Nurse Practitioner Ethical Dilemmas

As a family nurse practitioner (FNP), we have the responsibility to provide the best care we can with the patient’s best interest at heart. On a daily basis we deal with the needs and wants of our patients, this alone provides an ethical dilemma. What we think is best and what our patients want could in fact create an ethical dilemma, however, when we have an ethical dilemma, it is our responsibility to get to a decision with caring, respect, an open mind and honesty to our patients (Parker, 2007). In making a decision regarding an ethical dilemma it is our responsibility to use a framework model to guide us in making an informed decision that is best for our patients. It may not always be the most popular decision but if it is in our patient’s best interest, then you are practicing as a good and prudent, NP.

Ethical issues have always affected the role of the professional nurse. Efforts to enact this standard may cause conflict in health care settings in which the traditional roles of the nurse are delineated within a bureaucratic structure. Nurses have more direct contact with patients than one can even imagine, which plays a huge role in protecting the patients’ rights, and creating ethical issues for the nurses caring for the various patients they are assigned to. In this paper I will discuss some of the ethical and legal issues that nurses are faced with each and every day.

#1. According to Nursing Leadership and management ATI ethics is defined as an expected behavior of a certain group in relation to what is considered right or wrong. (Henery, McMichael, Johnson, DiStasi, Ball, & Holman, 2016) There are six ethical principles they are autonomy which is the ability of the client to make personal decisions, even when those decisions might not be in the client’s own best interest. The second principle is beneficence which is care in the best interest of the client. Third is fidelity which is keeping ones promise to the client about care that was offered. The next principle is justice which is fair treatment in matters related to physical and psychological care and use of resources. Then there is non-maleficence which is the nurse’s obligation to avoid causing harm to the client. The last principle is veracity which is the nurse’s duty to tell the truth. (Henery, McMichael, Johnson, DiStasi, Ball, & Holman, 2016)

While the nursing profession is fulfilling, it is not without challenges. Nurses are faced with a multitude of ethical dilemmas in clinical practice on a daily basis. According to Fant (2012) no matter where nurses function in their diverse roles, they are faced with ethical decisions that can impact them and their patients. Some examples of moral issues that nurses encounter in contemporary nursing practice and research include but not limited to: refusal of treatment, scarcity of resources, disagreement with caregivers, treating patients with impaired decision-making, futile treatment decisions for cancer patients, end-of-life decisions, advanced treatment directives, and euthanasia (Leuter, Petrucci, Mattei, Tabassi, & Lancia, 2013).

Cost of the end of life medical care is too expensive to continue at the rate it is going. The fiscal year 2016 saw 672.1 billion dollars spent on Medicare participants with just 5% using 49% of those monies ("NHE Fact Sheet," n.d., p. 1). The ANA provides a code of ethics that nurses should use to help guide them in clinical practice decision making. There are four fundamental responsibilities for nurses to adhere too they are: promote health, prevent illness, restore health and alleviate suffering. Ethical Principals for nurses are; respect & autonomy, beneficence, justice, veracity, and fidelity ("Code of Ethics for Nurses," 2012). Attempting to keep ethical responsibilities and principals in mind, while conducting a cost-benefit analysis to determine resource allocation for an aging population and end of life care causes many ethical dilemmas.

It is important to understand that when counselors practices in any setting with clients as they interact on regularly bases with other professional’s workers should always conduct themselves in an ethically and legally appropriate manner (Remley & Herlihy, 2014, p.317). Chapter 12 discuses counselors who are in training for private practice and the type of roles those counselors have with other mental health professionals that are supported in their community.

This case is purely about the legal and ethical implications of nurse T.C and her nursing manager of telemetry unit, nurse F.J. This nurse T.C has worked in a highly stressful environment before but her behavior has only recently deteriorated and become emotional with the occasional outbursts and uncontrollable crying. Her behavior put the legal issue of non-maleficence at risk for her patients as it would cause emotional stress on them. However, the legal issue that really matters is her case is that of defamation of her character as well as disclosure of her private and confidential mental state information by F.J to other nurse managers not in the unit she worked and to even the subordinates.

Throughout the course of their career, nurses will constantly face the reality of death and dying patients. Disparate from medical physicians, nurses are almost always on duty to treat and hand out medication. Therefore, a situation where it is not possible for their patient to completely heal can ultimately put the nurse in a high amount of stress. Such feelings can lead to discomfort with aiding hospice patients and a decrease in nurses in that area (Peters, et al., 2013). The quality of end of life health care is also jeopardized due to the nurse facing ethical issues and death anxiety (Hold, 2017, p. 13). The impact of a patient death can incite more stress in the health care worker, according to Bickham, "Nurses often experience

Nurses face ethical decisions frequently when giving patient care. These dilemmas can result from deciding how to allocate resources such as time or materials. Caring for patients from diverse backgrounds complicates decision-making when faced with dilemmas, because organizations that depend on standards of patient care that may not by culturally congruent. In these situations, the nurse must consider the patient’s beliefs and values along with the organization’s care expectations and bridge the gap between the two (Andrews and Boyle, 2016-a). In this post, I will describe ethical dilemmas with the current state of population health and health disparities, discuss the pros and cons of the Affordable Care Act, and explain how social justice

The role of ethics in organizational behavior is the underlying factor to the success and longevity of any organization. A set of rules and guidelines focusing on promoting safety, trust, and responsible practice within the workplace must be established internally. Organizations develop code of ethics that center upon the promotion of good. Ethics are vital in developing trusting relationships between employees and administration within.

Ethical and legal dilemmas are issues that nurses face in their professional careers. Nurses are accountable for safe and appropriate administration of medication. With the growth in malpractice lawsuits it is important that nurses take certain precautions to limit the risk of lawsuits. “Nurses can limit the risk of liability through maintaining open communication with patients, expertise in practice, attention to details, and autonomy. (Burkhart &Nathanial, 2013).

Nurses are responsible for being ethical, competent, safe, and stay consistent with local, state, and federal laws. They must have an understanding of how to apply these principles when providing care to a client, they are not only responsible for understanding but also protecting client’s rights. Clients who are in a mental health setting have legal rights and they are guaranteed the same rights as any other person. These rights include, the right to humane treatment and care, the right to vote, the rights related to granting, forfeiture, or denial of a driver’s license, the right to press legal charges against another person, they have the right to refuse treatment, a right to confidentiality,

Nurses are faced with many ethical and legal issues, such as protecting and maintaining the patient privacy and confidentiality. “A dilemma can arise when confidential information is requested by family members or friends of the patient” (McGowan, 2012, p. 61). As nurses during our pinning ceremony we took the “the Nightingale Pledge promised to do all in my power to maintain and elevate the standard of my profession, and hold in confidence all personal matters committed to my keeping and all family affair” (McGowan, 2012, p. 61). Protecting and maintaining patient confidentiality is a serious matter and you can be fined and faced with federal charges, if you are found guilty.

During this week’s clinical, we discussed a situation where a man did not want to tell wife he had HIV; this would be considered an ethical dilemma.

Picture your loved one in an independent senior residence, where they can do mostly everything on their own. This sounds great until they have an emergency medical issues and the nurses that are on staff refuse to help based on their interpretation of the company policy. As a nurse, they should be trained how to handle emergencies, but in this instance the person lost their life because the nurse did not take any action. This happened to 87-year-old Lorraine Bayless, who stopped breathing and the nurse at Brookdale Senior Living Center refused to do anything or allow anyone else to do anything based on what she read in the company policy. Since state or federal departments of health license or regulate independent or assisted living centers it can