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Introduction of ethics in nursing reseach
Introduction of ethics in nursing reseach
Ethics in nursing case study
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Over my nursing career there have been many ethical dilemmas that have arisen. One in particular stands out though. I was working in the intensive care unit on nights at the time. When I went to work one evening and was receiving report the off going nurse told me about a patient that had been admitted to the unit about 2 hours ago. The patient had been admitted with shortness of breath, but was stable per report. The off going nurse told me that the patient was placed in one of the step down rooms which is furthest from the nursing station due to her offensive odor. The nurse proceeded to inform me that the patient was stable, had no real reason to be admitted, and that the next assessment was due around 11 pm. Upon accepting my assignment, I proceeded to complete my assessments of my patients for the night, including this …show more content…
This patient was so sick, even at 7:30 pm when I completed my initial assessment that she was not able to pick up a glass of water by herself. Overt the course of a mere 2 hours this patient was crashing, requiring additional IV access sites and transfer to an ICU room to later be transferred to a different hospital. I ended up talking nursing supervisor on duty about the situation and was assured that the off going nurse would be talked with about the in appropriate room placement of the patient to prevent a similar scenario in the future. As a nurse, I fully believe that we are there to be our patients advocates. We are there to support and protect them in whatever way that we can. While I cannot fully attest to the resolution to this dilemma, the nurse later apologized for the way that she cared for this patient to the family
Nurses are required to protect and support their patients if they are to be an efficient patient advocate. Ethically questionable situations are quite common for nurses that conflict with their professionals and personal morals. At times, the patient necessitates the nurse to speak out for them demonstrating
I agree with you that the nurses violated provision 9 of the nursing code of ethics. Nurses have an obligation to themselves, their whole team and to the patients to express their values. Communication is key in a hospital, so everyone knows what is correct and what isn’t within the workplace. In order to have a productive, ethical, positive environment. These values that should be promoted affect everyone in the hospital, especially the patients, and can have a negative outcome if those values are not lived out. Nurses have to frequently communicate and reaffirm the values they are supposed follow frequently so when a difficult situation comes along that may challenge their beliefs they will remain strong and their values will not falter.
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).
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.
My initial response to the issues was only based on the hospital policies regarding the care of the patients within the hospital. However, when I was guided down the different paths and made to look through the different ethical lens, I found it tough to do so and seem to resort to my core values of autonomy and rationality. By putting the patients’ first, hospital policies, and then their loved ones in the first scenario, I determined that a compromise was necessary. Whereas in the second scenario, I feel as no agreement was needed just staff education (EthicsGame Simulation, 2016). In this particular case, Carlotta, the RN shift supervisor, needed further training to understand the hospital policy on who is or is not considered to be family (EthicsGame Simulation,
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.
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.
I have come to fully understand that in order to treat my patients in a way that is person centred, I have to treat each person as an individual and realise that every individual has different needs and different rights and preferences to me which may go against my morals and beliefs but I always have to maintain my professional boundaries and treat each individual with respect and dignity. If I was a nurse who witnessed a similar situation to Kat’s, where another healthcare professional was disregarding my patient or any patients views or requests I would go into the patient’s room and find out what the problem was. Then I would politely ask the healthcare professional to step outside of the room and I would gently remind them of the code of ethics ((Kozier, Erb's & Berman, 2010, p.97) and the Registered Nurses standards of practise (2016), and how every individual has the right to make their own independent decisions about their healthcare needs/goals based on their own values, morals and beliefs. I would further explain that the patients are our main priority and it is our responsibility as nurses’ to ensure that the patients are safe and are receiving the proper care. I would then explain to the patient what was happening and apologise to them about the situation, and I would rearrange and try to negotiate with the patient when the procedure could be performed. Then I would notify the Nurse Unit Manager on the ward to ensure that situations like this do not occur
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).
Davis J. Anne Diane Marsha and Aroskar A. Mila (2010). Ethical Dilemmas and Nursing Practice. Pearson
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...
Under the code of ethics for nurses this moral issue is also conflicting because you’re first and foremost obligation is to the patient. Now you also have your institution ethical code conduct that you also has to abide by. Provision 5. The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth (ANA, 2001, p.18). In this case the nurse owes it to herself in making the right moral decision to preserve integrity and safety of patient and
As a result, she breached the standard 6 which states that “registered nurse should provide a safe, appropriate and responsive quality nursing practice” (NMBA, 2016). In line with this standard, nurses should use applicable procedures to identify and act efficiently to potential and actual risk such as unexpected changing patient’s condition (NMBA, 2016). Through early identification and response by the nurse, this will ensure that the patient’s condition is recognised and appropriate action is provided and escalated (Australian Commission on Safety and Quality in Health Care, 2011). Moreover, the nurse did not immediately escalate the patient’s deteriorating condition to the members of the health care team. Therefore, she also disregards the standard 4.3 stating that nurses should have work with the interdisciplinary health care team and to collaborate, communicate and discuss the patient’s status (NMBA,2016). The purpose of collaborating and communicating with the team is to provide a comprehensive plan of care for the patient and to facilitate early treatments needed by the patient (Cropley,
Several ethical principles that are incorporated in the nursing care of patients on a daily basis are nonmalificence, autonomy, beneficence, justice, fidelity and paternalism. Nurses should strive to comply to as many of the principles as possible. In this case there are principles which support and conflict with the wishes of the patient. The first principle that supports the wish of the patient is autonomy. Autonomy means that competent patients have the right to make decisions for themselves and the delivery of the healthcare that they receive. Another factor that would support the patient’s wish to not be resuscitated is nonmalificence. Non maleficence means that nurses should not cause harm or injury to their patients. In this case the likelihood of injury after resuscitation was greater than if the patient were allowed to expire. A principle that could have negatively affected the outcome of the provision of ethical care was paternalism. Paternalism is when a healthcare provider feels that they know what is best for a patient, regardless of the patient’s desire for their own care. I demonstrated the principle of paternalism because I thought that I knew what was best for the patient without first consulting with the patient or family. This situation might have had some very negative consequences had the patient not have been competent. Practicing a paternalistic mindset might have caused a practitioner in the same instance to force their ideas about not resuscitating the loved one onto the family. This could have caused a sense of remorse and loss of control of care amongst the
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.