Page 548 - alligood 8th edition_Neat

CHAPTER 26 Gladys L. Husted and James H. Husted 529

ethical and does not become prescriptive. This is par- students. The broad applicability for Symphonology
ticularly important when considering making deci- makes it an excellent framework for nursing curri-
sions for those who can no longer make decision for cula. Beginning students can easily grasp and apply
themselves (Gropelli, 2005). Often clinical emergency the theoretical concepts. Using this theory as a basis
patients are unable to participate in decision making. for nursing interactions directs the student in ethical
Symphonology offers a method of ensuring that ethical practice from the beginning of learning nursing prac-
conclusion and actions are based on the best interests tice. The concept of context can be used as the basis
of the individual (Fedorka & Husted, 2004). for assessment. The bioethical standards direct the
Offering culturally sensitive care is increasingly im- student in choosing appropriate approaches, timing,
portant as our health care systems change in response to and type of interventions for each patient. Because
a global society (Wehbe-Alamah, 2008; Zoucha & of the holistic approach and central concern for the
Broome, 2008; Chenowethm, Jeon, Goff, et al., 2006). patient, Symphonology can be incorporated easily
Although cultural factors can be helpful in directing into existing nursing curricula.
care for a patient, nurses must also consider the indi- Brown (2001a) addressed the importance of ethi-
vidual’s personal commitment to the traditions and cal interaction between nurse educator and student.
beliefs of his culture. In this way, the nurse provides The agreement in this case is more explicit, because
care for the patient rather than the culture (Zoucha & both parties are more aware of the commitments and
Husted, 2000). Using the Husted model, care is directed responsibilities. Recognizing the bioethical standards
within the context of the individual’s circumstances. in both the educator and the student serves to direct
Imposition of a false context, cultural or otherwise, is ethical actions between them. Above all, the educator
avoided. and student recall that the educator-student-patient
Brown (2001b) advocated the use of Symphonology agreement is central to the learning process.
Theory to direct discussion and education of patients Steckler (1998) agreed with Brown’s application
regarding advance directives. Bioethical standards are of Symphonology in the educational process and rec-
used to guide discussion about what types of treatment ommended incorporating the theory in continuing
an individual would or would not want, given particu- education. The Husted model not only identifies and
lar circumstances. Hardt (2004) has proposed an inter- organizes professional values and ethical principles for
vention for nurses in ethical dilemmas. learners, but it helps the educator to develop a consis-
The emergence of health care teams as a method of tent professional ethical orientation. Cutilli (2009)
delivering comprehensive care brings many disciplines utilized case study applications with the Symphonologi-
together to serve patients’ needs. Overlapping roles and cal Theory approach to patient and family education.
disparate goals can cause confusion among team mem-
bers. Symphonological theory, with its patient-centered Administration
focus, can serve as common ground to initiate and Health care administrators make decisions at several
promote collaboration among health care professionals levels. They have a responsibility to the community at
of all disciplines. large and the financial viability of the institution within
Symphonology can be applied to all caring disci- the community, the employees, and those receiving
plines. Khechane (2008) developed a model for pastoral care. Hardt (2004) described how administrators use
care practice based on Symphonology. Using the deci- the principles of Symphonology to guide their decision
sion-making model, pastoral care practitioners provide making to produce ethically justifiable outcomes.
for the relief of suffering using the bioethical standards. With regard to issues at the community and insti-
tutional levels, one considers the needed services
Education provided by the institution. In cases in which the ser-
As Symphonology is disseminated, it is easy to inte- vices needed would not be feasible for the institution,
grate it into nursing education. More and more ethics resources within the community can be shared
is addressed throughout nursing curricula rather than and supported by the institution so that needed ser-
as a separate topic, particularly for advanced nursing vices are available with the least amount of loss to the