Ethical Nursing Practice: A Case Study

As a registered nurse practicing in the state of California I am responsible for practicing within my states legal regulations and nursing scope of practice. My concern for the welfare of the sick and injured allows me to practice ethical provisions of nursing. These are required if I am to carry out competent and effective nursing care. Nursing encompasses the prevention of illness, the alleviation of suffering, and the protection, promotion, and restoration of health in the care of individuals. Therefore, as health care professionals we must be familiar with the different philosophical forces, ethical principles, theories and values that influence nursing. At the same time, we must be respectful to our patient’s

Ever since the concept of mental illness became more mainstream, it has become a widely controversial topic. Based on what has been seen in society, people who are involved with mental disorders are often dehumanized in some way.

Nurses face numerous challenges in their daily advocacy duties. Some physicians may not respond to nurses in a timely manner as they prioritize their task differently (Mendes & Ventura,2016). Additionally, institutional limitation frequently makes barrier for nursing to be able to advocate for patients (Mendes & Ventura,2016). Some professional who support nursing advocacy believe nurses should have higher autonomy to protect the patient in better way (Mendes & Ventura,2016). Nursing ethics constantly deals with challenges to freedom of practice, especially in hospital settings.

When a person with mental illness feels stigmatized among the community they seek health care professionals who can help them feel better. Consumers expect to have understanding and respect in the health sector. Unfortunately, some consumers experience the opposite way and they also felt the stigma with health care providers (SANE Australia 2013).

The American Nurses Association (ANA) has the Code of Ethics which holds Nurses to the codes or provisions of these documents. I summarized Provision 1 of the ANA 's Code of Ethics. I give a scenario where this provision is broken by the nursing staff and consequences of doing so. Provision 1: Provision 1 reads as follows “The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems” (American Nurses Association 2001). Provision 1 is divided into five subdivisions. Provision 1.1 is titled “Respect for human dignity"(ANA 2001). The nurse always needs to place value on their patient as a unique individual. Provision 1.2 is titled “Relationships to patients” (ANA 2001). As a nurse you need to leave all prejudice, personal beliefs, and convictions out of the care of your patient. The patient’s self-worth and value is not defined by their religious choice, culture, lifestyle, hygiene, financial status, sex, and race. The nurse needs to form or follow an individual treatment plan that fits your patient’s personal preferences, religious beliefs, and requests. Provision 1.3 reads as follows “The nature of health problems” (ANA 2001). A nurse is not to judge or look down upon a patient by their "The disease, disability, or functional status “(ANA 2001).The nurse needs

As healthcare providers, maintaining a patient’s confidentiality, human dignity and privacy is expected at all times. Nurses are faced with maintaining patient confidentiality on a daily basis. The Coded of Ethics for Nurses is the framework of nonnegotiable ethical standards and obligations that all nurses are to uphold. Nurses are to be accountable for their actions and are expected to advocate and strive to protect the rights, health and safety of patients (American Nurses Association, 2011).

`Ethics' is defined as ."..the basis on which people...decide that certain actions are right or wrong and whether one ought to do something or has a right to something"(Rumbold, 1986). In relating `ethics' to nursing care, "Nursing decisions affect people... nurses have the power to good or harm to their patients" (Bandman et al, 2002). In this essay, the author will also identify the most important ethical principles and concepts of Evan's case, will outline the different stages of one's approach to ethical decision-making by utilising the "DECIDE Model for Ethical Decision-Making" founded by Thompson et al (2000) and will make a decision on the best course of action to take as a nurse in this

This essay will focus on scenario 5. It will discuss the illustrated inherent tensions in values and evidence shared decision- making and professional identity in nursing. This will include: confronting inappropriate behaviour constructively, labeling patients/dehumanisation and the use of professional barriers and setting an expectation for interactions. It will also outline the comments of the peer groups in relation to suggestions for conflict resolution within professional, patient and carer interaction.

Ethical principals are the seed of which nursing flourishes from. Many ethical principals were involved and dishonored in this case such as, justice, autonomy, beneficence, non-maleficence, confidentiality and fidelity (Burkhardt et al., 2014). I believe justice was the main principal involved as the entire ethical predicament was revolved around unjust behavior and treatment of the residents. The residents were treated poorly and given unequal rights as a causation of their illnesses. Autonomy, an essential piece of human rights was also being violated in this ethical dilemma. The residents did not have any choice or independence in their care or how they were being treated. Beneficence and non-maleficence are significant dynamics of this ethical situation, as the health care providers needed to reflect on how they can have the maximum benefit while diminishing possible damage to the residents (Burkhardt et al., 2014). Our actions as nurses should always be beneficent and non maleficent, continuously being kind, compassionate and doing what is in their best interest as well a removing and preventing harm. Confidentiality is a key component of nursing and it was blatantly being violated as the health care

Nurses are subject to a plethora of legal, ethical, and professional duties which can be very challenging on a day to day basis. Some of these duties include respecting a patient 's confidentiality and autonomy, and to recognize the duty of care that is owed to all patients. As nurses our duties are always professional; however there are legal implications if these duties are breached. We also must consider when it is okay as nurses to breach these duties and therefore ethical issues arise. As nurses one of our main priorities is to advocate for our patients, without our own personal feelings on the matter taking over.

In the scenario there is a young man, that has been admitted to the ward, with a diagnosis of haemophilia and requires a Factor Eight transfusion. The nurses are in hand-over, which is situated directly across from this man 's room, arguing loudly about their right to refuse him care. The senior Registered Nurse [RN] explains to the new graduate nurse, coming on duty, that the man is currently serving a term of home detention for sexual abuse offences. The new graduate is expected to adopt the same stance as the rest of the nurses and refuse this man care. The scenario outlines potential barriers to culturally safe care. This includes the unprofessional attitudes of the RN 's, and this possibly impacting on the new graduate 's ability to practice confidently and with autonomy. There is also the issue that the patient may have overheard this entire event, increasing his vulnerability.

Jones & Smith (2014) observe that nurses are the first line of health care professionals to recognize situations which are not in the best interest of patients and they can report these situations for changing them. The American Nursing Associations Code encourage nurses to be advocators for patients by reporting cases of patient abuse, including known or suspected cases of emotional, physical or sexual abuse (Marquis & Huston, 2009). Nursing advocacy plays a key role in providing safety of patients during their engagement with health care system; especially when the patient is too ill to serve his own advocate or when the patient is not fully aware or alert. Each encounter that the nurse has with his patient presents an opportunity for the

Nurses have a professional responsibility to ensure that safe boundaries are understood and maintained in a patient/nurse relationship. Nurses should be knowledgeable regarding professional boundaries and continued education assists them to achieve this. It is these boundaries that provide the nursing profession with integrity, and according to Baca (2010, pp.195) it is essential these boundaries be maintained because of the difference in power between the nurse and patient. However, boundary violations can occur, when a nurse crosses from the zone of helpfulness to over involved, the ANMC (2011 pp.3) believes that when a violation occurs a nurse is behaving in an unprofessional manner and misusing their power in the patient nurse relationship. This misuse of power can be categorized into 3 types; boundary crossing, boundary violation and the extreme form, of sexual misconduct. Often a nurse could cross the boundary without thought, a violation is a more serious matter when according to the ANMC (2011 pp. 5) the nurse puts his or her own needs in front of the

Nurses have an obligation to fulfill the needs and promote optimal health of their clients. Nurses can be considered moral agents, as they process the capacity to direct their actions in an ethical matter in order to do what is good and right and promote the well-being of the clients (Burkhardt, Nathaniel, & Walton, 2014; Canadian Nurses Association (CNA), 2008). In the workplace, it is important for nurses to create a moral community which values the safety of both clients and health care staff (Burkhardt et al., 2014). However, nurses may discover that they can feel morally distressed when clients and other members of the health care team challenge their ethical values. In this paper I will explore an ethical situation that involved the use of chemical restraints in residential care, and the ethical issue behind its use. Nurses need to have an understanding of the use of restraints and the ethical issue behind the use of restraints.

Background The scenario in question involves a patient called Karen. We are looking at this issue from the eyes of an RN on a medical surgical ward. Karen is 20 years old, female, and has been admitted for a series of bruises and cuts. Some of the cuts are so severe they require antibiotics. Karen is clearly in pain, but also needs to vent and download information. You quiet her concerns the best way possible, but also have other patients to attend. During the course of your shift, you notice another nursing colleague intentionally engaging Karen. When you check on the situation, the feeling is tenuous and the patent responds to the question as opposed to the colleague, suggesting something conspiratorial in their behavior.