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Chapter 2 the basics of ethics in nursing
Chapter 2 the basics of ethics in nursing
Chapter 2 the basics of ethics in nursing
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Thank you for very interesting post. I, too, had talked in my original post about scenario 1. You are absolutely right that there are so many “what ifs” that could go wrong in this scenario. I cannot even imagine how I would feel if I would not act/report my suspicions about Dr. Smith’s intoxication and something devastating would happen. I think that if I would be in such a situation I would rather say something and be wrong than not act on it and someone gets hurt. I found an interesting study where they asked 82 undergraduate nursing students and 83 experienced nurses regarding their willingness to report coworker’s misconduct to protect a patient’s interests. Interestingly, the results revealed that even though nursing students perceived
The Lewis Blackman Case: Ethics, Law, and Implications for the Future Medical errors in decision making that result in harm or death are tragic and costly to the families affected. There are also negative impacts to the medical providers and the associated institutions (Wu, 2000). Patient safety is a cornerstone of higher-quality health care and nurses serve as a communication link in all settings which is critical in surveillance and coordination to reduce adverse outcomes (Mitchell, 2008). The Lewis Blackman Case 1 of 1 point accrued
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
Nurses are central to patient care and patient safety in hospitals. Their ability to speak up and be heard greatly impacts their own work satisfaction and patient outcomes. Open communication should have been encouraged within the healthcare team caring for Tyrell. Open communication cultures lead to better patient care, improved outcomes, and better staff satisfaction (Okuyama, 2014). Promoting autonomy for all members of the healthcare team, including the patient and his parents, may have caused the outcome to have been completely different. A focus on what is best for the patient rather than on risks clinicians may face when speaking up about potential patient harm is needed to achieve safe care in everyday clinical practice (Okuyama,
Nurse A seemed confident and calm while nurse B appeared tired. With the first patients, I noticed that both nurses were asking for first and last name and confirmed the information with the picture in the computer and the medication cup. After a few minutes, I turned my attention to nurse B because I noticed she did not ask a particular patient for his name. Instead, she relied on the name provided by a patient care technician. When she was about to give the medication to the patient, nurse A noticed that the patient on the computer screen was not the patient on the counter. She immediately told nurse B “ That is not Mr… girl ” and nurse B responded while laughing “ He looks exactly like …, I need to get some coffee ASAP”. The patient immediately realized what happened and told nurse B his name. After that, nurse B reached for the right cup and administered the medication to the patient. Even though a medication error was not committed and no harm was inflicted to the patient, by violating important QSEN competencies this incident could have caused a negative patient outcome.
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
This correlates greatly with provision six which states: “The nurse facilitates improvement of the healthcare environment.” (Nurses Code of Ethics, 2015). As stated previously a nurses’ obligation is to help with creating and maintaining that balance of great virtues as well as excellence in the health care professions. If you think about it, if a nurse did have moral health ethics, would that nurse give unsafe patients and falsify a shift report change to the new nurse, so they could leave work? In addition, any nurse who witnesses such a false act by another nurse should report such an act immediately to their immediate. No nurse should ever agree or choose to work in an environment that enables unsafe practices. Not only are they putting the patients at risk they would be putting themselves at risk for physical harm or even losing their license as
To determine if the nurse was diverting narcotics, I would first want to discuss with the staff that stated that she suspected a fellow coworker of diverting and get the whole story from that nurse. I would document everything that the staff nurse told me, all subjective and objective data. Then, I would document what I saw that made me suspected the nurse as well. I would have all information about the first and second incident ready to present to either human resources or my supervisor. Then after discussing with the staff and gathering the data, I would discuss with the correct personnel about organizing a drug screen for all of my employees that were working during the shift in which the narcotics went missing. This would be to see if any of the employees had narcotics in their system, including the nurse suspected, and we would be especially aware of the type of drug that was missing (morphine, etc). I would then sit down with the staff member who was drug diverting or tested positive for the drug, to discuss consequences. I would also sit down with my staff as a whole about how to handle this type of situation in the future, the importance of reporting, the problems of using drugs and drug diversion, and debrief the staff about necessary information they needed to know about this incidence.
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,
...is causes injury or not is an example of unsafe practice. This act could also be categorized as careless or repetitive conducts that puts a patient in danger. Drug diversion is a type of drug dealing, nurses have access to many drugs and it is a part of the nurses’ responsibility to ensure those drugs go where they should, precisely document and closely supervised. Criminal conduct can happen in the work place or on personal time. If a nurse is convicted of a crime, such as Driving While Intoxicated, it could affect their ability to practice nursing. It is out of a RNs legal scope of practice to medically diagnose any patient, order a medical treatment or conduct a medical treatment that has not been ordered by a physician. It is the nurse’s duty to their patient’s to exhibit sound clinical judgment, with in their scope of practice to ensure patient safety.
Substance abuse among health care professionals is an issue that is continually gaining more attention due to the harmful affects it can have individuals as well as the patients. Substance abuse can greatly hinder the ability to provide quality care and if left unchecked could lead to serious implications within the health care facility. There are a significant amount of nurses and health care providers that deal with substance abuse problems. At one point, it was estimated, that 2-3%, of all nurses were addicted to drugs (Trinkoff, & Storr, 1998). To encourage nurses to seek help, the Texas Peer Assistance Program for Nurses was created. This program gives employers, LVNs and RNs the ability to seek help, education, guidance, and support in dealing with substance abuse and mental health illnesses. In this paper, we will examine the ethical perspectives that these programs foster and the ethical responsibilities of the patient, nurse, and coworkers as determined by the Texas Board of Nursing and the Nurse Practice Acts.
When the practices in the healthcare delivery system or organization threaten the welfare of the patient, nurses should express their concern to the responsible manager or administrator, or if indicated, to an appropriate higher authority within the institution or agency or to an appropriate external authority” (3.5 protection of patient health and safety by acting on questionable practice, ANA, 2015). The example of the practice is a patient discharge from the rehab facility to the Personal care unit with pending PT/INR results, which turned out to be critical. The admitting nurse demonstrated moral courage by questioning physician who wrote discharge orders and the nurse who completed discharge. Rehab physician refused to address lab results and referred the patient to the PCP. Admitting nurse raised a concern to administration to review discharge protocol and deviation from safe practice. Nurse acted on behalf of the patient and requested readmission to rehab based on patient’s unstable medical
...on’t tell policy that the nurses were using should be unacceptable and looked further into because everyone would now believe it’s okay for these harmful things to happen in organizations. We as people who work in organizations cannot allow it to happen so, if someone see or recognize it speak up it will mean a lot.
Why is substance misuse among nurses a serious concern? What is the most appropriate way to handle a suspicion that a coworker may be involved in serious substance misuse?
I think that both issues could have resulted in patient harm, even if that was not the intended action. The results in this case deals with beneficence and nonmaleficence. This is the basic duty of a health care professional: to do good and avoid harm. Both of which were violated in this case. I feel that Dr. Strunk realized that the hospital’s policy was violated his morals and code of ethics. I believe that the hospital’s administration only looked out for themselves. Although no visible harm was done to the patient, the best course of action was to inform the patient of the mistake. One could argue no harm, no foul, but I believe that the hospital should consider the patient’s overall well-being. If the patient found out about the error down the road, the hospital may be in even more trouble.
I hope this alleged issue is not true because not only did this staff member overstep some major boundaries, but they also compromised someone’s sobriety. Also, a professional and respectful staff member wouldn’t allow their own personal issues with someone to get in the way of what they are supposed to be