Nurses, other healthcare practitioners, and healthcare providers do their work with numerous enabling and hindering legal and ethical issues. While it is not possible to exhaust them all, below is a summary of the most common today.
Informed Consent
Informed consent is a legal and ethical concept that both hinders and enables nurses as part of their efforts to achieve patient outcomes. Informed concept works by the principle that if patients are to make better decisions, their care providers must explain all pertinent information about the options they have (Hoskins et al., 2018). This, however, is an ethical dilemma because providing informed consent requires a deep medical background, which the providers cannot give to their patients. Therefore, when the patient makes the suboptimal decision, the nurses have to respect their wishes even if it will affect their outcomes. For instance, when a teenager admitted due to acute pain of unknown origins, nurses can help relieve suffering by administering pain medication. However, if the parents refuse the medication based on their religious backgrounds, nurses will be obliged to accept the limitations.
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A remediation of this issue is improving the patient’s health literacy. For both inpatient and outpatient care centers, a policy proposal to prevent the limitations of informed consent and its inherent dilemmas needs to focus on patient education on all essential background of their conditions. While it is impossible to impart years of medical knowledge in a short period of time, the background needed to provide context will make a significant difference. To incorporate such a policy proposal, nurses could advocate their employers to set aside resources for patient education as it would not only help improve patient outcomes, but also reduce the provider’s operating costs.
Professional Boundaries
Some patients are vulnerable to influence by their practitioners due to their faith and respect in the work they do. On the other hand, the achievement of patient outcomes after treatment can result in the expression of happiness and deep feelings that can e misinterpreted. To avoid any failures in communication, verbal and nonverbal, professional ethics place boundaries between what the nurses and other practitioners have to follow. Professional boundaries are a legal requirement that prevent inappropriate conduct. Most of the boundaries are self-observed, where the nurses and other practitioners incorporate them into their personal values and ethics.
Healthcare providers also help to monitor professional conduct and boundaries between the patients and the practitioners in their employ. For instance, if a patient continuously offends the nurses, such as by telling offensive and sexist jokes, the provider’s work policies should have provisions on how to deal with the events. Most professional boundaries inform nurses on how to conduct themselves in different situations. However, the boundaries cannot exhaust all possible situations. A solution is to have a workplace policy where the nurses report any situation that hindered their work or crossed boundaries that were never specified. Nurses can then propose solutions, implement and test their effectiveness and create best practice guides that will complement their professional standards.
Data Privacy
Privacy and confidentiality of patient health information and records is an essential part of today’s practice. Laws like the Health Insurance Portability and Accountability Act (HIPAA) provide the legal and ethical policies regarding patient privacy (Theodos & Sittig, 2021). Not only are the nurses and other health care professionals prohibited from breaking patient trust, the laws also limit accidental disclosure. Accidents, happen, however, such as when the medical records of one patient are sent to another or when the physicians and nurses treat patients using the erroneous records. HIPAA was put in place to prevent such accidents from happening. However, the policy does not account for noncompliance or incorrect usage by the nurses and other healthcare practitioners.
A policy to remediate such an issue would be to train all nurses on all aspects of HIPAA, their implications, and how to implement them in their practice. When inconsistencies or conflicts arise, the nurses can raise the issues to their providers, who in turn can either provide solutions or be the nurse’s advocates to the relevant authorities and regulatory bodies. Furthermore, the training can include different ways of implementing HIPAA regulations, such that nurses can participate in evidence-based studies to determine the best practices. With time, these best practices can be policies that the nurses helped to create and implement.
Access to Care
Of all the legal and ethical concepts that influence the healthcare industry, access to care poses the most dilemmas. Nurses and healthcare professionals make an oath to do no harm to a patient. The professionals also have their needs that must be met. Therefore, balancing between quality healthcare and meeting patient outcomes is a big challenge (Suhonen et al., 2018). The situation is exacerbated when the patients do not have insurance coverage or their premiums do not cover their medical needs.
Developing policy proposals and detailing how nurses could incorporate the proposal into practice is a challenge. For instance, if the policy proposal is to adapt a pay-for-performance, where the government rewards meeting various performance metrics, the nurses will be able to provide the best care for their patients. However, providing quality care takes time, which means that fewer patients will be treated (Suhonen et al., 2018). Adding more staff is not an option as the operating costs will increase proportionally. In other words, there is no optimal solution. Nurses can, therefore provide the best care they can for their current patients while volunteering their free time to provide more care.
References
Hoskins, K., Grady, C., & Ulrich, C. M. (2018). Ethics education in nursing: Instruction for future generations of nurses. OJIN: The Online Journal of Issues in Nursing , 23 (1), 1-4.
Suhonen, R., Stolt, M., Habermann, M., Hjaltadottir, I., Vryonides, S., Tonnessen, S., ... & Scott, P. A. (2018). Ethical elements in priority setting in nursing care: A scoping review. International journal of nursing studies , 88 , 25-42.
Theodos, K., & Sittig, S. (2021). Health Information Privacy Laws in the Digital Age: HIPAA Doesn't Apply. Perspectives in Health Information Management , 18 (Winter).
