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Interprofessional collaboration in healthcare
Ethical dilemma analysis
Ethical dilemma analysis
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Every day nurses face ethical dilemmas. Ethical dilemmas allow nurses to learn more about themselves and help shape their morals and values. The article “In the name of good intentions: nurses’ perspectives on caring for a pregnant patient in a persistent vegetative state” discusses a case from admission to discharge involving a twenty-two-year-old pregnant patient, Judy, with an anoxic brain injury due to a heroin overdose and the nurses’ accounts of how they felt during the client’s hospital stay.
Judy was found unconscious by her boyfriend, but the amount of downtime was unknown. It was reported that CPR had been performed by a bystander and when medics arrived the patient was in sinus tachycardia. The patient was transported to the emergency department with a history of alcohol abuse, depression, and a previous attempt of suicide. It was determined she was eleven week pregnant, and there was a fetal heart tone and fetal movement. Although there was no bleeding or mass of the head, the patient experienced decerebrate posturing and had an upward gaze. The patient was transferred to the medical intensive care unit with an endotracheal tube.
Multidisciplinary meetings were held every three months while the patient was hospitalized. Judy’s team included critical care nurses, obstetrics and gynecology specialists, neurologists, and chaplain. Palliative care was also initiated. An ethics meeting was held early in the admission with the patient’s parents and grandparents to discuss the severity of the patient’s condition and to determine the appropriate plan of care for both the patient and her unborn fetus. A plan of aggressive treatment was determined. The parents, despite stating they fully understood the prognosis ...
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... in the best interest for the patient.
In an effort to better prepare nurses for ethical dilemmas education should be provided. Nurses need continuing education on this topic and should continuously review and discuss cases involving ethical dilemmas such as the case presented in this article. I also believe that future research should be conducted to study the effects of ethical dilemmas on nurses in order to better help nurses deal with those issues effectively.
Works Cited
Abazzia, C., Adamo, F., Gill, B., Morrison, R., Volpe, K., & Prata, J. (2010). In the name of good intentions: nurses’ perspectives on caring for a pregnant patient in a persistent vegetative state. Critical Care Nurse, 30(1), 40-46. Retrieved January 16, 2012 from http://cgez.waynecc.edu:2176/ehost/pdfviewer/pdfviewer?sid=d0433f30-4bbd-414a-a60b-90bbfd378cf0@sessionmgr114&vid=6&hid=121.
Deontology is an ethical theory concerned with duties and rights. The founder of deontological ethics was a German philosopher named Immanuel Kant. Kant’s deontological perspective implies people are sensitive to moral duties that require or prohibit certain behaviors, irrespective of the consequences (Tanner, Medin, & Iliev, 2008). The main focus of deontology is duty: deontology is derived from the Greek word deon, meaning duty. A duty is morally mandated action, for instance, the duty never to lie and always to keep your word. Based on Kant, even when individuals do not want to act on duty they are ethically obligated to do so (Rich, 2008).
They were part of the healthcare team and went along with the beliefs of their team. The team should have directly included the patient and parents. I cannot help but wonder if this legal battle would never have taken place had an ethics committee been assigned to this case. Ethics committees provide structure and guidelines for potential problems, serve as an open forum for discussion, and function as a true patient advocate by placing the patient at the core of the committee discussions (Guido,
In 1983, Nancy Beth Cruzan lapsed into an irreversible coma from an auto accident in Jasper County, Missouri. Cruzan was discovered lying face down in a ditch without detectable respiratory or cardiac function. Paramedics were able to restore her breathing and heartbeat at the accident site, and she was transported to a hospital in an unconscious state. An attending neurosurgeon diagnosed her as having sustained cerebral injuries combined with significant lack of oxygen. The estimated length of the period without oxygen was twelve to fourteen minutes. (Permanent brain damage generally results after six minutes without oxygen.) After the accident Nancy was not breathing on her own and was connected to a machine, five days later she was breathing on her own and the respirator was disconnected. She remained in a coma for approximately three weeks and then progressed to an unconscious state in which she was able to orally ingest some nutrition. She was moved out of ICU into a private room where the family tried on a daily basis to get a response. In order to ease feeding and further the recovery, surgeons implanted a gastrostomy feeding and hydration tube in Cruzan with the consent of her then husband. Nancy's parents Joe (Lester) and Joyce stayed at the hospital around the clock sleeping on couches and chairs. Her sister Chris visited as much as she could while her two daughters Miranda and Angie were in school. Nancy and Chris were be...
This allows the nurse to assess the patient’s pain and suffering related to the treatment plan in place (Settle, 2014). The ability to communicate well is essential for ethical decision making in the NICU (Monterosso et al., 2005). Nurses play a big role in supporting the parents while their child is in the NICU. Showing compassion and demonstrating caring actions when caring for the patient makes it more likely that the parents will trust the nurse and the information the nurse gives them regarding their child’s condition. This trust is important as it helps the parents feel confident in the decisions they are making about their child’s care. When the parents of an ill child in the NICU have decided to terminate treatment palliative care by the nurse and other healthcare providers comes into play. Palliative care is keeping the child comfortable by treating the symptoms and being there for the parents and child physically, emotionally, and spiritually (Eden & Callister, 2010). The patient and family should be placed in a private room that is dimly lit and has minimal noise. There should be enough room to accommodate other family members as well. All unnecessary medical equipment such as ventilators and monitors should be removed from the patient. IV access should remain in place to give adequate medication for pain. Supplemental
Patient A.B. was a 26 year old female who had delivered her baby girl at 0502, approximately two hours before I assumed care of the patient with my preceptor. This was her third pregnancy and all were a cesarean delivery. Gestational age at time of delivery was forty weeks and one day. Mom was group B strep negative and required no antibiotics, blood loss was approximately 400ml and baby had Apgar score of eight and nine. The patient had a very detailed birth plan which included some details such as; staying with her baby, breastfeeding, and providing
In the medical profession, doctors and nurses run into ethical dilemmas every day whether it be a mother who wants to abort her baby or a patient who has decided they want to stop cancer treatment. It is important for the nurse to know where they stand with their own moral code, but to make sure they are not being biased when educating the patient. Nurses are patient advocates, it is in the job description, so although the nurse may not agree with the patient on their decisions, the nurse to needs to advocate for the patient regardless.
During week 4, we became familiar with the application of ethics in the nursing practice settings. We learned about ethical theories and principles, which are crucial when practicing in any clinical settings during ethical decision-making and while facing one or multiple ethical dilemmas. Also, we were introduced to the MORAL model used in ethical decision – making progress. The MORAL model is the easiest model to use in the everyday clinical practice, for instance at bedside nursing. This model can be applyed in any clinical settings and its acronyms assist
Define a critical thinking task that your staff does frequently (Examples: treat high blood sugar, address low blood pressure, pain management, treating fever etc.). Create a concept map or flow chart of the critical thinking process nurses should take to determining the correct intervention. Include how much autonomy a nurse should have to apply personal wisdom to the process. If the critical thinking process was automated list two instances where a nurse may use “wisdom” to override the automated outcome suggested. Note the risks and benefits of using clinical decision making systems.
In the past there has not been an incredible amount of research done on the moral distress of neonatal nurses, but as Kain (2006) pointed out, the research that has been done has been conducted in the form of qualitative studies including surveys and interviews (p. 247). It could be assumed that the everyday obligations a N...
This paper will focus on two BNUR leaner outcomes (University of Calgary, 2013) relevant to my learned understanding of nurses as ethical decision makers. I will outline the ways that I have seen ethics used and not used in practice, what I learned about ethics and its use in my theory courses and throughout my practicums, and I will reflect on how this understanding will translate into my professional practice moving forward.
Since ethical dilemmas are not always easily answered through the use of The Code of Ethics, ethical decision-making models are effective tools that can assist nurses in dealing with ethical issues. Ethical decision-making models provide a framework for working through difficult choices. They seek to define the limits of what is morally acceptable and help clarify the guidelines for making those difficult decisions. Ethical decision making models assist nurses in analyzing situations by focusing on understanding the patient needs, need for responsiveness to circumstantial considerations, and recognizing the uniqueness of each situation.
In critical and complicating medical cases, family members often find it tedious to decide as to what mode or procedure of treatment is idyllic for the recovery of their patient. In such cases, well-qualified and medically educated can play a pivotal role in deciding the kind of treatment that should be given to the patient to enhance its recovery. In a contrary situation a nurse may know that administering a particular drug may improve the patient’s condition, but may be refrained from conducting the required action due to doctor’s absence or non-permission. There are numerous cases through which ethical dilemmas in the profession of nursing can be discussed. Nurses in order to remain within the defined boundaries ...
Neonatal resuscitation is intervention after a baby is born to strengthen it’s breathe or to boost its heartbeat. Approximately 10% of neonates require some assistance to begin breathing at birth, but only 1% require serious resuscitative measures. Informed consent regarding neonatal resuscitation is a constant ethical debate. This discourse ordinarily occurs between doctors and parents; parents often feel that the decision has been made for them, believing that they were not fully informed of any consequences that may occur before making their final action plan, or thinking that their opinion was not taken seriously; however, doctors see the procedure in a different light, that the parents can’t choose the best option for the child regardless of counseling, or performing as the parents wished but believing that the result could have differed if the parents had known all the effects that it will have further down the line, or convinced that they would have made a better
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