Ethical standards are important in healthcare for the role they play in promoting certain behaviors that assist in making decisions aligned to some preferred values. Nursing is often accompanied by ethical challenges in patient care. Nurses are expected to uphold pre-existing values and principles even as everything around healthcare is dynamic and transitions are happening quickly. This makes it harder for nurses to not only make prudent decisions consistently but also to have integrity in complex moral dilemmas that arise regularly. Even while there are no wrong answers in matters regarding ethics, the decisions made are judged according to the magnitude of their effects, and whether those effects are positive or negative.
My ethical issue was concerned with beneficence. Beneficence is the principle that a nurse should take actions that promotes good, ensuring that these are the best for the patient. As a nurse, situations that require critical thinking may arise only for the most favorable solution to be trumped by either the hospital’s code of conduct or even nursing ethics. To illustrate this, I had a personal ethical issue regarding the best step to take when a patient is in a crisis. The patient was experiencing symptoms of a heart attack. By the hospital’s protocol, which has a higher priority over my preferences, I had to inform the rapid response team before contacting the MD. This is despite the fact that I would be alongside the MD to give them my assistance (since I am more informed about all the variables) while they state their instructions on how the rapid response would handle the situation.
Delegate your assignment to our experts and they will do the rest.
In this case, I was concerned that the implementation of the hospital’s protocol might be costly for the patient. I felt that had I been given some authority, valuable time would be saved and some operations would already be underway by the time the relevant practitioners arrived. Due to the nature of some situations, like a cardiac arrest, some patients’ conditions might seriously deteriorate by this time. I raised this concern and I was notified that for such conditions, I would have to make decisions based on critical judgment, and if necessary a nurse might add standing orders while waiting.
The nursing code of ethics emphasizes the need for collaboration with other health professionals to uphold the quality of care and reduce health disparities (ANA, 2001). Nurses need to make critical decisions based on their ethical standards while ensuring they work within the dictates of the hospital codes ( Simpson, & Courtney, 2002 ). Protocols are set up due to the number of professionals in a facility to help control specialists according to their profession ( Ballangrud et al., 2017 ). In this case, I would not change the decision made although understanding why the protocols exist might have helped me be more comfortable implementing decisions that address discrepancies in patient care
I also had a harder situation with an end-of-life case, which is difficult for many practitioners for the psychological toll they take due to the nature of the effects. Such cases are even more frustrating when the patient’s decision conflicts your decision on the matter. To illustrate, I cared for an elderly patient who had major organ failure, which was probably caused by his sepsis condition. The patient had a very poor prognosis but his family could not accept a do-not-resuscitate (DNR) order as a viable option. The patient’s condition was constantly deteriorating reaching a point where he was not having any significant food intake. Despite the patient’s obvious pain and suffering the family would not budge although I felt that the patient would share my sentiment about the DNR order. However, I had to respect the family’s decision and adhere to the hospital as well as the nursing code of ethics, no matter how uncomfortable it was.
It is common for the patient to desire therapy alternatives that do not appeal to their practitioners. The conflicting opinions in healthcare were the reason the code of ethics was established. The code requires the nurse to work through their individual effort to promote, maintain, and improve the ethical environment of their work setting (ANA, 2001). The main reason for this is not only to promote safe and quality healthcare, but it also serves to ensure that the patient is the center of attention. The alternative of employing critical thinking and bringing better solutions, according to my ethics, would be insignificant if the patient or their family walked out of the hospital dissatisfied. Keirns and Goold (2009) suggest that if a patient refuses care that has a high probability of affecting their personal risk or even avoiding complications, then it would be better to look at the patient’s goals in health and life. Knowing what I presently do, I think it would be better to uphold the patient’s family autonomy and avoid the DNR if they do not feel comfortable with it. My sentiments are useless and selfish if they are not centered on the patient’s goals and thoughts.
If I were the nurse leader, I would ensure every member of my team fully understands why the nurses’ ethic code and even the hospital's code of conduct exist. Similar to the laws of practice the nurse should ensure they act according to the code and at all times they should ensure that the patient is their main concern. While putting the patient on the pedestal, it would also be helpful to encourage the nurses to think critically even while following protocol so that their decision seems like the most reasonable from all approaches. I would encourage the nurses under me to ensure that they integrate this into effective teamwork and ensure that any decisions are well communicated since this coordination is important for the patient’s safety.
I would also encourage my team members to put the patient’s priorities above their own concerns and suggestions. The patient-centered care model insists that physicians and practitioners should not only respect the patient’s goals, they should also incorporate this into the therapy and work around any obstacles that may arise ( Keirns, & Goold, 2009 ).
Healthcare institutions host a variety of problems that nurses encounter and have to ethically deal with. For this reason, nurses have their facilities as well as the ANA’s code of ethics to help them navigate successfully. Nurses should be trained on the purpose of these as directional signboards rather than rules. Nurse managers should also empower their team members to be more critical since most nurses may be reluctant about ethical issues in spite of their role in patient care ( Simpson, & Courtney, 2002 ). The most important factor while thinking about the code of ethics is remembering that the patient, and their needs, have the highest priority.
References
American Nurses Association. (2001). Code of ethics for nurses with interpretive statements . Nursesbooks. org.
Ballangrud, R., Husebø, S. E., Aase, K., Aaberg, O. R., Vifladt, A., Berg, G. V., & Hall-Lord, M. L. (2017). “Teamwork in hospitals”: a quasi-experimental study protocol applying a human factors approach. BMC nursing , 16 (1), 34.
Keirns, C. C., & Goold, S. D. (2009). Patient-centered care and preference-sensitive decision making. Jama , 302 (16), 1805-1806.
Simpson, E., & Courtney, M. D. (2002). Critical thinking in nursing education: Literature review. International journal of nursing practice , 8 (April), 89-98.
Yoder-Wise, P. S. (2014). Leading and managing in nursing-E-Book . Elsevier Health Sciences.
