Scenario Analysis: This scenario is professionally challenging because it involves a critical patient safety issue stemming from a breakdown in interprofessional communication and delegation. The registered nurse (RN) is responsible for ensuring safe patient care, which includes appropriate delegation and clear communication with the entire care team. Failure to address the unlicensed assistive personnel’s (UAP) concerns promptly and effectively can lead to adverse patient outcomes, potential harm, and breaches of professional standards. The RN must balance the need for efficient workflow with the imperative of patient safety and the proper utilization of the healthcare team. Correct Approach Analysis: The best professional practice involves the RN immediately stopping the UAP from administering the medication, verifying the order, and then engaging in direct, open communication with the physician to clarify the order and address the UAP’s concerns. This approach prioritizes patient safety by preventing a potentially incorrect medication administration. It upholds the RN’s responsibility for oversight and delegation, ensuring that all team members feel empowered to voice safety concerns. This aligns with the principles of patient advocacy and the professional standards of nursing practice, which mandate that nurses assess the competency of delegated tasks and ensure the safety of patient care. It also reflects best practices in interprofessional communication, encouraging a collaborative approach to problem-solving and patient care. Incorrect Approaches Analysis: One incorrect approach involves the RN dismissing the UAP’s concerns and instructing them to proceed with the medication administration. This is professionally unacceptable as it disregards a potential safety red flag, violates the RN’s duty to ensure safe delegation, and undermines the UAP’s role in patient safety. It fails to adhere to the principle of “do no harm” and neglects the critical importance of verifying medication orders, especially when doubt is expressed. Another incorrect approach is for the RN to proceed with the medication without directly addressing the UAP’s expressed concern or verifying the order, assuming the UAP is mistaken. This demonstrates a lack of critical thinking and a failure to engage in necessary verification processes, potentially leading to medication errors and patient harm. It also fails to foster a culture of safety where concerns are addressed collaboratively. A third incorrect approach is for the RN to delegate the task of verifying the order to the UAP. Unlicensed personnel are not authorized to interpret or verify physician orders, especially those involving medication administration. This delegation is outside the scope of practice for a UAP and places undue responsibility on them, while the RN abdicates their core responsibility for patient safety and order verification. Professional Reasoning: Professionals should employ a systematic approach to patient safety. When a concern is raised by any member of the care team, especially regarding medication administration, the immediate priority is to pause the action and investigate. This involves direct communication with the individual raising the concern to understand the nature of their doubt, followed by verification of the order with the prescribing physician. The RN must then assess the situation, clarify any ambiguities, and ensure the medication is administered safely and correctly, or that the order is appropriately modified or rescinded. This process reinforces a culture of safety, promotes effective interprofessional collaboration, and ensures adherence to professional standards of care.

Scenario Analysis: This scenario is professionally challenging because it requires the perianesthesia nurse to balance the patient’s immediate need for comfort and safety with the ethical and legal obligations to obtain informed consent. The patient’s diminished capacity due to pain and anxiety, coupled with the urgency of the situation, creates a complex ethical dilemma where the nurse must advocate for the patient while adhering to established protocols. Careful judgment is required to ensure the patient’s rights are protected and that any intervention is truly in their best interest, without compromising their autonomy. Correct Approach Analysis: The best professional practice involves a multi-faceted approach that prioritizes patient safety and advocates for their autonomy as much as possible under the circumstances. This includes assessing the patient’s capacity to understand the proposed procedure and its risks/benefits, even in their current state. If capacity is significantly impaired, the nurse should seek to identify and involve a surrogate decision-maker, such as a family member or legal guardian, to provide consent on behalf of the patient. Simultaneously, the nurse must document all assessments of capacity, the rationale for involving a surrogate, and the consent obtained. This approach aligns with ethical principles of beneficence (acting in the patient’s best interest) and respect for autonomy (even when diminished), and regulatory requirements for informed consent and patient advocacy. Incorrect Approaches Analysis: One incorrect approach involves proceeding with the procedure based solely on the nurse’s assumption that the patient would want it done, without formally assessing capacity or involving a surrogate. This violates the fundamental ethical and regulatory requirement for informed consent, as it bypasses the patient’s right to make decisions about their own healthcare. It also fails to establish a clear legal basis for the intervention. Another incorrect approach is to delay necessary treatment indefinitely until the patient is fully lucid and capable of providing consent, even if their condition is deteriorating and poses an immediate risk. While respecting autonomy is crucial, the principle of beneficence often dictates that urgent care should be provided when a patient is unable to consent and delaying treatment would cause harm. This approach prioritizes autonomy to an extreme that could lead to patient harm. A third incorrect approach is to obtain consent from a colleague or another staff member who is not a designated surrogate decision-maker. This is ethically and legally unsound, as only individuals with legal authority or a direct familial/personal relationship recognized by law can act as surrogates. Consent obtained from an unauthorized individual is invalid and exposes the healthcare team to legal and ethical repercussions. Professional Reasoning: Professionals should employ a structured decision-making process that begins with a thorough assessment of the patient’s condition and their capacity to understand and make healthcare decisions. This assessment should be objective and documented. If capacity is questionable or impaired, the next step is to identify and involve the appropriate surrogate decision-maker according to established hospital policy and legal guidelines. Throughout this process, clear and accurate documentation is paramount. The nurse should always advocate for the patient’s best interests while respecting their rights and adhering to regulatory mandates regarding consent and patient care.

The control framework reveals the critical importance of understanding the scope and limitations of perianesthesia nursing practice, particularly when encountering situations that extend beyond routine care. This scenario is professionally challenging because it requires the nurse to balance patient advocacy with adherence to established protocols and the recognition of their own professional boundaries. A failure to correctly identify the appropriate course of action could lead to patient harm, legal repercussions, or a breach of professional ethics. Careful judgment is required to navigate the complexities of patient needs, available resources, and regulatory expectations. The best professional approach involves a systematic and collaborative process. This includes a thorough assessment of the patient’s current condition, a review of the physician’s orders, and consultation with the anesthesiologist or surgeon regarding the patient’s specific needs and the rationale behind the current treatment plan. If the nurse identifies a discrepancy or a potential for improvement in the patient’s care that is not addressed by the existing orders, the most appropriate action is to communicate these concerns directly to the responsible physician or anesthesiologist, providing objective data and rationale for their observations. This approach upholds the nurse’s responsibility to advocate for the patient while respecting the physician’s ultimate authority and expertise. It ensures that any changes to the patient’s care are made through appropriate channels and with the full understanding of the medical team. This aligns with ethical principles of beneficence and non-maleficence, as well as professional standards that emphasize communication and collaboration. An incorrect approach would be to independently alter the patient’s medication regimen without explicit physician or anesthesiologist orders. This bypasses the established chain of command and the physician’s responsibility for prescribing and managing patient care. Such an action constitutes a significant breach of professional conduct and could have severe consequences for the patient, including adverse drug reactions or therapeutic failure. Another incorrect approach would be to simply document the observation without further action or communication. While documentation is crucial, it is insufficient when a patient’s well-being is potentially compromised. This passive approach fails to fulfill the nurse’s ethical and professional obligation to advocate for the patient and ensure their safety. Finally, an incorrect approach would be to discuss the situation with colleagues in a manner that constitutes gossip or undermines the physician’s authority, without initiating a formal communication with the responsible provider. While peer consultation can be valuable, it should not replace direct communication with the physician or anesthesiologist when a patient’s care requires adjustment or clarification. This can create a negative work environment and does not directly address the patient’s needs. The professional reasoning process for similar situations should involve a clear understanding of the nursing scope of practice, the importance of the physician’s orders, and the established protocols for patient care. When a discrepancy or concern arises, the nurse should: 1) Assess the patient thoroughly. 2) Review existing orders and the patient’s chart. 3) Identify the specific concern and its potential impact on the patient. 4) Consult relevant resources or guidelines if necessary. 5) Communicate concerns clearly and professionally to the appropriate physician or anesthesiologist, providing objective data. 6) Document the communication and any subsequent actions.

Scenario Analysis: This scenario is professionally challenging because it requires a perianesthesia nurse to navigate the complex and often stressful process of understanding and adhering to the certification board’s policies regarding exam eligibility, scoring, and retakes. Misinterpreting these policies can lead to significant personal and professional setbacks, including wasted time, financial loss, and delayed career advancement. Accurate understanding is crucial for maintaining professional integrity and ensuring fair assessment. Correct Approach Analysis: The best professional practice involves proactively and thoroughly reviewing the official Comprehensive Perianesthesia Nursing Board Certification (CPNBC) candidate handbook and website. This approach is correct because these official sources are the definitive authority on all CPNBC policies, including blueprint weighting, scoring methodologies, and retake procedures. Adhering to information directly from the certifying body ensures compliance with their established standards and requirements, thereby upholding ethical professional conduct by seeking accurate and authorized information. Incorrect Approaches Analysis: Relying solely on anecdotal advice from colleagues or study group members is professionally unacceptable. While well-intentioned, such information may be outdated, misinterpreted, or inaccurate, leading to a misunderstanding of official policies. This failure to consult primary sources violates the ethical principle of professional responsibility to seek and act upon verified information. Assuming that retake policies are similar to other professional certifications without verification is also professionally unsound. Each certifying body has unique regulations. Making assumptions bypasses the due diligence required to understand specific CPNBC requirements, potentially leading to non-compliance and disqualification. This demonstrates a lack of meticulousness in professional preparation. Interpreting the exam blueprint weighting based on personal experience with other nursing exams is inappropriate. The CPNBC blueprint is specific to their certification and reflects the knowledge domains they deem essential for perianesthesia nursing. Using external benchmarks without consulting the official CPNBC blueprint is a failure to adhere to the specific standards of the certification being sought. Professional Reasoning: Professionals should approach certification requirements with a commitment to accuracy and diligence. This involves prioritizing official documentation from the certifying body as the primary source of information. When faced with uncertainty, the decision-making process should involve seeking clarification directly from the CPNBC through their designated channels, rather than relying on informal networks or assumptions. This ensures that all actions are based on verified facts and align with professional standards.

The audit findings indicate a recurring pattern of candidates for the Comprehensive Perianesthesia Nursing Board Certification expressing significant anxiety regarding their preparedness and the adequacy of their study timelines. This scenario is professionally challenging because it highlights a potential gap between the certification body’s expectations for candidate readiness and the candidates’ perceived ability to meet those expectations. It necessitates a careful judgment call on how to best support candidates without compromising the integrity or rigor of the certification process, while also ensuring the audit findings are addressed constructively. The approach that represents best professional practice involves proactively providing comprehensive, evidence-based guidance on effective preparation strategies and realistic timelines. This includes offering a variety of resources, such as recommended study plans, practice examinations that mirror the actual test format and difficulty, and access to subject matter experts or forums for clarification. This approach is correct because it directly addresses the candidates’ expressed anxieties by equipping them with the tools and knowledge needed for successful preparation. It aligns with the ethical principle of beneficence, aiming to promote the well-being and success of the candidates. Furthermore, it supports the certification’s goal of ensuring competent practitioners by fostering a structured and informed preparation process, thereby upholding professional standards. An approach that involves simply reiterating the importance of self-directed study and advising candidates to consult general study guides fails to adequately address the specific anxieties and needs identified in the audit. This approach is professionally unacceptable because it neglects the responsibility to provide targeted support and may inadvertently disadvantage candidates who require more structured guidance. It could be seen as a failure to uphold the ethical principle of justice, by not providing equitable support to all candidates. Another professionally unacceptable approach would be to recommend an overly compressed study timeline, suggesting that candidates can adequately prepare in a significantly shorter period than is realistically required for comprehensive mastery of the material. This is ethically problematic as it sets unrealistic expectations, potentially leading to candidate failure and discouragement, and it undermines the credibility of the certification process by implying that thorough preparation is not essential. Finally, an approach that focuses solely on the difficulty of the examination without offering concrete preparation strategies or resources is also professionally inadequate. While acknowledging the rigor of the certification is important, failing to provide actionable guidance on how to navigate that rigor is a disservice to candidates. This can lead to increased anxiety and a sense of helplessness, rather than empowerment, and does not align with the ethical obligation to facilitate professional development. The professional decision-making process for similar situations should involve a systematic evaluation of audit findings, followed by a needs assessment of the target audience. Based on this assessment, the development and dissemination of tailored, evidence-based resources and guidance should be prioritized. This process should be iterative, incorporating feedback to continuously improve support mechanisms and ensure the certification process is both rigorous and accessible.

This scenario presents a significant ethical and clinical challenge for a perianesthesia nurse. The core difficulty lies in balancing the patient’s expressed wishes, which may be influenced by their current physiological state and pain, with the nurse’s professional responsibility to ensure patient safety and advocate for their best interests based on objective clinical assessment. The nurse must navigate the potential for impaired judgment due to pain and medication while respecting patient autonomy. The best professional approach involves a thorough, objective assessment of the patient’s physiological status and cognitive capacity, coupled with a compassionate exploration of their concerns and the rationale behind their request. This approach is correct because it aligns with fundamental ethical principles of beneficence (acting in the patient’s best interest), non-maleficence (avoiding harm), and respect for autonomy, while also adhering to professional nursing standards that mandate comprehensive patient assessment and advocacy. Specifically, nursing practice standards emphasize the importance of assessing a patient’s understanding and capacity to make decisions, especially when factors like pain, medication, and anxiety could impair judgment. The nurse’s role is to gather objective data, communicate it clearly, and facilitate informed decision-making, which may involve further consultation with the physician or other members of the healthcare team if the patient’s request poses a risk. An incorrect approach would be to immediately grant the patient’s request without further assessment. This fails to uphold the principle of non-maleficence, as the patient’s request, if granted without considering their current condition, could lead to harm. It also bypasses the nurse’s professional duty to assess for factors that might impair decision-making capacity, such as the effects of anesthesia, pain medication, or psychological distress. Another incorrect approach would be to dismiss the patient’s concerns outright and refuse to consider their request, citing only the standard protocol. This disregards the principle of respect for autonomy and can erode patient trust. While protocols are important, they should be applied with clinical judgment and consideration for individual patient circumstances. The nurse has a responsibility to explore the patient’s perspective and advocate for reasonable adjustments when clinically appropriate and safe. A third incorrect approach would be to proceed with the patient’s request based solely on their verbal assertion, without documenting the assessment of their capacity or consulting with the physician. This neglects the professional standard of clear documentation and communication within the healthcare team, potentially leading to misunderstandings and compromising patient safety. It also fails to involve the physician in a decision that may have significant clinical implications. The professional decision-making process for similar situations should involve a systematic approach: first, conduct a comprehensive assessment of the patient’s physiological status, pain level, and cognitive function. Second, engage in open and empathetic communication with the patient to understand their concerns and the reasoning behind their request. Third, evaluate the request against established clinical protocols and potential risks and benefits, considering the patient’s current condition. Fourth, if there are concerns about the patient’s capacity or the safety of the request, consult with the physician and other relevant healthcare professionals. Finally, document all assessments, communications, and decisions thoroughly.

Scenario Analysis: This scenario presents a professional challenge due to the inherent conflict between a patient’s expressed wishes and a perceived need for intervention based on a provider’s clinical judgment, complicated by the potential for medication errors and the ethical imperative to respect patient autonomy while ensuring safety. The perianesthesia nurse must navigate the complexities of informed consent, medication administration, and the potential for adverse drug events in a time-sensitive environment. Correct Approach Analysis: The best professional practice involves a thorough, documented discussion with the patient regarding the prescribed medication, its purpose, potential benefits, and risks, including the specific side effects they are concerned about. This approach prioritizes informed consent and patient autonomy. It requires the nurse to actively listen to the patient’s concerns, assess their understanding, and address their fears directly. If the patient, after a comprehensive discussion and understanding of the risks and benefits, still refuses the medication, the nurse must document this refusal and the preceding discussion, and then consult with the prescribing provider to discuss alternative strategies or confirm the patient’s decision. This aligns with ethical principles of beneficence (acting in the patient’s best interest, which includes respecting their choices when they are informed) and autonomy, as well as regulatory requirements for patient rights and informed consent in medication management. Incorrect Approaches Analysis: One incorrect approach involves administering the medication despite the patient’s expressed concerns and refusal, relying solely on the provider’s order and the assumption that the patient is not fully informed or is being unreasonable. This violates the principle of patient autonomy and informed consent. It bypasses the nurse’s ethical and professional responsibility to ensure the patient understands and agrees to treatment, potentially leading to a breach of trust and a failure to uphold patient rights. Furthermore, administering medication against a patient’s expressed wishes, even if they are later deemed to have been mistaken, can have legal ramifications. Another incorrect approach is to dismiss the patient’s concerns as unfounded and proceed with administration without further discussion or documentation. This demonstrates a lack of empathy and a failure to engage in a therapeutic communication process. It neglects the nurse’s duty to assess the patient’s understanding and address their fears, which is a critical component of safe medication administration and patient advocacy. This approach also fails to identify potential underlying reasons for the patient’s reluctance, which might be related to past negative experiences or misinformation. A further incorrect approach is to immediately contact the provider to override the patient’s refusal without first attempting to understand and address the patient’s concerns directly. While collaboration with the provider is essential, the nurse’s initial role is to engage with the patient, gather information, and facilitate informed decision-making. Escalating without this initial patient-centered engagement can undermine the patient’s sense of agency and may not resolve the underlying issue. It also misses an opportunity for the nurse to act as a patient advocate and educator. Professional Reasoning: Professionals should employ a decision-making framework that begins with patient-centered communication. This involves active listening to understand the patient’s perspective, assessing their knowledge and concerns, and providing clear, understandable information about the medication. If concerns persist, the nurse should explore them further, offering reassurance or clarification as appropriate. Collaboration with the prescribing provider is crucial, but it should be informed by the nurse’s direct interaction with the patient and their assessment of the situation. Documentation of all discussions, assessments, and decisions is paramount to ensure accountability and continuity of care.

This scenario presents a professional challenge due to the inherent tension between patient privacy, the need for accurate and timely clinical documentation, and the legal and ethical obligations surrounding electronic health records (EHRs). The perianesthesia nurse must navigate these complexities while ensuring patient safety and compliance with regulatory frameworks. Careful judgment is required to balance the immediate need for information with the long-term implications of data integrity and patient confidentiality. The best professional approach involves meticulously documenting all relevant patient information directly into the EHR system at the earliest opportunity, adhering to established institutional policies and procedures for charting. This approach is correct because it ensures that all clinical data is captured in a secure, auditable, and accessible format, which is a fundamental requirement of regulatory compliance (e.g., HIPAA in the US, or equivalent data protection laws in other jurisdictions). Accurate and timely documentation is crucial for continuity of care, patient safety, and legal defensibility. It also supports quality improvement initiatives and research, provided patient identifiers are appropriately managed. Ethical considerations of patient autonomy and the right to privacy are upheld by ensuring documentation is accurate, complete, and only accessible to authorized personnel. An incorrect approach would be to rely on informal notes or verbal communication to convey critical patient information to the next shift without immediately entering it into the EHR. This fails to meet regulatory requirements for comprehensive and permanent record-keeping. Such informal methods are not auditable, can lead to information loss or misinterpretation, and create significant risks for patient safety and legal liability. It also violates the principle of data integrity, as the official record remains incomplete. Another incorrect approach would be to delegate the charting of critical events to another team member without direct oversight or verification. While teamwork is essential, the nurse who witnessed or managed the event is ultimately responsible for its accurate documentation. Delegating this responsibility without ensuring its proper execution can lead to omissions, inaccuracies, and a breakdown in accountability, contravening regulatory expectations for individual professional responsibility in record-keeping. A further incorrect approach would be to delay documentation until the end of the shift, especially for critical events. This practice increases the risk of memory lapses, inaccuracies, and incomplete information. Regulatory bodies emphasize the importance of contemporaneous charting, meaning documentation should occur as close to the event as possible to ensure accuracy and completeness, thereby safeguarding patient care and legal compliance. Professionals should employ a decision-making framework that prioritizes patient safety and regulatory compliance. This involves understanding the specific documentation requirements of their practice setting and relevant regulations. When faced with time constraints, nurses should focus on documenting critical information first, even if it means a brief delay in less urgent charting. They should also be proactive in seeking clarification on documentation standards and utilizing available technological tools to facilitate accurate and timely record-keeping. A commitment to continuous learning regarding informatics and regulatory updates is essential for maintaining best practices.

This scenario presents a professional challenge due to the conflict between a patient’s expressed wishes and the perceived best interests of the patient, complicated by the patient’s diminished capacity. The perianesthesia nurse must navigate ethical principles of autonomy, beneficence, non-maleficence, and justice, while adhering to professional standards of care and legal requirements regarding informed consent and patient advocacy. The nurse’s role is to protect the patient’s rights and well-being, even when the patient’s decision-making capacity is compromised. The best approach involves a thorough assessment of the patient’s capacity to understand their situation and make decisions, followed by a collaborative discussion with the patient, their family or designated surrogate, and the surgical team. This approach prioritizes respecting the patient’s autonomy to the greatest extent possible while ensuring their safety and well-being. It involves seeking clarification on the patient’s understanding of the procedure, risks, benefits, and alternatives, and documenting this assessment meticulously. If capacity is found to be significantly impaired, the focus shifts to involving the appropriate surrogate decision-maker, guided by the patient’s known wishes or best interests, and ensuring the decision aligns with ethical and legal standards. This aligns with the ethical imperative to advocate for the patient and uphold their rights, even when their capacity is in question. An approach that proceeds with the surgery without a comprehensive capacity assessment and without involving the patient’s family or surrogate, despite concerns about their understanding, fails to uphold the principle of beneficence and potentially violates the patient’s right to informed consent. This could lead to harm if the patient did not truly understand the implications of the procedure. Another unacceptable approach is to unilaterally override the patient’s expressed wishes based solely on the nurse’s or family’s perception of what is “best,” without a formal capacity assessment or a structured process for surrogate decision-making. This disregards the patient’s autonomy and can lead to ethical breaches and legal challenges. Proceeding with the surgery based on a presumed understanding without confirming it through direct assessment and discussion with the patient and relevant parties is also professionally unsound. It bypasses crucial steps in ensuring patient safety and ethical care, potentially leading to a situation where the patient’s consent is not truly informed. Professionals should employ a structured decision-making process that begins with assessing the patient’s capacity to make informed decisions. This involves evaluating their ability to understand information, appreciate the situation and its consequences, reason through options, and communicate a choice. If capacity is questionable, the next step is to involve the patient’s family or designated surrogate, ensuring they are informed and that decisions are made in accordance with the patient’s known wishes or best interests. Collaboration with the interdisciplinary team, including physicians, is essential to ensure a comprehensive and ethical plan of care. Documentation of all assessments, discussions, and decisions is paramount.

This scenario presents a professionally challenging situation due to the inherent conflict between patient autonomy, the nurse’s ethical duty to advocate for the patient’s well-being, and the practical limitations of healthcare systems. The patient’s desire for privacy and control over their health information, coupled with their vulnerability due to their medical condition, necessitates careful navigation of ethical principles and professional responsibilities. The nurse must balance the patient’s right to self-determination with the need to ensure continuity of care and prevent potential harm. The best professional approach involves respecting the patient’s expressed wishes while actively seeking to understand the underlying reasons for their reluctance and exploring alternative solutions that uphold their autonomy and ensure their safety. This includes engaging in open and empathetic communication, educating the patient about the importance of information sharing for their care, and collaboratively developing a plan that addresses their concerns. This approach aligns with the ethical principles of beneficence (acting in the patient’s best interest), non-maleficence (avoiding harm), and respect for autonomy. It also reflects the perianesthesia nurse’s role in patient education and advocacy, ensuring that the patient is an active participant in their care plan and that their preferences are honored to the greatest extent possible within safe and ethical boundaries. Failing to adequately explore the patient’s concerns and immediately proceeding with information sharing without further discussion represents a failure to uphold the principle of autonomy. While the intention might be to ensure comprehensive care, it bypasses the patient’s right to be informed and to make decisions about their own health information. This could erode trust and lead to patient dissatisfaction or non-adherence to future care recommendations. Another incorrect approach would be to dismiss the patient’s concerns as unfounded and proceed with sharing information without attempting to understand their perspective or offer reassurance. This demonstrates a lack of empathy and disrespect for the patient’s feelings and potential anxieties, violating the ethical principle of respect for persons. It also neglects the educational component of perianesthesia nursing, which includes addressing patient fears and misconceptions. Finally, abandoning the attempt to gather necessary information and simply documenting the patient’s refusal without further intervention or escalation would be professionally unacceptable. While respecting the patient’s immediate refusal, this approach fails to ensure continuity of care and could inadvertently lead to adverse outcomes if critical information is withheld from the healthcare team. It neglects the nurse’s responsibility to advocate for the patient’s safety and well-being by ensuring all relevant parties have the information needed to provide optimal care. Professionals should employ a decision-making framework that prioritizes open communication, active listening, and collaborative problem-solving. This involves assessing the situation, identifying ethical principles at play, exploring all available options, considering potential consequences, and consulting with colleagues or supervisors when necessary. The goal is to find a solution that respects patient autonomy while ensuring safe and effective care.