With the evolution of nursing practice, nurses can now offer relevant information and even participate in decision-making during patient care. These responsibilities place them at the center of ethical issues. The decisions made by nurses could be a decline in the quality of patient care, strained clinical distress or even moral distress. In my case, for instance, the ethical dilemma I faced with was to break the circuit and save the patient’s life or fail to do so for fear of introducing viruses into the circuit. The ethical issue in question was the principle of autonomy, that requires nurses to respect the wish of the client.
Autonomy has gained prominence in nursing and general health care in the recent years. This is due to the growing understanding of the fact that patients have a right to determine and make decisions regarding the approach their care and health treatment should make. Furthermore, this is a patient right that has both national and international approval. However, while respect for autonomy is accepted as a tenet in nursing practice, the reality is in some situations it can create tension and ethical dilemmas for nurses (Nelson, 2017). This is because some times the wish of the patient can be in conflict with the professional or even the available clinical evidence regarding a particular approach.
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Often, nurses find themselves in situations where there are moral judgments based on ethical standards as required in the profession. Furthermore, nurses have the responsibility of care in order to minimize harm and at the same time act in the best interests of the patient (Dineen, 2019). In this case, for instance, the patient wanted a full code, yet the ventilator was supposed to remain airtight to avoid entry of more viruses. As a nurse, one has duty of care, in order to improve patients’ outcome. However, in some complicated situations such as this one of ventilators and COVID-19 patients, nurses have to make judgments based on ethical consideration before a decision is arrived at.
From a moral standpoint, nurses have the responsibility of making morally upright decisions that serve the best interests of the patient. Sometimes, however, these decisions are in conflict with the health care standards and in worst cases scenario life and death. As a nurse, one is the voice of the patient, as such sound decisions to improve the outcome of the patient have to be made (Lucier, 2017). Sometimes the nurses have to override work conditions and technology developments in order to save the life of a patient. Notably autonomic situations can be morally distressful to nurses.
Legally, nurses are expected to comply with the American Nurses Association Code of Ethics. The code is particularly important in the health care environment today because it outlines the responsibilities, identifies the boundaries and duty of care that at times is beyond the nurses’ own decision. In this situation, for instance, the nurse has the legal responsibility of respecting the wish for a full code even though it is against the requirements at the hospital. In a recent research carried out in a handful of health care centers in the U.S., findings reveal that most patients and nurses believe that autonomy should be respected (Carriere, 2019).
In conclusion, ethical dilemmas at the clinical practice often involved numerous issues. Often ethical dilemmas manifest as a result of decisions that have to be made by nurses. In this scenario, for instance we were faced with a dilemma of respecting patient’s autonomy or following the institutions’ guidelines. Amidst the dilemma, however nurses have a responsibility of care both legally and professionally as outline by the standards of the profession.
References
Carriere, S. A. L. (2019). How Nurses Balance Risk with Patient Autonomy When Making Decisions about Physical Restraint Use with Older Patients in Acute Care (Doctoral dissertation, University of Saskatchewan).
Dineen, K. K. (2019). Ethical and Legal Issues. Priorities in Critical Care Nursing-E-Book , 8.
Lucier, S. A. (2017). THE VOICE OF PATIENTS AND FAMILIES. Creative Nursing , 23 (2).
Nelson, B. (2017). Autonomy or Beneficence: An Analysis of End-of-Life Care in Pediatric Patients (Doctoral dissertation).
