Medical professionals are routinely confronted with ethical situations. Dilemmas occur when a decision between two undesirable choices has to be made. Yet, the presented options do not yield to be the perfect solution due to the possible unwarranted consequences. The purpose of this paper is to show the audience the ethical dilemma that this nurse has seen in her practice.
Ethical Narrative
Short staff in nursing is a never-ending concern that can be found in any hospital level, may it be in a community hospital or in a teaching medical center. In University of Chicago’s transplant unit, the burden of work load is felt by the staff nurses. This unit re-opened about a year and a half ago with most of its staff consisting of new graduate nurses. The care delivery design of this unit is promoting primary care delivery, where registered nurses directly provide all levels of care, from toileting needs to passing medications (Duffield, Roche, Diers, Catling-Paull, & Blay, 2010, p. 2243)
According to Kantian ethical philosophy (2014), actions are warranted to be ethical if the right motive is proposed (Pence, 2014 p. 11). In this situation, the intention of the staff is to tell the truth about the lack of human resources in the unit. Ensuring optimal number of nurses per shift, allows safe nursing ratio to certify that delivery of quality care is not compromised. Furthermore, American Nurses Association is a governing nursing body that upholds the ethical nursing standards. One of its ethical code provisions is the nurse’s responsibility of promoting patient safety (American Nurses Association, 2015). A feature of quality nursing care is when errors are prevented, such as zero falls or lack of inaccurate medication administration. Integrity of the profession is preserved if ideal number of staff were available, because the health care providers are not in a rush to assess, pass treatments, and
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
How would the code of ethic for nurses advise nurses in the moral issue of heavy workload of nurses and staffing difficulties? American Nurses Association (ANA) established the code for nurses as all members of the profession would adhere to the same moral and ethical standards. As I exam this first moral issue that nurses face I looked at the foundation of the code which is built on autonomy ANA defines “Autonomy as agreement to respect another’s right to self-determine a course of action; support of independent decision making.” Second “Beneficence meaning compassion; taking positive action to help other; desire to do good; core principle of our patient advocacy.” Third is “Nonmaleficence defines as avoidance of harm or hurt; core of medical oath a nursing ethics” Now that we have the basic of the codes next I looked at Provision 3. Provision 3. The nurse promotes, advocates for, and strives to protect the health, safety and rights of the patient (ANA, 2001, p. 12). As stated above staffing difficulties leads to heavier
Karen is a post visit register nurse (PVRN) at Cincinnati Children’s Medical Center (CCMC). She has been an employee at CCMC for nine years but has only had this position for about four years. PVRN’s are responsible for following up on any positive culture results to make sure the patient is on an appropriate treatment plan. If they are not receiving the correct treatment, the PVRN must contact the doctor to get orders for the necessary medications and educate the family of the updated treatment plan. PVRNs also make follow up calls to patients who have been seen in the Emergency Department (ED) within the last 24 hours. During these calls, they make sure the discharge plan has been implemented and any follow up care is arranged.
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.
Through centuries nurses were given the title “Caregivers”. Unlike some doctors, nurses actually care for their patients, not necessarily saying doctors do not; they both just have a different way of caring. Yes, doctors cure illnesses, but nurses are just as important because they help with the healing process. Most nurses can have the same exact education or knowledge as a medical physician but the only thing individuals see is a name tag with either the acronym CNA, LPN, R.N. and PH.D. Of course PH.D will get all the credit, seeing as how nurses do not exactly diagnose patients. A nurse could just become a doctor but there are different aspects of each title. Nurses take instructions from a higher administrator, which is sometimes a doctor. What needs to be known is doctors are not the only ones that stress and have rules to abide by. Nurses have ethical codes, daily ethical dilemmas, morals, and ridiculous distress, but some of these examples differ with country, state, and hospital. If nurses are capable, then they should be given the opportunity to make medical decisions or diagnosis in critical situations.
...care. It is not easy to prevent unjust practice in health care facilities, because each individual deal with each circumstances differently. All we can do is continuously teach nurses that the patient come first and our job is to advocate for client’s right to autonomy, respect, privacy, confidentiality, dignity, and access to appropriate information. Practice in accordance with the Nursing Profession Act and its regulations and bylaws, the Canadian Nurses Association (CNA) Code of Ethics, principles, statements, guidelines or documents. Nurse most also responds to and reports to appropriate person, when there is a situation, which may be adverse for clients or health care providers, including, incompetence, misconduct and incapacity. In conclusion, you should act as and role model for student nurses, colleagues and others, by doing the ethical thing.
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.
Planning included reaching out to other health organizations, objectives, and goals of health fair were established. The implementation includes getting volunteers, set up for the health fair. The evaluation of the process occurred throughout the implementation and changes were made as needed. The evaluation will be completed by gathering information from health booth to determine the number of participants. Review vendor and participant evaluations about the health fair including how they heard about the health fair, ratings of booths and suggestions for improvements. Record everything to determine changes. Reflection on past experiences and what worked and did not work.
According to American Nurses Association (ANA), (2010) “the nurse promotes, advocates for and strives to protect the heath, safety and right of the patient” (p. 6). Nursing responsibilities should be acted at the highest standard and must be based on legal and ethical obligations.
Ethical dilemmas are the issues that nurses have to encounter everyday regardless of where their workplaces are. These problems significantly impact both health care providers and patients. Patient safety is the most priority in nursing and it can be jeopardized by a slight mistake. Medication errors and reporting medication errors have been major problems in health care. Errors with medications have been found to be the most common cause of adverse drug effects (Brady, Malone, Fleming, 2009). Northwestern Memorial Hospital in Chicago conducted a research in 2012 that approximately forty percent of the hospitalized clients have encountered a medication error (Lahue et al., 2012). A nurse’s role is to identify and report these medication errors immediately in order to stop or minimize any possible harm to the patients. Ethical moral dilemmas arise when reporting the mistakes that have been made by one’s own colleagues, acquaintances, peers, or physicians.
An ethical dilemma is defined as a mental state when the nurse has to make a choice between the options and choices that he or she has at her disposal. The choice is a crucial task as the opting of the step will subsequently determine the health status of the concerned patient, hence it requires a great deal of wisdom along with proper medical and health training before any such step is opted as it is a matter of life and death. Strong emphasis should therefore be on the acquisition of proper knowledge and skills so that nurses do posses the autonomy to interact with patients regarding ethical issues involved in health care affairs and address them efficiently. It is normally argued that nurses are not provided sufficient authority to consult and address their patients on a more communicative or interactive level as a result of which they are often trapped in predicaments where their treatments of action and their personal beliefs create a conflict with the health interests of the patient. (Timby, 2008)
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).
The word ethics is derived from the Greek word ethos, which means character (1). Being moral always fills a nurse with morals respects, guidelines of good judgment and expert lead. There are three essential obligations for nurses, among many other which are the duty of autonomy, confidentiality, and obligation of care to all patients (2). There are professional duties with becoming distinctly legitimate obligations if any law and policies are ruptured in between professional practice. In 2001, a review found that there was an apparent requirement for more guidance on moral predicaments inside the medical professionals, subsequent to expanding legal cases and open request (3). Medical attendants ought to withstand to regulatory law and statutory law while managing the nursing practice.
Another huge ethical topic is the patient’s right to choose autonomy in the refusal of life-saving medicine or treatment. This issue affects a nurse’s standards of care and code of ethics. “The nurse owes the patient a duty of care and must act in accordance with this duty at all times, by respecting and supporting the patient’s right to accept or decline treatment” (Volinsky). In order for a patient to be able make these types of decisions they must first be deemed competent. While the choice of patient’s to refuse life-saving treatment may go against nursing ethical codes and beliefs to attempt and coerce them to get treatment is trespass and would conclude in legal action. “….then refusal of these interventions may be regarded as inappropriate, but in the case of a patient with capacity, the patient must have the ultimate authority to decide” (Volinsky). While my values of the worth of life and importance of action may be different than others, as a nurse I have to learn to set that aside and follow all codes of ethics whether I have a dilemma with them or not. Sometimes with ethics there is no right or wrong, but as a nurse we have to figure out where to draw the line in some cases.
Thousands of nurses throughout the nation are exhausted and overwhelmed due to their heavy workload. The administrators do not staff the units properly; therefore, they give each nurse more patients to care for to compensate for the lack of staff. There are several reasons to why