Introduction
Nurse leaders are faced with difficult decisions every day; many involve ethical, moral and legal considerations. The purpose of this paper is to discuss the frameworks leaders use to guide them in decision-making processes that affect patients and staff. One situation is outlined that illustrates the use of ethical principles to formulate a decision to meet the needs of a patient. The influence of this writer’s leadership style and the implication this style had in the decision-making process is described.
Ethical Frameworks and Principles
Ethical frameworks assist managers during the decision-making process. Complex decisions can create moral distress. Moral distress occurs when an individual encounters a situation which
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The frameworks are (a) utilitarian, (b) rights-based reasoning, (c) duty-based reasoning, and (d) intuitionist. The utilitarian framework infers that decisions should be for the greater good. In other words, the decision made should take into consideration the needs of a group versus that of an individual. Conversely, rights-based reasoning is more concerned with one person's rights. Duty-based reasoning focuses on the rights of the people and a caregiver’s duty to maintain these rights. Lastly, the intuitionist framework is based on the decision maker's feelings and instincts about a situation. It is the individual’s intuition that drives the decision. In addition to frameworks, there are ethical principles. The nursing profession is based on a group of ethical principles. As nurses, we strive to promote good (beneficence) and to do no harm (non-maleficence). Nurses support patient autonomy and self-determination. Society expects that nurses will be trustworthy, respectful and act with integrity (fidelity and veracity). Nurses have an obligation to tell the truth and treat patients fairly and equally; and, deal with them with respect and dignity (justice). These ethical principles, in addition to the ethical frameworks, help us, as leaders, to make the right decisions at the right time in all situations. The situations may be patient or staff-centered; ultimately, all healthcare …show more content…
According to the Keirsey Temperament Sorter (n.d.), my personality type is that of a guardian. The guardian is someone who likes structure, order, and rules. The personality type guardian was conducive to the previously mentioned scenario. To fulfill the role as patient advocate one must know what rights patients have and which rules society should follow. The patient has the right to receive care in the correct location and has the right not to be judged by past behaviors, nor the behaviors of her significant other. It is imperative that hospitals and facilities abide by societal and governmental rules and laws that require us to protect individuals. Justice is one of the fundamental ethical principles, implemented as a guideline for ethical reasoning, by the individuals utilizing either a utilitarian or a rights-based ethical framework (Marquis & Huston, 2015). It 's hard to state whether someone with a differing personality type would have had the same outcome. In this situation it was the rights, rules, advocacy and justice that swayed the decision of the external care facility; thereby, ensuring the patient was receiving equal
Ethical principles are judgments that serve as a basic justification for the ethical evaluation of one’s action. They are the viewpoints from which guidance can be obtained along the pathway to a decision. According to the Journal of the American Nurse Association, ethical principles are the general goals that each theory tries to achieve in order to be successful. The widely accepted prima facie ethical principles are; Autonomy, duty to respect one’s right. Beneficence, the desire to do good. Non-maleficence refers to avoidance of harm or hurt. Justice, duty to treat one fairly. (Beauchamp, 2004). While some of the ethical dilemmas includes: ensuring informed consent, determining decision-making capacity, promoting advance care planning, surrogate decision-making, withdrawing and withholdi...
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.
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 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.
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
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.
This paper will focus on two BNUR leaner outcomes (University of Calgary, 2013) relevant to my learned understanding of nurses as ethical decision makers. I will outline the ways that I have seen ethics used and not used in practice, what I learned about ethics and its use in my theory courses and throughout my practicums, and I will reflect on how this understanding will translate into my professional practice moving forward.
Since ethical dilemmas are not always easily answered through the use of The Code of Ethics, ethical decision-making models are effective tools that can assist nurses in dealing with ethical issues. Ethical decision-making models provide a framework for working through difficult choices. They seek to define the limits of what is morally acceptable and help clarify the guidelines for making those difficult decisions. Ethical decision making models assist nurses in analyzing situations by focusing on understanding the patient needs, need for responsiveness to circumstantial considerations, and recognizing the uniqueness of each situation.
Providing the steps to ethically sound excellent care, healthcare providers must acknowledge first the legal and ethical matters involved with proper investigation and then devise a plan for best possible action recognizing the rights of the patient and its benefits followed by the application of the chosen intervention with positive outcome in mind (Wells, 2007). Delivery of excellent and quality of care at a constant level (NMC, 2008) must be marked in any responsibilities and duties of the care provider to promote exceptional nursing practice. Codes of nursing ethics and legal legislation have addressed almost all the necessary actions in making decisions in consideration to the best interest of the patient. Nurses must make sure that they are all guided by the set standard to lead their action and produce desirable and ethically sound outcomes.
Before Nightingale, nurses were lower class citizens that were alcoholics or prostitutes with no to a little education. Florence Nightingale realized that nurses ought to have some education in caring for others and be of a higher class. In 1860, she opened the first nursing school in London that did not accept prostitutes and alcoholics. To signify Nightingale’s view of nursing, Lystra Gretter composed a Hippocratic Oath for nurses called the Nightingale pledge.
Since you examined the number of moral issues you will face in this profession, look through the code of ethics that you chose for this assignment and explain
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.
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.
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