Nurses have a professional duty and legal obligation to provide ethical nursing care. There may be situations of contrasting values and beliefs between the client and the nurse about what actions are beneficial or harmful, which leads to an ethical dilemma. An ethical dilemma that challenges two or more values, “values that support diverging courses of action” and weighs individual judgment (CNO, 2009, p.5). The solution to the ethical dilemma often leads to dissatisfy either one or both ends of the nurse-client relationship. Regardless of the solution, the primary goal is to improve resident’s well being. As a nursing student, she should collaborate with experienced nurses; seek knowledge and guidance on how to handle an ethical dilemma. …show more content…
24). “Nurses must be committed to building trusting relations as the foundation of meaningful communication recognizing that this takes effort. Such relationships are critical to ensure that a person’s choice is understood, expressed and advocated” (CNA, 2006, p. 11). A nurse recognizes, respects and promotes the individual’s right to make decisions; they do not force or misuse their professional power to influence client’s decision-making. “In most situations, an ethical practice includes respecting the client’s autonomy even if the nurse does not agree with the client’s decision” (CNA, 2006, p. 5). There are circumstances that nurses will have to disobey agency policies in order to achieve the best interest of the clients. Some people might want to argue about the legal issue of negligence for not providing the care to the resident. The nurse is to be accountable for not following facility policy, though there are some situations where charting that ‘care was offered but the resident refused’ is the safest action. Refusing care is part of the resident’s right for autonomy and likely the best option for their …show more content…
Dementia patients are often assumed to be incapable of decision-making, a stigma associated with mental health. The resident has mild dementia; it is helpful for dementia patients’ feelings to be validated. Nurses should be conscious of how to approach the resident, ask in an empathic manner and reflect it through body movements, change the timing of the approach and offer other options. It is the facility’s policy for the residents to bathe daily, if the resident was asked in the morning, attempt to ask some other time throughout the day. Asking the resident after breakfast when they have already eaten, possibly in a much better mood can make an amicable difference in the resident’s choices of action. As the student nurse, ask if the resident is comfortable with her providing the care or if the resident prefers a male care provider. Formulate an effective communication to the resident who has mild dementia by moving and speaking calmly, no rush, no arguing, provide simple explanations or instructions, ask a yes or no question, be aware of their facial expressions, make eye contact, and express affection by smiling or by holding their hand (Alzheimer’s Association, 2016, p.
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
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.
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.
Dierckx De Casterle B., Izumi S., and Godfrey N. S. & Denhaerynck K. "Nurses' responses to ethical dilemmas in nursing practice: meta-analysis." Journal of Advanced Nursing (2008): 540-549.
Ethics has been a popular topic in nursing for a long time. Nurses are expected to demonstrate ethical decision-making as well as professionalism. I believe that in order to accomplish this, they need to use the ANA Code of Ethics as framework for their decision-making. It is also imperative for nurses to have a strong understanding of ethics, because they will be faced with many difficult ethical decisions that do not always have a straightforward solution.
Nursing ethics has a vast spectrum of subjects. The history of ethics was around way longer then the declaration of specific ethical issues. According to Fox, Myers and Pearlman (2007), the field of ethics consultation has been developing over the last three decades, (Kosnick 1974; Rosner 1985). Ethics has become an organized and accepted division of healthcare services. Gallagher (2010), discussed the purpose of nursing ethics is to help us think, speak and perform better in our practice. The Nursing Code of Ethics was addressed by Lachman (2009). “Futile care” is discussed by Sibbald, Downar, Hawryluck (2007). Ball (2009) addressed the need for clarification of DNR orders in surgery patients.
I chose to go into nursing because I had taken a sports medicine class in high school I enjoyed, and I thought I would be guaranteed a job graduating that had something to do with medicine. I can remember being so excited to learn how about illnesses and medications, and all the difference procedures done in the hospital. At the time I thought a nurse’s job was to do what the physicians said, and I expected set guidelines that would tell me what I was and wasn’t allowed to do. I had no idea that I was entering onto a career path involving so much complexity, and that the skills I had dreamed of learning were such a small part of nursing in comparison to the emotional, decision making, and critical thinking skills that a nursing career requires. Ethics in nursing was not something that had ever crossed my mind when I chose to take this path, however now ethics is something that I think about every day I am practicing, whether in clinical or theory courses. Ethical theories often come from the idea that because we are human we have the obligation to care about other’s best interests (Kozier et al., 2010), however in nursing ethical practice is not just a personal choice but a professional responsibility.
The author as a healthcare assistant working in the nursing home will present a scenario of Mrs. Keller (not her real name) who is confined in the dementia u...
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.
Berman, A. J and Burke, K. (2000), looked at nursing ethics as an integral part of nursing, that has t has to do with moral principles and values that guide nurses to make decisions and choices that lead to quality and effective client care. In providing nursing care, nurses find themselves in situations where sensitive decisions are made about the best way to treat illness and solve healthcare problems. Values influence decisions and actions and value clarification promote quality decisions by fostering awareness,
Davis J. Anne Diane Marsha and Aroskar A. Mila (2010). Ethical Dilemmas and Nursing Practice. Pearson
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).
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
The four fundamental nursing responsibilities of promoting health, preventing illness, optimizing health and alleviating the ill are represented in the code of ethics. (Arnold & Boggs, 2016) One can say that the code of ethics are rules that a nurse needs to follow in order to effectively communicate and protect the patients. The American Nurse Association provided the code of ethics to guide nurses to ensure that patient’s care, safety, rights and health are well cared for and well managed. Models like Utilitarian, deontological, and the human rights-based all contribute in answering dilemmas that can arise with a patient. Thus, explaining what some of the code of ethics are, and how the code of ethics influence our responsibilities as a nurse will impact the overall care of the
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