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Acute pain management theory
Basic principles of nursing ethics
Basic principles of nursing ethics
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Recommended: Acute pain management theory
On Thursday June 23, 2016 I was rotating through fast track when I came across an incident that involved a 27-year-old African American female patient. This young woman arrived at the emergency department suffering severe lower back pain, which was exacerbated while walking. She stated that she bent over to grab something out of the floorboard of her vehicle, and upon standing back up she felt an aching pain throughout her lower back. I walked in the room to find out more information on why she was at the ED. The patient proceeded to explain the story that I listed above. I asked her if she had pain anywhere else, and she said “No, but my back is hurting really bad, can you get me pain meds already”? I asked her to rate her pain and she stated …show more content…
The first provision states that the nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person (ANA, 2015). This is based on the respect for human dignity, which I don’t believe was incorporated with this patient. This patient was in pain, and needed medication. She depended on the health care providers to show compassion and care for her as they would any other patient. A nurse should consider the needs of every patient and help advocate for them, instead of just ignoring their wishes. Provision two states that the nurses primary commitment is to the patient, whether an individual, family, group, community, or population (ANA, 2015). It involves the primacy of the patient’s interest and states that the primary commitment is to the patients. Each plan of care must reflect the fundamental commitment of nursing to the dignity of the patient (ANA, 2015). I also don’t think this was implemented because when the patient came seeking medication to ease her pain, the nurse did not stand up for her. They placed a label on her saying that she was a “drug-seeker”, which is not showing dignity towards the patient. The third provision states that the nurse promotes, advocates for, and protects the rights, health, and safety of the patient (ANA, 2015). The nurse did not advocate for this patient by any means. …show more content…
I feel as if the patient’s are our number one priority. They come to us for help, and we should be there for them and advocate their wishes. The code of ethics was put in place partially for this reason, to make sure our patient’s have top of the line care. When a patient comes in and states they are in pain, they should be treated as if they are in pain. If a patient declines a medication due to the route and location, then the nurse and physician should work together to form another option. A patient should never be sent away without being treated first. One recommendation I would make is to form an algorithm for pain treatments, just as they do for cardiac arrest. That way when a patient comes in and declines the first option, there is a protocol in place that includes other options. I would also recommend transferring the patient to another unit to be treated if fast track does not have the resources. The patient should also be informed of the treatment right away before making them sit and wait for
Paramedics deemed the patient competent and therefore Ms. Walker had the right to refuse treatment, which held paramedics legally and ethically bound to her decisions. Although negligent actions were identified which may have resulted in a substandard patient treatment, paramedics acted with intent to better the patient despite unforeseen future factors. There is no set structure paramedics can follow in an ethical and legal standpoint thus paramedics must tailor them to every given
The first provision of the American Nurses Association’s (ANA) “Code of Ethics” states, “ The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.” The second provision states, “The nurse’s primary commitment is the patient, whether the patient is an individual, family, group, or community” (Fowler, 2010). As nurses we need to respect the autonomy and allow for the patient to express their choices and concerns. We also need to provide them with support by giving them knowledge and understanding so they
The provision states, “Respect for human dignity requires the recognition of specific patient rights, particularly, the right of self -determination. Self -determination, also known as autonomy, is the philosophical basis for informed consent in health care. Patients have the moral and legal right to determine what will be done with their own person; to be given accurate, complete, and understandable information in a manner that facilitates an informed judgement; to be assisted with weighing the benefits, burdens, and available options in their treatment, including the choice of no treatment; to accept, refuse, or terminate treatment without deceit, undue influence, duress, coercion, or penalty; and to be given necessary support throughout the decision-making and treatment process (nursingworld.org)”. Ms. Rogers cannot even get to this point because of the resident refusal to treat her. There could many things going on with her. She could have pancreatitis, gallbladder issues or many other diagnosis related to her abdominal pain. She won’t know until a physician does a full workup on her. She obviously wants to be seen or else she wouldn’t have come to the ER. She knows something is not right is she is staggering in the hospital. She has rights as a patient to be seen by a physician. I think is the resident doesn’t want to evaluate her then the ER nurse needs report that person and go find another physician to do the job. I would also talk to the house supervisor about the situation so it could be reported to administration. Doctors go into medicine to help all people, not to pick and choose who they want to
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
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.
Q.3 Nurses as part of regulated health care practitioners are responsible and accountable to abide by the standards, codes and guidelines of nursing practice (NMBA, 2016). The nurse in the case study has breached the standard 1.4 of the Registered Nurse Standards for Practice. According to standard 1.4, the registered nurse should comply with "legislation, regulation, policies, guidelines and other standards or requirements relevant to the context of practice” when making decisions because this will be the foundation of the nurse in delivering high quality services (NMBA, 2016). The nurse in the scenario did not follow the hospital policy concerning “Between the Flags” or “red zone” and a doctor should be notified of this condition. Furthermore, the nurse failed to effectively respond to a deteriorating patient.
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.
1. Legal, ethical and professional principle frameworks underpin all fields of nursing, and it is a requirement for all Registered Nurses to be competent and knowledgeable, act with integrity and maintain professional standards set out by Nursing and Midwifery Council (NMC, 2015). Working with multidisciplinary teams within our profession, it is important to acknowledge and recognise the way in which all the professionals are guided by law and their independent regulatory bodies. The needs of the individual patient is to be considered by doctors and nurses alike, who share professional values and are set out in the respective codes of practice, The Code (NMC, 2015) and GMC (2013).
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.
A lot of information has been stipulated concerning how patients should be treated and the legal rights involved in the health care system. Different values are, therefore, involved. In the correctional setting, the patient entirely relies on the nursing service offered and various services are expected to be offered by a nurse. However, in the process of providing these services, a nurse has to uphold all ethics that dictate the profession (National Commission on Correctional Care, 2011). The legal ethics include right to autonomy where the patient’s view should be respected and incorporated in the provision of nursing care. A nurse should always tell the patient the truth according to how he or she is fairing on health wise. The principle of beneficence also allows a nurse to concentrate on provision of services that are beneficial to the patient. A registered nurse also ensures equitability and fairness in the provision of care to the patient (National Commission on Correctional Care, 2011). Another principle that a nurse understands is the principle of fidelity that allows a nurse to remain committed in the process of provision of care. The principles help a nurse in making ethical decisions in the process delivering nursing care to the patient. For instance, having in mind the principle autonomy, one can be able to appreciate an advance of health care directive that enables one to act as per the patient’s
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.
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.
The nursing code of ethics has a very standard definition. It is the base on how nurses should guide themselves in conduct by making the right decision regarding ethical issues. According to the National Student Nurses Association “students of nursing have a responsibility to society in learning the academic theory and clinical skills needed to provide nursing care” (2003). In the clinical setting nurses have a lot of responsibilities while caring for an ill patient, they have the obligation to practice their profession with compassion, love, and respect the uniqueness of each patient, as nurses we are not supposed to deny care to a patient because of their economic status, their skin color, race, or the nature of health problems, we are here to help the people in need in particular those of susceptible populations. The NSNA states that the code of conduct is based on an understanding that to practice nursing as a student is an agreement that trust and honesty is depended on us by society. The announcement of the code provided direction for the nursing student in the personal development of an ethical foundation and not limited to the academic or clinical environment but can assist in the holistic development of a person. (National Student Nurses Association, 2003)
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
Integrity, respect for persons, justice, non-maleficence, and responsibility are all identified within the code, however compassion is not directly stated but is implied. To show compassion for others during suffering is an almost automatic response in nursing. When nurses decide to act either beneficently or non-maleficently they are doing a service to those being cared for. When dealing with human lives moral value becomes especially important, and is not situationally dependent. Ethical neutrality does not have a place in professional ethics, and an obligation to respect the moral values is necessary. The code deals with specific issues related to the nursing profession, and ensures standards are upheld. Creation of code of ethics within a profession limits misconduct, create safeguards, promote trust for the profession within society, and preserves the integrity of the profession (Soskolne, 1984) It is important for me to emphasize the difference between the nurse’s code of ethics and the Hippocratic Oath. The nurses ethical code is tailored toward the care provided to the patient, and not the involved science and diagnostic aspect of the