Nursing Ethics Issues - Essay Example

Nursing Ethics Identify the issue and collect information Martina and Omar are registered nurses working the same shifts at the emergency department of a small regional hospital in Queensland. Martina appeared to be very distracted during one of their shifts and almost fed a patient who was nil by mouth. He was fortunately stopped by Omar. Martina apologized but was still acting very much distracted during her shift. Omar is worried about Martina’s ability to do her job, but he chose not to disclose his concerns to their superior. There are two issues on this case: whether or not Omar is right in failing to disclose to their superiors Martina’s inability to do her job; and whether or not Martina violated ethical or legal standards in nursing practice for almost committing a medical error and for working in a distracted state. . 2. Evaluate the issues Ethical considerations (Beauchamp and Childress, 2001) Beneficence: The patients in Martina’s care have the right to be administered with the correct and competent care from Martina (Masters, 2009). Beneficence implies that actions which seek to benefit the patient must be the ones which should be administered to the patient. Since, the patient has the right to receive appropriate, timely, and effective care, such care must be administered at all times by the nursing and other health care professionals (Beauchamp and Childress, 2001). Failure to deliver such beneficial care violates ethical principles of beneficence. Nonmaleficence: First, do no harm. This is the very basis of nonmaleficence (Masters, 2009). Under this ethical provision, all actions of the nurses and other health professionals must not cause the patients any harm. Martina’s lack of focus almost caused the patient harm. Her continued lack of focus has placed her patients at a continuous risk for various medical errors including medication errors and neglect (Butts, 2012). Omar’s concealment of Martina’s lack of focus is also another act which causes the patient harm. The concealment can potentially be dangerous for patients because repeated errors may occur unless actions by the superiors are carried out (Butts, 2012). Martina has issues she has to deal with on her own and she has to be relieved from her work, given time off, or given a vacation until she can be fit to work efficiently again as a nurse. Legal issues: In the case of Omar and Martina, there is a need to establish whether Omar’s actions in failing to reveal his observations on Martina’s actions constitute negligence and merit legal action. Various principles constitute negligent action according to Staunton and Chiarella (2008). First and foremost, there must be a duty of care. Such duty of care in this case is very much implied. As Martina and Omar are nurses which are required to deliver quality care, they also have the duty to be vigilant of any negligence on the part of their colleagues (Deakin, et.al., 2007). Failure to do so is likened to the act of omission which in the end, has the same effect as the actual act of committing the medical error (Deakin, et.al., 2007). There was a breach in that duty of care because although Omar was vigilant in calling Martina’s attention to the near medical error, the fact that he failed to inform his superiors about the incident and about Martina’s lack of focus constitutes failure in his duty of care (Staunton, 1991). By covering up for Martina, he placed the other patients at risk. The Code of Ethics (2008) also indicates the duty of care and the legal requirement for nurses to deliver safe and competent care for patients at all times. The legal provision which also specifies that nurses must comply with the standards of the profession is yet another legal support for this case (Code of Ethics, 2008). Nurses Value Statement 1: Nurses value quality nursing care for all people. “Valuing quality nursing care involves nurses accepting accountability for the standard of nursing care they provide, helping to raise the standard of nursing care, and taking action when they consider, on reasonable grounds, the standard of nursing care to be unacceptable. This includes a responsibility to question and report what they consider, on reasonable grounds, to be unethical behaviour and treatment” (Code of Ethics, 2008, 4) Omar and Martina should have placed a significant premium on providing quality care for all their patients. Quality care involves the process of nurses accepting that they have the responsibility to comply with the standards of the nursing practice (Code of Ethics, 2008). This necessarily also includes the act of questioning and reporting what they consider as unethical behaviour and treatment. As far as nurses are concerned, placing value on the quality of nursing care indicates that they are also responsible for the decisions they make in relation to the patient’s care. Moreover, this also means that they would accept the moral and legal responsibilities which seek to ensure their knowledge, skills and experience in a safe and competent nursing practice (Atkins, et.al., 2011). These nurses also acknowledge the fact that nurses must participate in decisions relating to their patient’s care and to question any unethical or illegal practice. They must also actively ensure that minimal risks are placed on their patients (Atkins, et.al., 2011). It is their responsibility to question and report any illegal, unsafe, incompetent and illegal acts of other nurses. It is also their responsibility to provide support to their fellow nurses who are able to provide competent care. Value statement 6: Nurses value a culture of safety in nursing and health care “Valuing a culture of safety involves nurses actively engaging in the development of shared knowledge and understanding of the crucial importance of safety in contemporary health care. Nurses who value a culture of safety appreciate that safety is everyone’s responsibility. Nurses support the development of risk management processes and a practice environment designed to reduce the incidence and impact of preventable adverse events in health care. Nurses also support the open disclosure of any adverse events to any person affected during the course of their care” (Code of Ethics, 2008, 9). The above value statement highlights the importance of ensuring safety in health care delivery. In this case, it is important for the nurses to practice within the specifications of their knowledge and skills. They must also recognize and avoid instances where their ability to deliver quality care would be impaired (Crisp and Taylor, 2008). Martina has not recognized the fact that her ability to deliver quality care is impaired, therefore, it is now the responsibility of Omar, whom she shares shifts with, to inform the superiors of the lapses in the quality of Martina’s nursing care. There are preventable human errors in the medical practice, and patients are often vulnerable to the impact of these human errors. These nurses have a major role in detecting and preventing errors in the health setting and they are also tasked with identifying circumstances whereby individuals are often put at risk for medical errors (Crisp and Taylor, 2008). Omar therefore has the burden of ensuring that no further risk would be incurred by other patients due to Martina’s lack of focus in her duties. It is also his duty to work with Martina and with their superiors in order to ensure open disclosure of events. Action 1. Conduct Statement 1: Nurses practise in a safe and competent manner (Code of Professional Conduct, 2008) Nurses must be made personally responsible in providing safe and competent care. In order to secure safety, they must increase their knowledge, improve their skills, and they must participate in ongoing professional development. Nurses must be aware of that actions beyond their expertise may compromise the safety of patients. The nurse’s actions must therefore be based on what he or she is trained for. Nurses must inform their superiors of their nursing practice, as well as the possible limits to such practice. Delegated care must be based on safe and quality delivery of services. The safe environment must not be compromised by health limits, including alcohol or drug abuse 2. Conduct Statement 2: Nurses practise in accordance with the standards of the profession and broader health system (Code of Professional Conduct, 2008) Nurses must maintain the standards of practice as indicated in the professional code of practice for nurses. They must also comply with elements of safety in the health care system. Any issues in safety and failure to deliver minimum standards of care must be reported to the appropriate authorities. If unresolved, the nurses must intervene on behalf of the patient. The actions of Omar and Martina failed to comply with the minimum standards of care as indicated above. The appropriate legal and ethical sanctions must therefore be taken in order to prevent any future breaches. 4. Implement Upon discovery of the actions of Omar and Martina, the appropriate legal actions may be taken against them, both for negligence and for failing to comply with the minimum requirements of the nursing practice (Staunton and Chiarella, 2007). Failing to ensure the safety of the patients is also another legal and ethical breach which requires necessary action from the superiors. Martina cannot be allowed to work while she is distracted by personal issues and she must be reprimanded for almost committing an error in the patient’s care. Omar’s actions may also be well-meaning however they must also be accorded the appropriate legal remedies from his superiors. Covering up and failing to report the incident and his co-workers distracted state is unethical and violates the code of ethics and the standards of the nursing practice (Staunton and Chiarella, 2007). 5. Assess outcomes After evaluating the actions of Martina and Omar, I believe that the appropriate action must be taken by the superiors. Firstly, as far as Martina is concerned, the appropriate reprimand for the negligence and for failing to deliver safe and quality care must be imposed. Since, the error was prevented by Omar, a more lenient sanction may be imposed (Freckelton and Peterson, 2006). However, she cannot be allowed to continue working until she is fully physically and mentally functional. Secondly, as far as Omar is concerned, the appropriate reprimand must also be imposed for his failure to report Martina’s distracted state and for almost committing a medical error (Freckelton and Peterson, 2006). Omar has a legal and ethical duty to report these incidents in order to protect the nursing practice and, more importantly, the patients. References Atkins, K., de Lacey, S., and Britton, B. (2011). Ethics and law for Australian nurses. London: Cambridge University Press. Australian Nursing and Midwifery Council (2008). Code of Professional Conduct for Nurses in Australia. Australian Nursing and Midwifery Council (2008). Code of Ethics for Nurses in Australia Beauchamp, T. and Childress, J. (2001). Principles of biomedical ethics. London: Oxford University Press Butts, J. and Rich, K. (2012). Nursing ethics: across the curriculum and into practice. Victoria: Jones & Bartlett Publishers. Crisp, J. and Taylor, C. (2008). Potter & Perrys fundamentals of nursing. Sydney: Elsevier Health Sciences. Deakin, S., Johnston, A., and Markesinis, B. (2007). Markesinis and Deakins tort law. London: Oxford University Press. Freckelton, I. and Petersen, K. (2006). Disputes and dilemmas in health law. Melbourne: Federation Press. Masters, K. (2009). Role development in professional nursing practice. Victoria: Jones & Bartlett Publishers. Staunton, P. and Chiarella, M. (2007). Nursing and the law. Sydney: Elsevier Australia. Staunton, P. (1991). Nursing and the law. Australian Nurses Federation. Retrieved from http://nrha.ruralhealth.org.au/conferences/docs/PAPERS/1_PATSTA.pdf Read More