I choice to use the Seven Step Model of a Decision-Making Model for Resolving Ethical Issues in order to define what is ethical in this case study. 1. Gather the Facts 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. 2. Define the Ethical Issues The following case presentation illustrates the moral distress a nurse may experience when her patient advocacy meets resistance, and her moral courage is challenged. It also describes ineffective management strategies to help nurses resolve the problem. If doctor or supervisors will hear Joanna and could recognize early that patient has ruptured abdominal aortic aneurysm, the surgery would save Mrs. Kelly life. Joanna 's conflicting values were feeling that something is not right with the patient. She was doing what was in her power to make others pay attention that
The ethical decision making model has a total of eight steps. This helps the counselor to know what the client is going through and is able to work towards finding a solution to solve the client’s crisis situation.
It is important to look at ethical dilemmas in a systematic way, thus increasing the chance of achieving a solution that gives the best possible outcome. An ethical problem solving model taken from American sources (Paradise and Siegelwaks, 1982; Austin et al., 1990) was used to develop a six-step process to follow, in order to achieve this (Bond 2010, pg. 227). This process informs this paper, and I am in the role of counsellor.
As the nursing profession progresses throughout the years, its nature becomes more complex in meeting the professional standards and codes of ethics that are required by all nurses. The American Nurses Association has a specific code of ethics that each nurse should follow and adopt as their own beliefs. The public and the patients should be the priority when providing care in the healthcare setting. The knowledge and education that nurses’ gain is valuable and allows them to encourage health, avoid illness, restore health, and aid in coping for those who are all ill. (LeMone, pp.192) Given that the code of ethics is put into place, there are many registered nurses who violate these codes in various situations. The following will discuss
The method of ethical decision making which was developed by Dr. Cathryn A. Baird presented two components contained in all ethical decisions which are; The Four ethical Lenses and the 4+1 Decision process. The Four Ethical Lenses issue claims that different ethical theories and the means in which we tend to approach the situations which form part of our ethical traditions are looked at in four different perspectives. From each perspective there are different values on which to decide whether the action taken is either ethical or not and each lens also lays emphasis on determining whether the decision made is of ethical requirement. In the 4+1 Decision Process, people who are responsible for making final decisions in an organization do it
Nurses apply their moral and ethical training in difficult scenarios within the workplace where leadership and guidance are necessary in the nursing profession.
Making sound ethical decisions require an intentional process that utilizes thoughtful reflection, supervision/consultation, and action. Many ethical decision making models exist and the seven-step model introduced by Forester-Miller and Davis (1996) is a succinct amalgamation of these earlier models. The model by Forester-Miller and Davis (1996) follows seven progressive steps: (a) identify the problem, (b) apply the ACA Code of Ethics (2014), (c) determine the nature and dimensions of the dilemma, (d) generate potential courses of action, (e) consider the potential consequences of all options and determine a course of action, (f) evaluate the selected course of action, and (g) implement the course of action.
Healthcare professionals have an ethical obligation to respect patient’s wishes. Consequently, many legal and ethical dilemmas arise in healthcare in response to clinical decisions related to the needs, beliefs, and preferences of patients and families. Other dilemmas result over concerns about the integrity, competence, or actions of other healthcare professionals. Preserving human dignity, relieving suffering, equality, integrity, and accountability are essential nursing values (Kangasniemi, Pakkanen, & Korhonen, 2015). Nurse leaders have an
I learned that as a nurse it is my duty to always consider my own well being, along with my patient’s. I must keep a high moral character both in the workplace and in my personal life. I must continue to educate myself and keep myself up to date with all the latest nursing practices and research. I must subject myself to peer review and evaluation. I must never let my personal feelings about a patient’s lifestyle affect my care for them. When met with a tough choice that places me in an ethical crisis I must keep a good head on my shoulders and always have my patient’s best interests in mind. If I feel that a situation at work is in direct conflict with my personal values or my oath to be an ethical nurse I must go through the proper channels to work through the problem.
Apply the ethical decision making model presented in week one lectures (adapted from Beemsterboer, 2010; Velasquez et al, 2009) to the case study.
The patient went as far to admit that she currently is having a hard time breathing, but has an appointment with her gynecologist on Monday. This writer advised the patient that if she has difficulties breathing she will need to go to the ER immediately and be medically assessed by Nursing. The patient started crying about she does not want to be medically assessed as she needs to return her boyfriend vehicle so that he can work. This writer informed the patient about the seriousness of her health comes first. This writer called Nursing Chrystal, but no response. Then this writer and the patient went to the Nursing Director office to be medically assessed. According to the Nursing Director, she advised the patient to go to the ER first and will not be dosed today unless she provides proof of documentations of her visit. Again, the patient fussed and then says, " I am fine, it's not serious," however, the patient was advised to follow medical
1. The four-step model for decision-making; See, Judge, Act, and Evaluate, applies onto the storyline by providing more insightfulness and reflection onto the decisions each character performs. In such cases, Sam uses this method by somewhat agreeing to let his daughter, Lucy, go into the foster care system. This was shown when he later confides and agrees to see Lucy on a limited amount of times each month. Even though at first, he was upset and furious having his only daughter taken away from him, he slowly managed to admit to this term when he recognized Lucy's happiness and safety.
The purpose of this quantitative study is to describe the degree of moral distress associated with clinical practice events by registered nurses working in an urban health care network. It determines the frequency of morally distressing events and explores RN’s utilized resources, both personal and institutional, when they are confronted with distressing ethical dilemmas (Zuzelo, 2007, p. 345).
Nurses are constantly challenged by changes which occur in their practice environment and are under the influence of internal or external factors. Due to the increased complexity of the health system, nowadays nurses are faced with ethical and legal decisions and often come across dilemmas regarding patient care. From this perspective a good question to be raised would be whether or not nurses have the necessary background, knowledge and skills to make appropriate legal and ethical decisions. Even though most nursing programs cover the ethical and moral issues in health care, it is questionable if new nurses have the depth of knowledge and understanding of these issues and apply them in their practice
Moral distress is describe as the phenomenon in which a nurse understands and has clarity about a right action to take, but is constrained from taking it. It differs from an ethical dilemma in which there is recognition of a problem; in which at least two ethically justifiable but opposing solutions can be applied (American Nurses Association, 2014). Moral distress was first recognized among the nursing field; because of this, many of the studies have focused on the nursing population. However moral distress has also expanded to many other fields, making it now a multidisciplinary concern
Nursing, in my view, has always been a field in which moral courage was inherent. Nursing is one of the few fields in which individuals disregard their own personal wellbeing in favor of other people’s health. Moral courage is an elusive topic to define, as it is such an intangible concept. According to Murray, “moral courage is considered to be the pinnacle of ethical behavior; it requires a steadfast commitment to fundamental ethical principles despite potential risks, such as threats to reputation, shame, emotional anxiety, isolation from colleagues, retaliation, and loss of employment (2010.) To exemplify this issue, Murray continued to give an example of moral courage with a novice nurse named Emily.