Not so long ago, health care was characterized by a paternalistic mindset: health care professionals acted in the best interest of a patient without regard to their wishes. This outdated practice has now been replaced by a much more ethical approach. As an extension of patient autonomy, the concept of shared patient decision-making empowers patients by giving them the opportunity to work with healthcare professionals to make important decisions about care. In collaborative decision-making, patients and providers work together to make decisions about tests, treatments, procedures, and overall care strategy. In a sense, the patient`s joint decision is a form of informed consent and vice versa. As with informed consent, nurses and others who make decisions with patients are responsible for educating them about treatment and discussing options with them. An example of a common ethical dilemma that caregivers face is setting boundaries with patients. Nurses and care managers dedicate their careers to supporting patients in need, so it can often be difficult to set career boundaries. Patients should not rely on nurses beyond their professional abilities and should not form romantic relationships with them or give them gifts. Nursing managers can intervene in situations where ethical and professional boundaries are crossed by patients or nurses. Another common ethical dilemma in nursing is the concept of informed consent. Informed consent to treatment is a process by which a patient or surrogate gives permission to their health care provider to perform a treatment or procedure after being informed of their potential benefits and risks and informed about alternative treatments. Informed consent is required for many medical procedures, including anesthesia, blood transfusions, chemotherapy, and most surgeries.
Informed consent usually requires written documentation with a patient`s signature. When caring for large numbers of patients, caregivers are often faced with ethical dilemmas. These ethical issues can take all shapes and sizes. Sometimes these problems arise from a patient`s discomfort during treatment, rejection of treatments due to cultural or personal ideologies, or when patients and their families have to make life-or-death decisions about their health condition. In these cases, nurses must not only provide quality care, but also adhere to the official code of ethics for nurses. The reasons listed above, combined with the nine provisions of the Code of Ethics for Nurses, lead to some typical ethical dilemmas in nursing examples that most nurses will encounter at least once in their careers. At its core, overcoming ethical dilemmas is as simple as ABC because all you need to consider is this: As you may have seen in some of the ethical dilemma “solutions” listed above in nursing examples, the best course of action is often to put the nurse`s code of ethics before what you think is the right choice. influenced by emotions and feelings. This principle includes own legal capacity and the right to take a decision.
Each individual has his own morals and values. Respect for the patient`s decision is an important ethical principle, Nurse Mavis refused the nurse`s care. Ethically, this is the patient`s decision and nurses must respect, but as a nurse, it is the responsibility to provide safe, high-quality care (Bratz & Sandoval-Ramirez, 2017). Ethical questions arise when decisions need to be made, the answers may not be clear, and the options may not be ideal. This could result in a decline in the quality of patient care; problematic clinical relationships; and moral distress, which is defined as knowing what to do, but not being allowed or able to do it. Nursing managers, in particular, are vulnerable to ethical nursing issues and moral distress because of their leadership and mentoring roles. Nurses and other medical staff look to care managers to make appropriate and ethical decisions. The ANA Code of Ethics provides a standard by which nursing managers can assess ethical issues in care. However, the way ethical dilemmas are addressed can vary from situation to situation. An ethical dilemma that can arise in healthcare facilities is when nurses themselves are not sufficiently equipped to perform their duties. Nurses who notice their colleague`s lack of knowledge face an ethical dilemma as to whether to escalate the issue to their care manager. To address this ethical dilemma, caregivers can work hard to educate their nurses on the code of ethics and educate them on the code of ethics of their specific medical facility.
Nursing managers can also provide regular training to their nurses on recurring issues. In addition, Altman suggested that nurses contact “the hospital`s ethics committee, the hospital`s code of conduct, or a variety of educational resources. Some organizations have an ethics advisory service whose members proactively assist employees in discussing potential or actual ethical issues. The American Nurses Association creates and publishes recognized guidelines for ethical nursing practice in the United States. The ANA Code of Ethics is a living document that evolves as the profession progresses. The ANA also publishes separate ethics guides for different areas of expertise and controversial areas, such as ethics in end-of-life decision-making. As a nurse, you face ethical dilemmas regarding the spiritual vs. scientific approach of your patients, their family members, and loved ones regarding their health status. What if the relatives of Patient X, who has little scientific chance of surviving the surgery, refuse to acknowledge the risk because of their spiritual belief that all will be well? “Every day, nurses in all hospital departments face a variety of ethical issues and must align their own values with their commitment as nurses,” said Marian Altman, RN, M.S., CNS-BC, CCRN-K, clinical practice specialist at the American Association of Critical-Care Nurses (AACN). This principle concerns respect for the patient`s privacy. It is very important that caregivers respect a patient`s right to privacy and maintain the nurse-patient relationship.
Nurses must follow ethical guidelines to apply confidentiality in nursing practice (Airth-Kindree & Kirkhorn, 2016). However, in this case, the registered nurse was able to preserve the patient`s privacy by closing the door and covering the patient`s body when exposed. When patients feel supported and trust their doctors and nurses, they are more likely to follow a treatment plan and achieve better outcomes. To avoid ethical dilemmas, caregivers need to ensure that patients fully understand all facets of their treatment plans. Details include knowledge of all risks and disposition, how a procedure will work, or how certain medications and treatments will affect them. Otherwise, it could endanger the health of patients and lead to high costs for hospitals. Therefore, healthcare professionals should take all necessary steps to ensure that their patients understand the treatment plan in order to obtain informed and secure consent. “They may think the behavior should be reported because of the threat to patient safety, but are reluctant to do so because it would exacerbate staff shortages,” Delgado said.
“Some dilemmas can be framed as competing obligations, such as protecting the patient on the one hand and protecting staff on the other.” Informed consent requires that the patient or surrogate be aware of the risks, benefits and other treatment options. The person signing the form must voluntarily agree to the treatment plan. It refers to the “right to self-determination” in the Code of Ethics of Care. The ANA adopted its first code of ethics in 1950. Since then, it has undergone several revisions to compensate for advances and changes in research, technology, law and general challenges in care. The guidelines are divided into nine provisions covering issues such as human dignity, confidentiality, moral virtue and health care as a right. The ANA said each of the provisions covers issues important to the challenges of care in the 21st century. Another case where a nurse must decide to proceed with necessary treatment that the patient refuses is examined in the ethical dilemma of autonomy versus charity. Ethical decisions related to justice often involve the allocation of fear resources.
An example of the ethical dilemma nurses faced in allocating resources emerged after Hurricane Katrina, when hospital staff had limited access to medicines and life-saving equipment. Doctors and nurses were faced with the ethical challenge of deciding which patients would be treated and which patients would simply put them at ease. Dealing with ethical issues can be challenging, which is why it`s best to surround yourself with experienced in-house nurses who can help you in these situations.
