Nursing Ethical Dilemmas

According to trait 1.1 “Respect for Human Dignity” of provision 1, “A fundamental principle that underlies all nursing practice is respect for the inherent worth, dignity, and human rights of every individual. Nurses take into account the needs and values of all persons in all professional

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.

The Royal College of Nursing (2015) (RCN), believe professional values are to be followed to create the evolving nurse, with Advocacy highlighted as a fundamental feature. The central thesis of this paper is to reflect my understanding of advocacy against my own clinical practice as a first-year student nurse. The analysis to reflect on this clinical practice will use Driscolls (2007) ‘The What?’ Model, which questions the stages of the learning cycles to reflect on, the incident, what has been learned and the outcome on both current and future practice. Patient Confidentiality will be protected and respected throughout this reflection as described in The Nursing and Midwifery code (2015) (NMC), and The Data Protection Act (1988), all personal information including the patient’s name is considered privileged information and be dealt in a way which does not comprise the patient’s dignity or infringe upon their right to privacy.

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.

Ethics plays a very important role in the healthcare setting, especially when minors are involved. There are several factors and outliers that affect the decision making process as well as the quality of patient care. A major dilemma nurses face is confidentially, especially when parents or guardians have certain legal rights over the minors that limit their choices. All patients whether they are minors should still be able to expect confidentiality. The argument is whether or not teens are able to make these difficult medical decisions alone and whether they understand what’s going on, the procedure process, and all the risks and consequences involved. The ethical dilemmas that many nurses face with teen pregnancies are confidentiality, informed consent, and competence. Nurses face whether or not to

Nurses and all other health care professionals continue to be confronted with ethical and legal issues in their daily practice. In order to protect the legal and ethical rights of the patient the health care professional must be knowledgeable about ethical principles (Guido, 2014). Ethics involves the principles or assumptions underpinning the way individuals or group ought to conduct themselves; ethics is concerned with motives and attitudes and the relationship of these attitudes to the individual (Guido, 2014). The healthcare professionals should be dedicated to provide competent medical care with compassion and respect for human dignity and rights (AMA, 2015). Ethical principals are developed for the benefit of patient

For many healthcare provider’s and registered nurses, ethical decision-making invokes the concept of ethical dilemmas (Guido, 2014). When healthcare providers and registered nurses establish a trusting relationship with their patients these caretakers can sometimes experience a variety of ethical dilemmas throughout their healthcare careers. However, caring for a patient's one’s personal belief can sometime intertwine with patients personal and ethical beliefs. When making ethical decisions, nurses need to combine all the elements using an orderly, systematic, and objective approach (Guido, 2014). Registered nurses have a moral and ethical obligation to ensure patient safety regardless of their personal beliefs (Inoue, Karima & Harada, 2017).

In the busy daily operations of the healthcare system, one may be surprised to learn of the internal disruption that often transpires among nurses – violence. Lateral violence is occurring; this includes incivility and bullying, which can be described as disruptive acts intimidating fellow colleagues and may pose a threat to patient care (Yoder-Wise, 2015). As a group, we were given an opportunity to experience conflict within the workplace firsthand and then asked to find a suitable resolution. As the assigned role of the nurse manager, the following will analyze the ethical framework and the communication techniques utilized during the group assignment. Ethical Framework

The ethical dilemma is a situation by which it’s difficult to determine whether a situation is can be handled without disappointing both sides. Therefore, an ethical dilemma exists when the right thing to do is clear or when members of the healthcare team cannot agree on the right thing to do. Ethical dilemmas require negotiation of different points of view (potter, Perry, Stockert, & Hall 2011pg 78).

The ANMC (2010, pp.6) state on the topic of confidentiality, that nurses must insure the information obtained in a professional setting remain private and that information received is not used by nurses to give them an advantage or power in any way. Education in the matter is one solution to guarantee the boundaries and to keep a professional position. These breaches can be classified as boundary crossings, boundary violations or sexual misconduct and can lead to violations of a nurse’s professional responsibility causing consequences to occur.

Nurses rely on personal knowledge and their professional skills to provide ethical care (Creasia & Friberg, 2011). In everyday practice, nurses must balance the needs of their patients against those of the organization, society and themselves. They strive to deliver the highest level of care for patients, but adjusting for limited organizational and personal resources often requires difficult decisions. This paper explores the following scenario suggested by Maville and Huerta: “You are a nurse providing home care to a mother, and you suspect child abuse after observing the mother’s reaction to her child” (as cited by Arizona State University, 2014). When faced with a moral dilemma, a competent nurse incorporates ethical, bioethical and legal considerations. In the proposed story, incorporating the nursing ethics of advocacy, beneficence, nonmaleficence and collaboration will guide the nurse towards an appropriate and legal course of action.

Nursing leaders are burdened with ethical responsibilities for their nursing staff, patients, their organization and their profession ( Dunham-Taylor & Pinczuk, 2015). This is because nursing leaders must cope with the realities of limited resources and have to make difficult choices that prioritize resource needs into those that are fulfilled immediately, those that are partially fulfilled, and those that are either differed or rejected (Harlew, 2013; Marquis & Huston, 2014). In addition, leadership decisions are strongly influenced and determined by social, political and economic factors (Dunham-Taylor & Pinczuk, 2015). As a result, the debate on the healthcare resources allocation for a rationing environment often takes on an ethical perspective.

This essay will discuss why confidentiality is important within nursing practice and the reasons why a registered nurse and student nurse are accountable and to whom they are accountable to in relation to patient care. It will further discuss patient’s rights in relation to law.

This assignment will consist of discussing and identifying issues that directly impact on the professional practice of nursing with the concept of consent. During my nursing placement, I witnessed consent occurring on a day-to-day basis. “A fundamental principle underlying ethical practice is ‘informed consent.’” (Dobson, 2008) Such as the consent to treatment is fundamental, as all healthcare professionals have a responsibility to ensure that they gain consent prior to proceeding with any care or treatment. The principle of consent is an imperative part of medical ethics and the international human rights law. Consent needs to be valid, therefore it must be voluntary and informed, with this the individual giving consent must have the capacity to make the decision. Healthcare professionals needs to provide all the necessary information in relation to the terms of what the treatment involves, which includes the benefits, risks and if there are any other valid alternative treatments and what will happen if treatment does not proceed. Informed consent applies when a person can be said to have given consent based on a clear appreciation and understanding of the facts, and the implications and consequences of an action.

I have taken into account; The code of professional standards of practice and behaviour for nurses and midwives, I have gained and maintained individuals’ right to privacy and confidentially regarding the patients name and trust details (Nursing and Midwifery Council 2015 p. 6).