Discussion Questions on Nursing Ethics
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Question 1: Find and discuss your initial response to a news article involving a nursing concern.
Ethical care is the expected output for the nurses in their everyday job. In other words, the care should be good, correct and rational. Patients have the freedom of choice when it comes to their care, and it is the nurses duty to provide individualized care to them to ensure that they are at their maximum possible state of well-being. According to an article by Patricia Bratianu (2015), nurses are victims to the ethical dilemmas that they face every day in their profession. It is a nurses duty to provide the utmost care to the patient, and it is done following the six fundamental principles. They include autonomy, beneficence, non-maleficence, justice, veracity, and fidelity. Autonomy and self-determination are the key ethical principles that govern nursing where the patients choice or decision in care is given extensive consideration.
According to Patricia (2015), nurses face dilemmas because of this principle considering that they have to respect the patients decision concerning their care. It is their obligation not to harm their patients as dictated by the non-maleficence ethical principle. Regardless, the dilemmas may occur where the patient makes a decision that may lead to self-harm. For instance, an elderly patient may choose to walk without supervision from the Nurse (Burkhardt & Nathaniel, 2014). The nurses dilemma is that the ethical principles lead to a jam where the autonomy and self-determination principle conflicts with the non-maleficence principle. The former asserts that the nurse should respect a patients decision whereas the latter implies that she should do no harm. The fact that such dilemmas could result in the patients death indicates that some principles should be ignored to allow the patient to avoid death or worse fates.
2: Discuss the legal and ethical issues the nurse might have considered when this situation was presented.
As mentioned earlier, the nurse is a profession that is heavily influenced by ethics and ethical decisions. In order to ensure this, six fundamental principles allow nurses to make such decisions. They include nonmaleficence, veracity and autonomy (Kreimer, 2010). Non-maleficence declares that a nurse should do no harm to a patient whereas veracity implies that the nurse should always tell the truth. Autonomy refers to the nurses ability to respect the patients decision regarding his or her care. In the case of the ethical dilemma discussed above, the nurse has to consider the autonomy and non-maleficence principles from the six moral principles to make a decision. Regardless, it should be noted that a nurse is troubled with whether to allow the elderly patient to walk unsupervised even though it might lead to harm.
The Hippocratic Oath is one that nurse practitioners take which requires them to swear to several healing Greek gods that they will uphold the ethical standards that are needed to ensure the utmost care of the patients. The principles mentioned before are to be sustained by the nurse at all times he or she is providing care to the patients. The Hippocratic Oath is considered to be a rite of passage for health practitioners but at the same time serves as a basis of benchmarking ethical care. Regardless, the oath does not help to avert the dilemmas. If anything, things are only made worse. For instance, if the elderly man requesting to walk unsupervised is allowed to do so, the nurses career would be in danger considering that he or she might cause harm to his or her patient.
3: Discuss the implication on healthcare policy
The primary goal of any health facility is to provide the best care for its patients. As such, the manpower that is selected to fulfill this need is usually trained on means to ensure that the patient is properly taken care of. Among the health strategies that exist, ethical nursing has proven to make sure that the patients are provided with the best care that conforms to their desires (autonomy). Healthcare policy refers to the plans, decisions, and actions undertaken by the society to meet set healthcare goals. Ethical dilemmas impact heavily on healthcare policies (Iley, 2004). The society asserts that nursing care provided to patients should be proper and unrestrained. However, such dilemmas that nurses find themselves in during their work inhibits policies aimed to improve healthcare. The nurse should not allow an elderly patient to roam unsupervised, but because the patients decision should be respected, the necessary steps in the policies are ignored.
The nursing workforce is the most essential one in a healthcare setting considering that their role is to care for the patient till they get better. Therefore, the health policies that exist usually revolve around the nurses. The Hippocratic Oath together with the six ethical principles governs the delivery of care by nurses. They are meant to ensure that they provide the standard or above standard care to the patient. In other words, poor performance by nurses would imply that the patients lives are put in danger. The ethical dilemmas that the moral principles sometimes lead to inhibit the delivery of such quality care. At other times, the patients lives are put in severe dangers that are unnecessary considering that the nurse is aiming to fulfill the six ethical principles of his or her profession (Iley, 2004).
4: Compare and contrast your initial response about this issue to your response after you have analyzed the legal and ethical issues. Initially, I used to believe that in the nursing profession, it is essential to follow the six principles of ethics for the desired outcome on the patients condition to be achieved. The nurse should always respect the decisions and choices that a patient makes considering that the contemporary health system employs the patient-centered approach. Also, the nurse should always do positive or good (beneficence) and avoid doing any harm (non-maleficence) (Burkhardt & Nathaniel, 2014). The nurse should be fair and just in her decisions, truthful at all times (veracity) and remain committed to her patients (fidelity). Considering the six principles, the nurse should be able to ensure that the patient is cared for and at the same time avoid any dilemmas that might come up. This thinking was, however, more theoretical than practical.
After coming across this news article, I could see things clearer than before. I can at least point out that the nurse is usually facing so many risks concerning her job especially when ethics is concerned. In a bid to meet the requirements of the profession, a nurse opts to allow an elderly patient to roam unsupervised. There is increased possibility for the patient to incur harm during the time he is unsupervised. If the patient comes to harm, the nurse might face legal charges considering that she went against the principle to avoid causing harm to the patient. In this sense, nurses face a lot of risks in their career. When it comes ethical dilemmas, nurses are faced with an impossible decision to compromise on some of the principles which should not be the case.
References
Bratianu, P. (2015). Nursing Ethics - Ethical Dilemmas Faced By Nurses Everyday. Retrieved from http://www.nursingexplorer.com/blog/nursing-ethics-ethical-dilemmas-faced-by-nurses-everyday-47Burkhardt, M. A., & Nathaniel, A. K. (2014). Ethics & issues in contemporary nursing (4th ed.) Stamford, CT: Cengage Learning.
Iley, K. (2004). NURSING AND HEALTHCARE MANAGEMENT AND POLICY Occupational changes in nursing: the situation of enrolled nurses. Journal Of Advanced Nursing, 45(4), 360-370.
Kreimer, S. (2010, July 28). Five Ethical Challenges in Healthcare. Retrieved from http://www.amnhealthcare.com/latest-healthcare-news/five-ethical-challenges-healthcare/
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