Ethical Dilemmas in Health Care Nurses are constantly challenged by changes which occur in their practice environment and are under the influence of internal or external factors. Due to the increased complexity of the health system, nowadays nurses are faced with ethical and legal decisions and often come across dilemmas regarding patient care. From this perspective a good question to be raised would be whether or not nurses have the necessary background, knowledge and skills to make appropriate legal and ethical decisions. Even though most nursing programs cover the ethical and moral issues in health care, it is questionable if new nurses have the depth of knowledge and understanding of these issues and apply them in their practice …show more content…
I personally consider that changing the medical records in this way is both “legally and illegally inappropriate” (Lazaro, 2004) and I can identify 3 possible course of actions for Jill. She could completely rewrite her note, make no changes to the documentation or write an addendum to her previous progress note, which would explain clearly and in detail the care and treatment she performed on Mary. Even though she cannot remember for sure if she left the call light within Mary’s reach she could argue that is it her practice to always place the call light within reach of her patients. Ethical Theories The two ethical theories that can be found in this case are utilitarism and deontology. If Jill follows the utilitarian perspective, she could decide to alter the documentation in a way that protects her and the facility from a potentially law suit, but if she decides to follow the deontological perspective by not altering the documentation, she would put the patients’ needs and rights first. Ethical Principles. There are some legal and ethical principles Jill should take in consideration before she decides whether to revise her notes, as requested by the director of nursing and the facility administrator. First is the principal of beneficence which “requires nurses to act in ways that benefit patients” (Burkhardt, 2014, p.69). This principle tells us that one should promote good, prevent harm and remove evil or harm.
The main ethical issues that presented in the case scenario is maintaining privacy and confidentiality. “Privacy is limited access to a person, the person’s body, conversations, bodily functions or objects immediately associated with the person” (CNO, 2009, p. 7). Nurses recognize the importance
Williams should also make sure that he serves rather than steer Mr. Chisholm in the right direction. He should listen to the patient and allow and follow the patients wishes as long as it is not harming others in the society. In addition, the nurse should follow the principles of utilitarianism and deontology. These both mean that the patient is the center of moral concern. As a healthcare professional he should give priority to the patient rights and needs.
The document will explain how unethical and disturbing her behavior was by falsifying a patient information and the document should further highlight additional corrective actions that may be taken if she were to repeat this act. In addition, she should receive additional training in the policies and requirements for providing accurate medical data, the legal perspectives of employee responsibilities, and consequences for employee misconduct. Plus, an investigation should be opened up in the matter to evaluate Ms. Smith entire performance for that day and whether she might have falsified patient data previously in other situations. This procedure may unravel potential issues that can pose harm for the organization in the
Provision 5.4 Preservation of integrity applies to scenario 2 because the nurse has the right to protect his or her integrity and not compromise it. The nurse is solely responsible to uphold integrity and cannot blame mistakes on others. The ANA Code of Ethics (2015) states, “Such threats may include requests or requirements to deceive patients, to withhold information, to falsify records, or to misinterpret research aims” (p. 20). By having the nurse reflect upon the provision at hand, it is clear that falsifying records violates this code.
Butts and Rich (1-26) point out that effective nursing requires both broad knowledge and a set of well developed abilities and skills. The required tasks, are many and varied and in order to do them properly, care must be taken to respect each patient's rights and sensitivities. This is why, according to the authors, nursing care must be guided by a code of ethics. The purpose of this paper is to provide an overview and discussion of the "Code of Ethics for Nurses with Interpretive Statements" developed by the American Association of Nurses (ANA 1-2).
The first version of the code of ethics was named after Florence Nightingale in 1893. Designed after medicine’s Hippocratic Oath, the author, Lystra Gretter, believed that Florence Nightingale exemplified the “highest ideals of nursing” (Fowler, 2010, p. xiii) and wrote the “Florence Nightingale Pledge” in her honor. To this day, nursing schools all over the country, recite this, or similar versions at, at graduation. This public expression of nursing’s values, commitments, and duties was the foundation for the American Nurses Association’s (ANA) Code of Ethics for Nurses with Interpretive Statements (The Code) that is so well known today. The Code is a “nonnegotiable ethical standard” that “provides a succinct statement of the ethical values, obligations and duties of every individual who enters the nursing profession” ("ANA," 2016). Using The Code and the deontological decision-making model, the author of this paper will analyze the case scenario provided, and resolve the ethical dilemma.
Following the appropriate ethics is of extreme importance in the nursing profession. “Ethics are of universal concern and crucial in all professional healthcare” (Gustafsson & Stenberg, 2017, p.420). The leading goal in nursing is to achieve patient-centered care. According to Arnold and Boggs (2016), “Patient centered care focuses on fully partnering with the client to provide care that incorporates his or her values and preferences to give safe, caring, compassionate and effective care” (p.25). In order to provide a well-grounded, caring environment, nurses need to be able to balance their personal differences with the ethical care standards they are obligated to provide patients (Gustafsson & Stenberg, 2017). Nurses spend the most time with patients; therefore, they eventually will develop a “sense of rightness” (Gustfasson & Stenberg, 2017, p.420).
One ethical issue that came across my mind was during one of the patient staffing meetings. The patient had schizophrenia under stable conditions with minimum positive symptoms. I felt like the psychiatrist was withholding knowledge from the patient about her discharge arrangements. Patient was not aware of this conceal information because of her mental condition and memory problems. The psychiatrist should have told the patient just enough information to keep her moving in care
The purpose of this paper is to identify the ethical issues in the case study provided in the week one assignment. A discussion of how to use ethical principles to address the issues presented in the case study will be covered within the paper. A description of conflicts of this nursing student’s personal values and the ethical principles applied in this case study. The paper will
At a practice level, the importance and guidance of the Code of Conduct, Code of Ethics and NPA are demonstrated on a daily basis with regard to the issues of documentation, informed consent and open disclosure, and confidentiality. With respect to documentation, nurses must be able to document patient assessments and responses in an accurate, comprehensive and confidential manner and record all observations objectively. Informed consent and open disclosure are also major legal issues nurses face daily. It refers to the communication between the patient and health professional that results in the patient's agreement to undergo a specific procedure and requires that the patient has thoroughly understood the procedure, implications and risks prior to giving written consent.
Explore strategies: Deborah can accept the years of fraud the private clinic has been conducting and take part. Putting herself at risk and her patients. Currently that we are aware of the only people facing an ethical dilemma is Deborah. However other healthcare providers could have taken part in the suggestion by their supervisors to maintain their job. It is clear that Deborah is not content with the information she received from her superior. We know this because she is hesitant to carry out the action. Inventing diagnosis to receive compensation on behalf of Medicaid is not acceptable for the patient and the government providing the funds. We can clearly see that the providers do not want to deliberately cause harm to the patients. If anything they want to keep the clinic open to help the community. However, this method of business will not be sustainable and is doing more harm than good. That is, saying patient medical records will affect the individual in the future. Or she can either
Health care professionals make ethical choices on a daily basis within the work environment. Nurses, in particular, make ethical decisions every day when caring for patients, whether when explaining procedures to patients, performing actions related to doctors’ orders, telling the patient their results, or answering the patients’ questions. These choices can result in positive or negative outcomes, which incorporates the four principles of bioethics into every situation in relation to handling the deliverance of patient related information. There are four principles of ethics which include the principle of respect for autonomy, the principle of nonmaleficence, the principle of beneficence, and the principle of justice (McCormick, 2013).
Doreen, I found your discussion response to be very interesting. Nurses are the members of the care team that are most accessible to the patient, therefore they deal with ethical issues on a daily basis when providing patient care. According to Silva, Marvins, Bobre, Frazao, & Rosa (2014) ethics, is a fundamental aspect of the nursing practice, and nurse should understand both their competencies and limitations when delivering care (p. 241). I experienced the exact example you gave for an ethical situation. We had a patient on the unit who has not only a DNR on her chart, but also a copy of her living will which clearly stated no ventilator. She had a relatively minor procedure with complications, which is why she ended up in ICU.
Nursing embraces the protection, promotion, and restoration of health and well-being. Those who become nurses are expected to obey the values, moral norms, and ideals of the profession, as well as encompass them as part of what it means to be a nurse (American Nurses Association, vii). In providing care beyond the physical realm of healing, illness can be viewed in a different perspective. Illness can rather be viewed as an enablement, allowing one to grow both spiritually and emotionally. It can also empower, as it can act as a summons to selflessness (Pellegrino & Thomasma, 14). Nurses are expected to consider these views in their daily work, and are expected to hold core ethical values in their profession that guide the decisions they make in the care they provide. Some examples of ethical principles in nursing that I believe to be of most importance include: respect for human dignity, autonomy, beneficence, nonmaleficence, justice, fidelity, caring, integrity, diversity, and excellence.
The importance of ethical theory plays a large role in nursing practices. It is often difficult to understand where the lines of confidentiality should be drawn, so in order to help decipher the feelings nurse practitioners have of what they consider to be fair or unfair, there are a number of ethical theories that can be used in order to