Nursing Ethics Case Study

A nurse attending stated “during the morning’s second surgery, he actually dozed off. The nurse took him aside and recommended that he take a break, but he refused and returned to the operation.” The nurse here was in fault in more ways than one. This nurse should never allowed the doctor return back to operate on the patient, he should have been removed from the operating room immediately. The nurse should have

The charge nurse met the writer in her room and stated, "I am so glad to see you but, you have a "fresh heart" tonight.  The assignment was clearly outlined during bedside report.  But this writer quickly pointed out that she had not been heart trained and could not accept the "fresh heart".  The charge nurse validated the assignment by informing this writer that staffing was really short and she felt this writer was the most qualified nurse for the job.  The charge nurse also added, she would be available for any issues, should they arise. Logically, as the charge nurse had explained the scenario, the assignment was delegated correctly according to the available staff.  But for this writer, it was  morally wrong for her to accept the "fresh heart" knowing she was not following the outlined protocol.  Also, by caring for the "fresh heart" a question was raised if it was the safest thing for this writer to accept.  The ANA Code of Ethics Provision 4.3 states nurses are responsible for assessing their own competency within practice (P475 ethics).   Since this writer had previously validated her competency and training with the devices and medication being utilized in caring for the "fresh heart", she did not violate The Code of Ethics.   Additionally, Provision 4.3 states nurses are to accept or reject assignments based on the nurses knowledge and competence, as well as their assessment of the level of risk for patient safety (Para 1 p475).    The ethical principal of nonmaleficence could have been an issue had there had been any harm committed to the patient  by this writer. This writer knew she could have rightfully rejected the assignment due to safety concerns, but did not.   Legally, this writer did nothing wrong in caring and monitoring for the "fresh heart"

In the Code of Ethics for Nurses provision 4 states “The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care.” This was not done, there was no regard for human life. The patients in the hospital were treated as a burden. A meeting was held where the doctors agreed that

It was found that the nurses had insufficient recording of wound care and the staff were not monitoring the wounds consistently or keeping Mr Selir’s GP up to date on his condition. After this incident, the nursing home introduced new staff, systems and processes to improve the quality of care to residents. I felt frustrated and disturbed as coming from overseas, my family background has always taught us to respect and look after our elderly therefore back in our country we don’t believe in nursing homes. According to Nursing and Midwifery Board of Australia [NMBA] 2016, health professionals ought to provide safe, appropriate and responsive quality nursing practice.

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.

Provision 8.1 of the American Nurses Association Code of Ethics denotes that health is a universal right. The provision states, “the nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities” (Lachman, Swanson, & Windland-Brown, 2015, p. 365). From chapter 1, the ethical theory that best fits provision 8.1 is utilitarianism. The ethical theory of utilitarianism theorizes “one should act so as to do the greatest good for the greatest number” (Baillie, McGeehan, Garrett, & Garrett, 2013, p. 4). This theory promotes a universal method because it signifies that even if a decision is made and does not benefit every single person; however, benefits most

Beneficence compounded by nurse-physician communication created ethical problems in this case. Mainly, Joanna’s assessment of Mrs. Kelly being ignored by the resident physician and the nursing supervisor. Joanna worked within the scope and standards of practice, she assessed, evaluated, and monitored her patient’s condition. She then reported her findings to the resident twice, and also sought nursing support from her shift supervisor. After Joanna’s first call to the resident, and her continued concern she needed to advocate in a proactive manner. Continuing her assessment of Mrs. Kelly to include palpation and auscultation could have offered additional clinical information enabling her to articulate the problem to the resident and nursing supervisor.

An ethical dilemma is defined as a mental state when the nurse has to make a choice between the options and choices that he or she has at her disposal. The choice is a crucial task as the opting of the step will subsequently determine the health status of the concerned patient, hence it requires a great deal of wisdom along with proper medical and health training before any such step is opted as it is a matter of life and death. Strong emphasis should therefore be on the acquisition of proper knowledge and skills so that nurses do posses the autonomy to interact with patients regarding ethical issues involved in health care affairs and address them efficiently. It is normally argued that nurses are not provided sufficient

“The definition of a health professional is a person who works to protect and improve people’s health by the diagnosis and treatment of illness to bring about a complete recovery from mental, physical and social perspectives, either directly or indirectly (Kurban, 2010, pg. 760).” Nurses in the community today have acquired an increasing responsibility to intervene with medical decisions. In the past, there were clear differences between nurses and doctors. It was more common for a nurse to be supervised directly under the physician. They are not just performing Doctor’s orders anymore. The nurse role in patient care has been widely expanded. Allegations against someone can be one of the most stressful moments of their careers. Negligence

Legally nurses have a duty to act vigilantly when treating their clients, nurses are expected to achieve at least the minimum standard of care consistently. If a nurse fails this they will be judged as negligent (McHale and Tingle 2007). When analysing the scenario within our sessions, it was discussed that the nurse providing care was negligent, if so they would have been held accountable. Chitty and black (2005) inform the reader that negligence is ‘the failure to act as a reasonable careful practitioner would, in particular circumstances '. To assess how particular practitioner would act in a certain situation in relation to another is more complex and hard to resolve. The law simplifies this judgement using a tool called the bolam test. Simplified this dictates that a practitioner cannot be deemed negligent if the actions taken conform with that of another rational competent health care professional. (samanta 2004). The scenario can be related to adult nursing as well as the other

`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

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.

During this situation, the nurse who was allocated to take care of this patient made the right decision that he called for help when he cannot handle this situation himself and called rapid response according to the health policy. According to registered nurse standards for practice, registered nurses should “determine, coordinate and provide safe, quality nursing” (Nursing and Midwifery Board of Australia [NMBA], 2016). There are seven standards, for instance, conducting comprehensively assessments, working collaboratively with other health professionals and documentation (NMBA, 2016), which was demonstrated on this nurse. In this situation, the nurse conducted assessments to collect relevant information; hence, the other health professionals

Then forgetting to pass along the information to the physician and the staff. Standard 4.2 requires nurses to take responsibility for their actions. The case study does not state how the nurse reacted to her actions. Nurses are to take responsibility for their action every shift. The taking of responsibility for starting an IV in the foot without an order and then forgot to pass along the incident in report is a not taking responsibility for her actions. The other nurses caring for Mrs, Smoltz did not do a complete assessment and was not responsible in their nursing practice as well. If the nurses caring for Mrs. Smotlz had done a complete assessment, they would have seen the injection site, redness, and swelling in the patient’s right leg only. Ethical standard 4.3 states “individual nurses are responsible for assessing their own competence”. If a nurse is over worked, short staffed, and uneducated to the nursing guidelines and policies of the hospital, the nurse is not stopping to assessing their abilities and they are liable for their performance.

Joanna is an experienced nurse taking care of Mrs. Kelly, who was Joanna’s patient many times in the past for her primary problem which is COPD. This time Mrs. Kelly was admitted with complaints of abdominal pain what was different from her primary diagnoses. Her vital signs were with normal limits and no significant changes from privies results, but for the nurse she looks sick, and Joanna know that something is wrong. She calls the resident doctor, but he tell her to watches and calls back with series changes. Joanna multiple attempts to report that something needs to be done to evaluate the cause of Mrs. Kelly pain was ask to calm down. However nobody took patient symptoms series and the next day patient died.