How should a nurse handle a conflict between a patient’s wishes and family demands during planning?

How should a nurse handle a conflict between a patient’s wishes and family demands during planning?

• A. Always defer to family wishes to avoid conflict.
• B. Respect patient autonomy, involve the patient in decisions, and when capacity is lacking, use surrogate decision-makers per policy; document.
• C. Document only after care plan is implemented.
• D. Ignore patient preferences if family requests different plan.

Answer: (B)

When planning care, the nurse’s priority is to honor the patient’s right to participate in decisions about their own health. Start by involving the patient directly, clarifying their goals, values, and preferences, and ensuring they understand the options. If the patient has decision-making capacity, their wishes should guide the plan, even if family disagrees. When capacity is lacking, follow established policies to appoint a surrogate decision-maker and apply the patient’s known wishes or best interests as appropriate. Throughout the process, document all discussions, decisions, and the rationale to ensure transparency and accountability. Deferring entirely to family or ignoring the patient’s preferences undermines autonomy and ethical standards. Documentation should occur as decisions are made, not only after the plan is implemented, to support informed consent and legal/ethical compliance.

When planning care, the nurse’s priority is to honor the patient’s right to participate in decisions about their own health. Start by involving the patient directly, clarifying their goals, values, and preferences, and ensuring they understand the options. If the patient has decision-making capacity, their wishes should guide the plan, even if family disagrees. When capacity is lacking, follow established policies to appoint a surrogate decision-maker and apply the patient’s known wishes or best interests as appropriate. Throughout the process, document all discussions, decisions, and the rationale to ensure transparency and accountability.

Deferring entirely to family or ignoring the patient’s preferences undermines autonomy and ethical standards. Documentation should occur as decisions are made, not only after the plan is implemented, to support informed consent and legal/ethical compliance.