Nursing Ethical Dilemmas

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.

Nurse’s face ethical dilemmas every day in their nursing practice. No matter what specific role the nurse plays, these ethical dilemmas impact the nurses as well as the patients. Sometimes it’s no right solution to some of the dilemma we nurses face. First to describe what ethics is, it is the act of doing good by not causing harm to the individual involved.

Sule stated that, “The Patient Bill of Right adopted by American Hospitals Association states that ‘a patient possesses the right to be informed of the medical consequences of his or her actions and decisions and refuse treatment to the extent permitted by the law’. However, this is true only if the patient is in position to understand the consequences of his treatment. Incompetent, senile patients neither have the correct judgment regarding which treatment is appropriate for them, nor are they in a state of understanding the implications of their treatment. In such case, their willingness to grant or deny consent cannot dictate the course of treatment.” Problem with the Act is being able to find that the patient component enough to make such a call. Another issue that Sule stated was on confidentiality and autonomy. According to Sule, “This is another ethical issue erupting from the conflict of patient's rights and professional ethics in nursing job and profession. The Patient Bill of Right makes it mandatory for the medical practitioners to reveal the form and extent of the ailment along with the course of treatment to be undertaken by the practitioners. However, this law of autonomy clashes with the nursing ethic that the professional should maintain high degree of confidentiality regarding the patient's health and treatment.” This can cause conflicting issues in the NP’s

The nurse in the case study is faced with an ethical and professional, dilemma. How can she be an advocate for her patient Mr. E? Dr G. is proceeding on a course of action or plan of care that is directly contrary to the patients advance directive and his verbalized objections to the course of treatment proposed by the physician and that is concerning for her. There are multiple issues to consider. For the nurse, she needs to think about her code of ethics, her scope of practice and the legal issues regarding advance directives and Durable Power Of Attorney (DPOA). She also needs to consider the patients right to privacy and confidentiality. As with most areas and issues in modern healthcare the statues can be

#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)

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.

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

Time, cost, and efficiency. Those three barriers are the challenges within Bellin’s current refill team covering six clinics. Beginning with medications not being filled at office visits. Patient’s changing pharmacy’s. Refills remain that the pharmacy and patients reading their medication bottles that state Refills remaining:0 and that is only due to the last older script being pulled from the pharmacy file. A new script has been often sent in but doesn’t register when a patient picks up a new script bringing the patient to call the clinic for a refill. When really a new script is on hand at the pharmacy already. So, then I research and verify with the pharmacy. Then there is the common scenario of the patient calling the clinic requesting

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).

Ethical issues in nursing will always be an ongoing learning process. Nurses are taught in nursing school what should be done and how. Scenarios are given on tests with one right answer. However, there are situations that nurses may encounter that may have multiple answers and it is hard to choose one. “Ethical directives are not always clearly evident and people sometimes disagree about what is right and wrong” (Butts & Rich, 2016). When an ethical decision is made by a nurse, there must be a logical justification and not just emotions.

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,

An ethical problem is not a routine decision with a predictable outcome. It is the opposite. Ethical problems may include differences in opinion, power struggles, and even intuition (Burkhardt & Nathaniel, 2014). The ethical problem from the case study is the struggle the nurse, Joanna, has with her peers to determine the cause of abdominal pain in her patient and the deadly outcome of her intuition. The dilemma Joanna faced was a frequent COPD patient, Mrs. Kelly, who began to complain of abdominal pain.

For the purpose of this assignment, ethics in relation to nursing will be discussed. "Ethics; A code of principles governing correct behaviour, which in the nursing profession includes behaviour towards patients and their families, visitorsand colleagues" (Oxford Dictionary of Nursing 2004).

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.