Ethical Practice: Physical Restraints and Planned Parenthood
Nurses face ethical issues every day. Knowing how to spot them and respond appropriately to them is so important that it’s taught early on in nursing school and continues throughout the nurse’s career. Ethics is defined as “the discipline dealing with what is good and bad and with moral duty and obligation” (Merriam-Webster, 2017). What is “good” and “bad” have different meanings for some people. Because of this, several codes of ethics have been created as a general guideline for medical professionals. There are several different ethical dilemmas a nurse can face during his or her career. I am going to discuss two of those: physical restraints and planned parenthood.
Physical
While this is essentially true, there comes a point where the safety of the patient takes precedence. Some may even see it as the patient being treated like a prisoner. Restraints are currently only used as a last resort. If the patient is at a tremendous risk of harming themselves, restraints may be the only thing appropriate. When I think of physical restraints, the first thing that comes to mind is protecting a patient from falls. The use of restraints are for so much more than that. Think about the patient who is constantly trying to pull tubes out that are attached to them. What if the patient is pulling out a endotracheal tube or central line? This could cause problems that are fatal. What if a patient keeps messing with their sutures from a major surgery and the wound ends up dehiscing or becoming severely infected? There are so many different indications for restraints to protect
This could include keeping patient confidentiality, being trustworthy, keeping promises, and simply “doing what is right.” Every action a nurse performs should be done with fidelity. A confused patient may not trust a nurse after restraints were applied, so fidelity, in this case, may be strained.
Another topic that is currently trending as a major ethical dilemma is Planned Parenthood. There are many groups determined to shut the organization down. Planned parenthood describes themselves as the nation’s most trusted reproductive health care. They advertise that they provide vital reproductive health care, sex education, and vital information to millions around the world (Who We Are, 2017). Just reading their description, many would wonder why there is such a dilemma. The major ethical problem with them is that they perform
Nurses everywhere face problems and challenges in practice. Most of the challenges occur due to a struggle with the use of ethical principles in patient care. Ethical principles are “basic and obvious moral truths that guide deliberation and action,” (Burkhardt, Nathaniel, 2014). Ethical principles that are used in nursing practice include autonomy, beneficence, non-maleficence, veracity, confidentiality, justice, and fidelity. These challenges not only affect them, but the quality of care they provide as well. According to the article, some of the most frequently occurring and most stressful ethical issues were protecting patient rights, autonomy and informed consent to treatment, staffing problems, advanced care planning, and surrogate decision making (Ulrich et. al, 2013). The ethical issue of inadequate staffing conflicts with the principle of non-maleficence.
The first provision of the American Nurses Association’s (ANA) “Code of Ethics” states, “ The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.” The second provision states, “The nurse’s primary commitment is the patient, whether the patient is an individual, family, group, or community” (Fowler, 2010). As nurses we need to respect the autonomy and allow for the patient to express their choices and concerns. We also need to provide them with support by giving them knowledge and understanding so they
Every nurse will be faced with a decision making dilemma at some point in his or her career. Being familiar with the nursing code of ethics, what is ethically and morally expected in society and how to approach the situations can help make dilemmas less of a nightmare. “The purpose of nursing ethics is to inspire questions and examine what would be the ethically right action in health care situations demanding a choice between at least two undesirable alternatives” (Toren & Wagner, 2010, p. 394). There are many different ways one can approach a situation to reach a resolution, finding a method that works best with the situation at hand is ideal.
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.
This literature review is focusing on discussing the effects of seclusion and restraints on treatment consequences of patients in mental health area. Seclusion and Restraint are used for controlling the behavioral patterns of the mentally ill patients in different surroundings consisting of psychiatric management facilities and hospitals (Kentley, 2009). Over past decade, comprehensible consensus has come out that seclusion and restraints are secure interventions of last alternative and application of those interventions should and can be diminished significantly (Knight, 2011). However, recent studies indicated that it is traumatic for patients experiencing or witnessing restraint and seclusion traumatic; patients can feel high levels of anxiety, fear, and anger once aware that restraint is going to take place, sometimes it could resulting in an exacerbation of patient’s mental status (Stewart et al, 2010). Due to the humanitarian, ethical, and legal issues which could lead to, seclusion and restraints are known as the most controversial management strategies (Holmes, Kennedy & Perron, 2004). Previous studies and researches could not analyze this topic adequately; thus, further researches and studies related to the effects and risk managements of using seclusions and restrains will be discussed in below.
According to the American Nurses Association (ANA), (2010) “the nurse promotes, advocates for and strives to protect the health, safety and rights of the patient” (p. 6). Nursing responsibilities should be acted upon at the highest standard and must be based on legal and ethical obligations. Healthcare provider’s perception and judgment of the patient’s well being, as well as taking into account the rights of the patient in every action, is one of the key elements in nursing practice. International Council of Nurses (ICN) (2006) states “The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance public confidence” (p. 3).
Integrity is the “consistent regard for the highest standards of behavior and the refusal to violate personal and professional code.”(Professionalism initiative, 2012) Being held accountable for your actions and acting in the best interest for your patient is a vital professional nursing role. Possessing integrity is important; “studies show nurses top the list of the most trusted professionals…and ranked highest for honesty and ethics” (Pophal, 2013). Being considered among the most trusted professions is not a difficult task. It is accomplished by nurses who consistently follow this moral code and take responsibility for their achievements and mistakes.
Section 5.4, which is the preservation of integrity, suggests that nurses will inevitably have to deal with threats to their moral or professional integrity at some point in their careers. Nurses should do their best to maintain professional integrity when met with adversity, weather it be from uncooperative issuance companies, an unsound work environment, or from the patients themselves. When working in an unsound or unsafe work environment that violates law or the ANA code of ethics nurses must go through the proper channels to fix the problem. If a nurse feels that a procedure or treatment their patient is having conflicts with his or her own moral integrity and they cannot participate, the nurse must report they unwilling to tr...
Fidelity is following through with one’s commitments and keeping promises previously made (Yoder-Wise, 2015). These two go hand-in-hand and can significantly influence patient care. Ethical integrity is often the first sacrifice made when faced with an opportunity to rise to top. These ethical principles must not be sacrificed in my line of practice, as trust has to be established among the people I serve. An ethical leader exhibiting veracity stands firm and upholds their ethical integrity in all circumstances and situations. They are committed to telling the truth in all situations and doing the right thing. The ultimate demonstration of leadership is when a nurse’s ethical integrity stands out through demonstration of fidelity. These are the leaders who not only know the right thing to do, but who also put this into action (Holt & Convey,
In an article written by Samantha P. Ziglar, BSN, RN, she describes the main purpose of restraints through her eyes in the medical field. Ziglar states that at least one in every four patients will be restrained at least once, that’s 79.715 million people in the United States (Population). “Specific reasons include fall prevention, limiting wandering behavior and preventing dislodging or interference of therapeutic devices, and controlling violent or agitated behavior” (Ziglar 1). Ziglar emphasises the growing problem among restraints; improper use among nurses. “Patient safety should be every nurse’s top priority; therefore, nurses need to have a thorough knowledge base of the risks and benefits of using physical restraints” (1). As a result of what a nurse needs, restraints are required to succeed in his or her profession, making their patient as safe and comfortable as possible. The purpose of restraints as a whole is to provide patient protection. Ziglar lists the pros and cons of the use of restraints. Some major
In a health care profession, people look up to those providing care and need to establish a trusting relationship with them. Since nurses are at the forefront of care in a hospital, it is crucial for nurses to show and have integrity in the hospital setting. As nurses, we are the person that is in constant interaction with the patient and the last line before administering or doing any care to the patient. Nurses develop integrity in many ways, through given situations and the need to stand up for what is right for the patient. The core value of integrity can be used in the clinical setting now as sophomore students and throughout our time as a nurse. The core concept of integrity is holding true to what is right for the patient and providing the most beneficial care to the patient.
The American Nurses Association Code of Ethics for Nurses has five elements that pertain to the Principle of Autonomy. Each individual element applies to “respect individual persons” (Baillie, McGeehan, Garrett T, M., Garrett R. M., 2013, p.33). In Chapter 2 of the Health Care ethics: Principles and problems text, it discusses thouroghly the consent of an individual to make their own decisions regarding their health and future requests of care. As a nurse or within all heath care professions, we must treat each individual patient with care, respect, and to remain mindful to the patient regarding any aspect of their lives. In the ANA Code of Ethics for Nurses, it explains ways of maintaining the empathy required in the health field. It further discusses that the respect for human dignity must be a priority, relationships to patients must remain neutral, the severity of the situation, the right to self-rule, and the professionalism that must be upheld by the nurse and their associates.
The American Nurses Association created guidelines for the profession including, a set clear rules to be followed by individuals within the profession, Code of Ethics for Nurses. Written in 1893, by Lystra Gretter, and adopted by the ANA in 1926, The Code of Ethics for Nurses details the role metaethics, normative ethics, and applied ethics have within the field (ANA, 2015). Moral obligation for an individual differs within professions than it does within an individual’s personal life, so the code of ethics was written to establish rules within the profession. The moral obligation to provide quality care include the fundamental principles of respect for persons, integrity, autonomy, advocacy, accountability, beneficence, and non-maleficence. The document itself contains nine provisions with subtext, all of which cannot be addressed within this paper however, core principals related to the ethical responsibilities nurses have will be
In every nurse's career, he or she will face with legal and ethical dilemmas. One of the professional competencies for nursing states that nurses should "integrate knowledge of ethical and legal aspects of health care and professional values into nursing practice". It is important to know what types of dilemmas nurses may face
In conclusion, there are numerous legal and ethical issues apparent in the nursing practice. Nurses should study and be as informed as they can with ethics and legality within their field in order to ensure no mistakes occur. Ethical issues vary based on patient’s views, religion, and environment. Nurses are influenced by these same views, but most of the time they are not the same as the patients. As a nurse we must learn to put the care of our patients and their beliefs, rights, and wishes before our own personal