client’s values and preferences. If there are concerns about capacity, a formal assessment should be conducted. Collaboration with the client, their family (with client consent), and the healthcare team is crucial in developing a safe and ethical care plan that respects the client’s autonomy to the greatest extent possible. Documentation of all assessments, discussions, and decisions is a critical component of professional practice.

Scenario Analysis: This scenario is professionally challenging because it requires the nurse to balance immediate patient needs with the complex ethical and legal considerations surrounding patient autonomy, informed consent, and the duty to report. The patient’s expressed desire to avoid reporting, coupled with the potential for harm to others, creates a significant ethical dilemma that demands careful judgment and adherence to professional standards. Correct Approach Analysis: The best professional practice involves a multi-faceted approach that prioritizes patient safety while respecting patient rights and fulfilling legal obligations. This includes a thorough assessment of the patient’s capacity to make decisions, providing comprehensive information about the implications of their condition and the reporting requirements, and exploring all avenues for voluntary disclosure and support. When a patient lacks capacity or refuses to consent to necessary reporting that poses a clear risk of harm to others, the nurse has a legal and ethical duty to report to the appropriate authorities to protect potential victims. This aligns with the principles of beneficence (acting in the patient’s best interest and the public’s interest), non-maleficence (preventing harm), and justice (fairness in protecting the community). Specifically, in the context of Caribbean jurisdictions, nursing practice is guided by professional codes of conduct and relevant public health legislation that mandate reporting of communicable diseases or conditions that pose a significant public health risk. The nurse must document all assessments, discussions, and actions meticulously. Incorrect Approaches Analysis: One incorrect approach would be to immediately report the patient’s condition to the authorities without first attempting to educate the patient about the necessity of reporting and exploring their concerns. This fails to uphold the principle of patient autonomy and could erode trust, potentially leading the patient to avoid future healthcare engagement. It also bypasses the opportunity to assess the patient’s understanding and capacity, which is a crucial step in ethical decision-making. Another incorrect approach would be to respect the patient’s wishes to withhold information and not report, despite the clear risk of harm to others. This directly violates the nurse’s legal and ethical duty to protect the public from preventable harm, particularly when dealing with conditions that have significant public health implications. This failure to report could have severe consequences for the community and expose the nurse to professional and legal repercussions. A third incorrect approach would be to disclose the patient’s confidential information to unauthorized individuals, such as family members or friends, without the patient’s consent or a legal mandate. This constitutes a breach of patient confidentiality, a cornerstone of professional nursing ethics and privacy laws prevalent in Caribbean healthcare systems. Such a breach undermines the patient-provider relationship and can lead to legal action. Professional Reasoning: Professionals should employ a structured decision-making process that begins with a comprehensive assessment of the situation, including the patient’s condition, capacity, and expressed wishes. This is followed by an ethical analysis, considering relevant principles (autonomy, beneficence, non-maleficence, justice) and professional codes of conduct. Legal obligations, including mandatory reporting requirements, must be identified and understood. Consultation with supervisors, ethics committees, or legal counsel is crucial when faced with complex dilemmas. Finally, the nurse must document all steps taken and the rationale behind their decisions.