Nursing Ethical Dilemmas
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Director of ANA Ethics addresses ethical dilemmas facing nurses during COVID-19
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Becoming a nurse includes responsibilities ranging from safe patient care to handling laws and ethical dilemmas that can happen within that patient care. One thing that falls under these responsibilities for a nurse is the mandatory reporting law. This includes clients ranging from children to vulnerable persons, such as older and dependent adults. The time frame for reporting abuse is within Introduction Nurses face ethical dilemmas on a daily basis. As nurses, we must be knowledgeable about the tools we have to help guide our decisions when solving an ethical dilemma. The tools we have are our ethical principles, ethical framework, and the ANA Code of Ethics for nurses.
This paper will describe a scenario where nurses were faced with an ethical dilemma regarding a baby. The ethical frameworks and ANA Code of Ethics will be discussed in helping guide a solution to this scenario. Nursing Ethical Dilemma Words 6 Pages. Ethics 1. According to Nursing Leadership and management ATI ethics is defined as an expected behavior of a certain group in relation to what is considered right or wrong.
The second principle is beneficence which is care in the best interest of the client. Third is fidelity which is keeping ones promise to the client about care that was offered. The next principle is justice which is fair treatment in matters related to physical and psychological care and use of resources. Identify whether the issue is an ethical dilemma. It must first be determined an ethical dilemma or not in order to move on to the next step. State the ethical dilemma, including all surrounding issues and individuals involved.
It is important that the patient know what the options are who will be involved and what issues can affect the outcome. List and analyze all possible options for resolving the dilemma, and review implications of each option. This is similar to the. Get Access. Sister Aloysius is trying to teach her how to strong in this world that oppresses women to dial down their intelligence and to bow at the feet of men. As displayed through the conversations before between Father Flynn and Sister Aloysius, Sister Aloysius stood up against him acting as if she was questioning her authority and she was the boss or they were on the same level.
She is one of those women who would stand against a man and question him without feeling threatened or. Being forced to follow strict rules all the time to meet society 's standards can be tremendously stressful and overwhelming. Jing-mei clearly illustrates the agony she is in as a result of parading the stern rules set by her mother. She feels the immense pressure of being forced to fit into a modern culture allowing her not to be herself which has most definitely taken a toll on her character. Furthermore, she is struggling mentally to keep serene; later learning that the person in the mirror is despondent. Therefore, these dilemmas cannot only impact on their personalities but also affect their patients.
The RN is working in military, so obeying orders is the most important rules in where the nurse practices. Show More. Nurse Ratched Words 4 Pages So Can only imagine that when McMurphy arrives and plays the role of resistance against Ratched, she of course isn 't happy. Read More. Simulation Exercise Case Study Jenny's Dilemma Words 3 Pages The simulation exercise demonstrates the consequences on patients and staff as Jenny, the charge nurse chooses the wrong path on her decisions. Yellow Wallpaper Downfall Words 4 Pages She is oppressed by not only her husband, but her illness as well and she wishes to break free just as the woman in the wallpaper does.
Character Analysis Silver Sparrow Words 4 Pages The audience can also excuse some of the things she does that might be frowned upon by society, such as drugs, because she is going through that. Inequality In John Steinbeck's 'The Chrysanthemums' Words 3 Pages The story is one of a good meaning, but oppressive husband who drives his wife mad in an attempt to help her. Open Document. When you think about ethics in that way, it's important for the foundation of nursing to be grounded in ethical values so that we've got a firm foundation to operate from. And I see nurses who start their careers, and they have that same passion. And then when I see them two years later, they are depleted and burned out, and to me there's something wrong with a system that does not engage that passion and commitment.
It's a loss. It's a big loss to the profession, and also to the people we try to serve. It does no one any good to expend the time and energy to train nurses and then have them leave the profession in less than two years. That is not a good return on investment. Rushton is a leading force in nursing ethics. As a professor of clinical ethics as well as a professor of nursing and pediatrics, her personal mission is to give nurses a voice and to see conversations about ethics happen on a daily basis as a part of routine health care, instead of being an afterthought or occurring only when things reach a boiling point.
She's been working on it for more than 30 years and feels like she's making headway. Rushton speaks with an enthusiasm and optimism not always associated with conversations about death, moral distress, and professional burnout. The committee provides recommendations to health care workers, patients, and their families on how to proceed in cases where ethics are a factor. Rushton says nurses are a big part of its consultations. She gives the example of an elderly man with cancer who now was going to die.
He had undergone multiple operations on his abdomen, which had left him with a host of complications. The man and his family knew that death was imminent, but they requested that he continue to receive donor blood until he passed away. The medical team, including the nurses, understood the family's wishes but faced a dilemma: Donor blood was in limited supply, and a transfusion now would not help the patient. So the ethics committee was called in.
They spoke with the family and conveyed that unlimited transfusions in this case were ethically unjustified. Rushton says she wants such conversations to happen before there is an ethical crisis or confrontation. She and her colleagues have begun to lead ethics rounds, during which they meet with the health care team, patients, and families to normalize conversations about ethics. To the health care team: How do you feel, ethically speaking, about the current course of care?
Have you discussed the ethics with the family? To family members: If the patient could speak right now, what would she want us to do? Has she expressed any preferences in the past? The rounds are almost like educational icebreakers—they rotate among departments as a way to jump-start conversations about ethics. Rushton says her hope is that even after she leaves the department, health care teams across the hospital will continue to think and talk about ethics in everyday practice. While many hospitals have codes of conduct or guidelines to ensure quality and safety, fewer give the same attention to ethics.
The Johns Hopkins Hospital's Code of Ethics in Patient Care articulates the hospital's values—respect for cultural traditions, patient autonomy, confidentiality, and so on—and how those values should apply to decisions on everything from mandatory flu vaccinations to allocating scarce supplies, staff, and space. Individual departments are taking steps to do what they can, as well. The Kimmel Cancer Center, for example, has initiatives in place to support nurses as they deal with the moral distress that comes with treating long-term cancer patients, according to Sharon Krumm, administrator and director of nursing for the center and an associate professor at the School of Nursing and School of Medicine.
The center has a staff chaplain to discuss dilemmas with nurses, and she feels her team is empowered to speak up. They are also aware of the available options for consultation. The School of Nursing has a dedicated ethics and theory course for master's students, which provides tools for identifying and addressing ethical issues for practicing nurses. The course, co-taught by Wenzel and Rushton, has students role-play scenarios, draft position papers, and engage in debates.
Rushton gives an example scenario: You're the nurse who thinks the patient's pain is not being managed properly, but the doctor says he will not increase the dosage. What do you say? How do you react? Are you willing to bypass the doctor and go up the chain of command? Students who go through the course often may know how they feel about a scenario but have trouble verbalizing why they feel that way, Wenzel says. By having discussions and debates, students learn not only about their own values but how to empathize with those on the other side of the argument. Everyone admits there is always more that can be done. In many departments, despite efforts to spur conversations about ethics, those discussions still don't happen as often as they should.
There is too little time, money, and staffing. When nurses get busy, ethics may go on the back burner. For Krumm the biggest problem is staffing. When budget cuts strike, nurses are hit hard, as nursing is the Kimmel Center's largest expense. That can lead to overworked and overwhelmed nurses who feel they can't give the best care. If your numbers are cut, you can't sit and hold a patient's hand while they're working through some emotional issues because you've got two IVs to hang," she says. There's always more that we could be doing.
It's a matter of resources, honestly. The path to nursing was more of a squiggle than a straight line for Brian Wise, Nurs ' After getting a bachelor's degree in philosophy, Wise enrolled in seminary school. He was halfway to a master's degree in divinity when, as he describes it, "I stopped believing in God as a literal thing. He sees nursing as similar to theology that way. Nurses play a balancing role, he says: learning what's best for the patient, what the family wants, and what the health care team has planned.
Especially in the Hopkins PICU, where the sickest of sick kids end up, he says nurses play that role against a backdrop of ever-advancing technology that can keep these kids' hearts pumping, perhaps when that's not the best thing. Or are we just doing that because that's what the family wants. And is that OK? He cites a recent case. The patient was a child with a complex medical history and a poor prognosis. The patient's doctors and family were talking about more invasive procedures that would be painful and hard on the child. Children are resilient, Wise says, and they can surprise with how well they respond to a procedure.
But there's always a chance that the doctor will go forward with a painful, invasive procedure only to have the child die anyway. Wise was asked by the parents what he would do were the roles reversed.
