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Autonomy in nursing essay
Autonomy in nursing essay
Autonomy in nursing essay
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Code of Ethics
My assigned case study is Provision 1. It is about a female, homeless veteran named Ms. Rogers with a history of alcoholism and PTSD. She staggers into the ER one night with a complaint of abdominal pain. It is noted that the homeless shelters are currently full. The weather is cold and rainy. The resident does not want to do a full work up on the patient as they think she just wants a warm bed for the night and food to eat. The story does not detail if the patient has any more medical history than what is listed above.
According to Provision 1, “The principle of respect for persons extends to all individuals with whom the nurse interacts. The nurse maintains compassionate and caring relationships with colleagues and others
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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
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
- Nurse should place the patients well being above their personal beliefs and values. They should focus on treating the patient and making sure the patient’s needs are being met. This also means that tough decisions have to be made in the process whether it goes against what the health care team wants or it goes against what Mrs. Dawson wants.
The main points of provision five of the ANA code of ethics are as follows: section 5.1, which is moral self-respect, suggests that nurses must care for themselves as much as they care for their patients. Nurses must do their best to maintain professional respect to themselves in regards of their competence and moral character. Section 5.2, which is professional growth and maintenance of competence, suggests that nurses must continue to self and peer evaluate themselves throughout their careers. Nurses must continue to learn current, up to date nursing practices through self, peer, and higher education. Section 5.3, which is wholeness of character, suggests that nurses must develop and take into consideration their own moral perspectives when practicing in their careers. Nurses are encouraged to express their moral viewpoint when it is helpful to the recovery of their patients, but must never express moral beliefs based on social stigmas that could negatively affect patient outcomes.
The ethical principle of non-maleficence demands to first do no harm and in this case protect the patient from harm since she cannot protect. Nurses must be aware in situations such as this, that they are expected to advocate for patients in a right and reasonable way. The dilemma with non-maleficence is that Mrs. Boswell has no chance of recovery because of her increasing debilitating mental incapability and the obvious harm that outweighs the intended benefits. If the decision were to continue treatment, the suffering of the patient and family would be evident. Autonomy is the right to make your own decisions and freedom to choose a plan of action.
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
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.
The Code of Ethics for Nurses was created to be a guide for nurses to perform their duties in a way that is abiding with the ethical responsibilities of the nursing profession and quality in nursing care. The Code of Ethics has excellent guidelines for how nurses should behave, however; these parameters are not specific. They do not identify what is right and wrong, leaving nurses having to ultimately make that decision. Ethics in nursing involves individual interpretation based on personal morals and values. Nursing professionals have the ethical accountability to be altruistic, meaning a nurse who cares for patients without self-interest. This results in a nurse functioning as a patient advocate, making decisions that are in the best interest of the patient and practicing sound nursing ethics.
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).
Dignity and respect for patients is important in adult nursing because without it, it dehumanises them, and creates opportunities for abuse and ill treatment to occur. Lack of dignity and respect can also cause emotional problems for patients, as they are already in a vulnerable state.
Provision one states the nurse in all professional relationships, practices with compassion and respect for inherent dignity, worth, and uniqueness of every individual (ANA,
Nurses must have a professional relationship with all types of people. The nurse must be a professional with their coworkers, superiors, and patients. The most important relationship is with the patient; if a professional relationship does not exist with them, the nurse as well as the organization will get a bad reputation. This in turn will ruin our professional relationship with our coworkers and superiors and will eventually cost that person a
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.
In the code of ethics, the very first ethical principles that nurses are expected to uphold in order to exemplify that they are competent professionals are autonomy, beneficence, and nonmaleficence. That is, nurses as professionals are expected to advocate for their patients while preserving their respect and dignity and
The American Nurses Association created guidelines for the profession including, a set clear rules to be followed by individuals within the profession, Code of Ethics for Nurses. Written in 1893, by Lystra Gretter, and adopted by the ANA in 1926, The Code of Ethics for Nurses details the role metaethics, normative ethics, and applied ethics have within the field (ANA, 2015). Moral obligation for an individual differs within professions than it does within an individual’s personal life, so the code of ethics was written to establish rules within the profession. The moral obligation to provide quality care include the fundamental principles of respect for persons, integrity, autonomy, advocacy, accountability, beneficence, and non-maleficence. The document itself contains nine provisions with subtext, all of which cannot be addressed within this paper however, core principals related to the ethical responsibilities nurses have will be