Background
The nursing profession is hinged on the need for upcoming and practicing nurses to uphold professional standards and ethics. Educators must introduce student nurses to ethical and legal issues common in the nursing profession, thus laying a foundation for understanding the relevant professional standards, values, and institutional ethics that should be followed. The nursing profession's dynamicity and expertise diversity in the healthcare sector create fertile ground for the emergence of new ethical dilemmas. Thus, there is a need to continuously generate knowledge on how to address these emergent ethical scenarios. According to Brunt and Russel (2018), due to the evolving nature of the healthcare landscape, nurses' roles and responsibilities have also changed, triggering the need for revising the existing standards. There is thus a need to prepare nursing students and practicing nurses for the changing healthcare landscape and specifically the nursing environment. An in-depth understanding of professional standards will help nurses observe institutional ethics ( Willson & Angell, 2017 ). In conjunction with professional standards, institutional ethics provide a real-world basis for recognizing the actions, intentions, and motives allowed in the nursing profession (Haddad & Geiger, 2019). This paper aims to analyze professional standards and institutional ethics concerning informed consent in nursing, the legal implications, and the values and attitudes that a nurse must integrate into their profession.
Potential Ethical Dilemma in Nursing
Informed consent is a sensitive ethical issue in nursing that can arise in a healthcare service delivery scenario. Patients must be allowed to choose to have a treatment or a particular procedure, which should be defined by their holistic understanding of the recommended options' benefits and risks. This also necessitates that nurses provide clients with other possible alternatives, including their benefits and associated risks. It thus implies that patients have an inalienable right to autonomy and self-determination to consent or reject any recommended treatment or procedure. For example, a medical practitioner must disclose the most likely risks, including severe ones such as brain damage. However, one may opt to skip details of the possibility of such an eventuality without prompting a discussion, thus not giving a patient a leeway to truly give informed consent.
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Stakeholders Impacted by this Ethical Issue
In the above scenario, several parties can be affected. The first party is the patient who may bear the highest cost of the ethical dilemma. For example, the patient may develop some severe complications that can lead to a lifetime health issue. Also, depending on the procedure or treatment, one can lose their life. Second, the patient's family will be affected if a procedure that they were not aware of adversely affected their loved one. The emotional torture that results from that situation will affect them for a long time. Third, the hospital name will be affected because the family can sue the facility and its management, effectively affecting its credibility and customer loyalty. Last, the healthcare practitioners responsible for this error of omission will be subjected to a disciplinary process, and they might lose their employment and their license.
Legal Concerns Associated with the Issue
It should be noted that although ethical principles should be employed in the nursing profession, especially when dealing with patients, there is no definite sanction available if such a moral principle is not followed. However, if, in the above case, proper informed consent is not sought from the client in conjunction with their family members, legal implications will arise (Smith & Parkhouse, 2018). For example, if a nurse administered a particular medication without informing the client of the benefits and risks, and the patient developed brain damage, the hospital and the nurse will be sued. The damages of a court battle with a client can be damaging to a healthcare facility and involved personnel's careers. Brunt and Russel (2018) write about the revised professional standards with competency management among the six nursing professional development standards. Healthcare facilities must ensure that the competency of their nurses and other professionals is topnotch. A nurse who understands the ethical requirement of informed consent will not hesitate to inform a client of any impact of a procedure or treatment. Therefore, competent nurses will execute their mandate in a way to protect their career, the credibility of their hospital, and enhanced healthcare outcomes of their patients.
Professional and Personal Values Related to Ethical Scenario Above
Altruism and Human Dignity
The nursing profession is founded on the core principle of care for patients and their family members. In their duty, nurses will connect with different types of people, including patients, colleagues, practicing students, and others. As such, nurses should have a caring spirit and attitudes towards all the people they meet in the course of their professional mandate. Concerning the above case, altruism, which involves others' welfare and well-being, is the best fitting value that a nurse must have ( Poorchangizi et al., 2019 ). Hence, with altruism, a nurse will place the patient's needs first, and this will include recognizing the need for informed consent. As mentioned above, competency is a crucial professional standard that will combine well with altruism. When one is skilled and understands the nursing profession's requirements, especially on ethical conduct, they will be able to nurture altruism and integrate it into their professional practice. Besides altruism, human dignity could appositely fit in this subject matter. Any patient is entitled to be informed of any treatment or procedure they are about to undergo. With information, they will be able to make an informed decision on the available choices.
Alternative Position on the Issue
The issue of informed consent and the associated ethical connotations could be different for the nurse and the healthcare facility if they are critically ill. For example, if the patient is in ICU, they may lack the capacity to give informed consent due to sedation, coma, or underlying medical conditions. Institutional ethics in nursing grant nurses the autonomy to make independent decisions concerning patients’ health ( Seo & Cha, 2016 ). For instance, the patient might have suddenly developed a complication, and a nurse is obligated to employ some immediate interventions. In this case, a nurse will be in a dilemma because the condition can improve or worsen regardless of their decision. This is because the patient is not in a position to make an informed consent. Altruism and human dignity will dictate that the nurse intervenes and assists their client manage the situation.
New Knowledge Gained
Professional standards and institutional ethics are critical pillars for each nurse to integrate into their nursing practice. One crucial piece of knowledge gained from the reviewed literature pertains to the need for individual and professional nursing competency. A nurse must have progressive values, attitudes, and beliefs that will enable them to make concrete and correct decisions. In this regard, competency management is a concern of a healthcare facility and individual nurses. Therefore, this requires nurses to be continually evaluating the professional standards and core ethical requirements and integrate them into their practice.
Conclusion
Professional standards and institutional are critical aspects of the nursing professional that each nurse must purpose to cultivate. A crucial professional standard concerns the need for competency management, which will provide nurses with the ability to execute their mandate within ethical restrictions. When a nursing student internalizes professional standards and understands how to work ethically, they can handle any ethical dilemma. For instance, a nurse must understand the dynamics of informed consent and any legal implications that can arise when one does not provide a client with the needed information. Nurses should always inform their clients of the benefits or risks involved in each medical procedure or treatment. Such professional conduct is often enabled by values such as altruism and human dignity. When a nurse cannot engage a client in a discussion on informed consent, the health worker must leverage their autonomy to make the best decision that fits the situation.
References
Brunt, B. A., & Russell, J. (2018). Nursing Professional Development (NPD) Standards. Retrieved from www.ncbi.nlm.nih.gov/books/NBK534784/
Haddad, L. M., & Geiger, R. A. (2019). Nursing Ethical Considerations. Retrieved from www.ncbi.nlm.nih.gov/books/NBK526054/
Poorchangizi, B., Borhani, F., Abbaszadeh, A., Mirzaee, M., & Farokhzadian, J. (2019). The importance of professional values from nursing students' perspectives. BMC nursing , 18 (1), 26.
Seo, E. J., & Cha, N. H. (2016). Relationships among nursing professional values, bioethics, and death ethic perception in nursing students. Journal of Digital Convergence , 14 (5), 349-358.
Smith, A. & Parkhouse, J. (2018). Informed consent; legal and ethical considerations. Nursing and Residential Care, 20(4), 158-161. http://dx.doi.org/10.12968/nrec.2018.20.4.158
Willson, G., & Angell, K. (2017). Mapping the Association of College and Research Libraries information literacy framework and nursing professional standards onto an assessment rubric. Journal of the Medical Library Association: JMLA , 105 (2), 150.
