Ethical Dilemmas in Nursing - Essay Example

 Ethical Dilemmas in Nursing Ethical dilemmas in the nursing profession are part of the daily routine. However, there are some moral concepts and theories in medical field that are help in dealing with such dilemmas. As much as patients have their preferences in terms of medication, for instance some will prefer an injection to a tablet or vice versa, it is the role of the nurse to administer services with the professionalism required. For instance, a nurse should not lie to the doctors nor the patient, this is giving the medication through informed consent where the patient must know what medication they are being offered and for what purposes. Studies show that nurses resort to different measures in order to come up with solutions from an ethical dilemma. There are various studies conducted amongst nurses about the ethical dilemmas they face in their profession. From the findings, 90% of the participants agree that the chances of having an ethical or moral dilemma with their patients are very high. Some who deal with serious patients such as chronic diseases claim that the moral dilemmas are an everyday issue and that they have learnt to understand their patients, the patients’ families as well as their ethical responsibilities in different situations. (Basso Musso, 2012). Humanism is a concept that goes beyond any person’s professional laws and requirements. Nurses may need to resort to their moral values and beliefs when coming up with a solution. (Benjamin, 2010). Some situations need to be weighed on closer look so that the best decision is made. During a moral dilemma there is not a right or wrong decision to make. (Hold, 2013). All in all, the dilemma must be solve particularly when the patient’s life is at risk. Mr. Smith, 67 years of age and widowed, is fighting a UTI. This is a urinary tract infection which if not treated at the stage in which it is, it can cause further complications in his system. The only way to stop this complication is to offer him with Intravenous antibiotics which will ultimately kill the bacteria causing the UTI. However, Mr. Smith refuses the medication at all costs even after the doctors, nurses as well as his close family members have explained to him the importance. Informed consent is important in medicine and the doctors have done a good job telling Mr. Smith and his family of his condition and what needs to be done. While it normal to see such a case where old people refuse treatment, Mr. Smith happens to not have a sober mind following the serious effects of the complications. The doctors and nurses have used this as basis that he is not legible to make any serious decisions by himself. Following this, the IV antibiotics are still being administered to Mr. Smith without his approval. Informed consent is not fully acted upon as he does not find out that the nurses and doctors are against his wishes. The first thing we learn from this is the role of informed consent in nursing. In this, the family understands why the treatment is being administered and the situation puts both the doctors and nurses in a moral dilemma. Ethical dilemmas are an everyday situation in hospitals. In definition, ethics includes judgments made from determining what is wrong or rights according to one’s profession as well as the legal principles. (Bezerra do Amaral, 2012). Mr. Smith provides a case where giving him the IV antibiotics can be considered unethical, unprofessional and illegal since the patient is not willing. Moral dilemma indeed. In relation to this situation, we comprehend professionalism as the set of activities that a nurse acts upon to a patient at any time so as to keep the health of the patient as a priority. (Benjamin, 2010). Academic literature is employed by the MDT to come up with solution for the UTI. Through reviewing NMC code, nurses tend to have the role of getting on a personal level with the patient, understanding the patient and helping them in their healing process while administering the needed prescription. (Ma, 2013) The nurse dealing with Mr. Smith did not adhere by this to help the MDT realize that the patient might be of sober mind but has other reasons that prompt him to refuse the drug. The nurse did not agree with Mr. Smith, neither did he or she try to have a talk with him. The principles of nursing demand that a nurse has the power to influence a patient. (Spear, 2010). Ethically, a nurse provides better patient care by creating a caring and respectful atmosphere for the patient. Mr. Smith has been declared as a patient who is not of sound mind hence his rights as a patient have been given up to the family and the doctors. This might be a wrong solution to this problem because, Mr. Smith was not taken to a psychiatrist to determine whether his state of mind is sound or not. Legally, this is a wrong decision to declare a patient’s state of mind as unsound prior to testing. Accountability as well as the standard code of conduct allow a nurse to serve as an advocate of the patient. Therefore, all matters brought up by the doctors and Mr. Smith’s family must have been analyzed by his nurse before any hasty decision was made. (Sockolow, 2010).This creates a moral dilemma whereby, while saving the life of Mr. Smith is very important, going against his will of refusing the treatment can cost the nurse her job. All registered nurses must serve patients regardless of what the physician or the family members think is best. In this situation, the moral obligation of the nurse was to ask for a psychiatrist to check on Mr. Smith’s mental health. However, patient confidentiality is another principle that nurses must adhere to. It is the right of all patients to receive confidentiality throughout their treatment. (Davis, 2010).Therefore, bringing in a psychiatrist would invite more people in knowing Mr. Smith condition. Autonomy is a concept in nursing that legally allows patients to make their decisions while being guided by the nurse. (Howatson-Jones, 2012). Mr. Smith’s autonomy has been interfered with since he is being given medication without his consent. In essence, the administration of the IV antibiotics to Mr. Smith is ethically right but illegal according to the laws that support the rights of patients. The reason why the nurse disagreed with Mr. Smith, like the rest of the MDT, was probably due to the concept of Accountability. According to (Frankel, 2005), the consequences of administering the IV antibiotics after Mr. Smith has rightfully refused to take them can lead to suing of the hospital on a later date. The nurse in charge of Mr. Smith will have to be accountable of the actions he or she took to save the life of a patient. Nonetheless, accountability has taken a form in our laws where empathy has become a sign of unprofessionalism such that if the nurse was to agree with Mr. Smith and refuse to give him the drugs, she could be held accountable for the death of the man. (Basso Musso, 2012). People will argue that the nurse failed in her humanistic and professional requirement to save a life. However, it is in utter shock that professionals will chose accountability over empathy, which dehumanizes people in their profession. The current standard of conduct demand that accountability that tags along with an empathetic emotion is in order. The nurse was legible to have empathy on Mr. Smith for whichever reasons he has to refuse the medication. (Terpstra, 2011). He probably is tired of the UTI and other stressful matters in his life and wishes to die. His decision to refuse treatment may have led to the overall perception by family members and doctors that he is insane. However, the nurse must create an environment that will influence Mr. Smith to open up and explain why he refuse the drugs. Moral virtues like acting upon the wishes of a sick, widowed old man must be taken seriously by Mr. Smith’s nurse. Moral courage is another aspect in nursing that helps in ethical dilemmas. (Westrick, 2009).Coming up with solutions from an ethical dilemma mean that a nurse has the moral courage to analyze a situation and determine whether to act according to the patient’s wishes or the professional mandate of doing what is best for a patient. Saving the life of Mr. Smith is the professional mandate of the nurse hence he or she must administer the IV antibiotics. The wish of Mr. Smith would lead to his death, death which would be ultimately blamed on the MDT by Mr. Smith’s family and the society. This basically means that, (Smith, 2008), the nurse was afraid to go against the rest of the team treating Mr. Smith. There was no individual who was courageous enough to agree with Mr. Smith. Moral courage requires following the ground rules of nursing by and ethical principles without fear of the consequences. In this situation, the rights of Mr. Smith to refuse the IV antibiotics can be contested for through the nurse. His state of mind has been declared by doctors who are not registered psychiatrists. (Peternelj, 2008). A morally courageous nurse will follow Mr. Smith’s wishes and agree with him in all his decisions after having a close conversation with him. The consequences of moral courage can be loss of license as a nurse as well as facing a court of law. The most severe risk can be death of Mr. Smith following his rights as a patient to refuse drugs. A decision must be made in every problem. (Bower, 2009). Nurses must have identified the dilemma with Mr. Smith’s scenario and realized that the decision made will affect the overall outcome of the patient, the people around the patient, in this case the family and in some cases the nurses’ professional career may be at jeopardy. (Duncan, 2010).Therefore, it could be important that the nurse dealing with Mr. Smith to evaluate the two options carefully. Resorting to the code of conduct of nurses is one step in trying to solve this dilemma. Following the code of ethics would have helped the nurse determine how to address Mr. Smith’s refusal to take the antibiotics. After going through the codes, the nurse could brainstorm his or her colleagues with the situation in a hypothetical manner so as not to disclose Mr. Smith’s health condition to the wrong people. Confidentiality is key for any nurse. The colleagues would help the nurse in weighing his or her options. (Westrick, 2009). We comprehend the importance of continuous study for nurses, so as to apply some ethical codes in daily situations that may arise. Moral virtues are concepts that guided the nurse as he or she considered the result of not giving Mr. Smith his medication. The nurse determined how this will affect Mr. Smith and to what extent. (Nortvedt, 2013). The steps listed in the nursing academic literature on moral virtues guided the nurse into coming up with a solution from the ethical dilemma. (Doka, 2005). Although the nurse agreed with the family and the doctors on offering Mr. Smith the treatment he refused, the nurse may analyzed the whole situation and decided to disagree with the patient’s wish in order to save his life. However, the nurse probably also questioned Mr. Smith’s state of mind then thus disagreed with him. Nursing is a profession that requires moral commitment to the patients and their families. Commitment means creating a sense of care for the patient to feel at ease and confident in the services a nurse is offering. (Davis, 2010).Claiming an authoritative take in issues with patients can lead to poor ethical decision making in times of dilemmas. The nurse dealing with Mr. Smith might have been authoritative instead of friendly hence he or she did not make decision upon ethics but upon the law and their professionalism. Decisions made solely in accordance to the law can be wrong for different situations. (Westrick, 2009). In this case, Mr. Smith is a patient whose body and health is at risk if he is not treated with the IV antibiotics. If the nurse was a person who adheres to the professional rules that demand the rights of a patients to refuse drugs as legal, Mr. Smith could probably die. The nurse chose not to follow the laws of professionalism or the wishes of the patient. Mr. Smith’s example portrays how nurses must not only follow their code of ethics before scrutiny of the situation. (Driscoll, 2008). Evaluation is crucial before implementing decisions especially work involving patients who could possibly die. The analysis and independent thinking comes about when a nurse is in an ethical dilemma. (Hallett, 2012). The decision to follow doctor’s instructions and give the patient the antibiotics was made after thorough evaluation, although the nurse did not exhibit moral courage by trying to go against the MDT. (Bower, 2009). There are a number of challenges that may have contributed this ethical dilemma with Mr. Smith’s nurse considering he is an aged patient. (Tabloski, 2010). The stereotypes and perceptions the society has on aged individuals may have affected the decisions of the MDT. It could however be unprofessional if the nurse made the decision on a Mr. Smith’s dilemma while considering the stereotypic nature of the situation in hand. Some of the misconceptions that may have crossed the minds of the MDT are the fact that Mr. Smith is old and widowed, he probably is dependent on his family and has no right to make his decisions on any matter. (Sockolow, 2010). Also, the MDT may have argued that the misconception of old people being unable to take care of his health is the result of his chronic UTI hence he might die of complications. All these are misconceptions that must not be used in any ethical dilemma. (Myhrvold, 2013). The trick is to observe, analyze and evaluate the dilemma before implementing any decision. In conclusion, ethical issues together with the laws governing the nursing profession are complex. They are set and documented such that nurses have access to the information. (Sigma Theta Tau International, 2012).However, being ethical does not solely mean doing the right thing for the patient. It means using the best principle for the particular situation at hand. If it means going against the laws of nursing and doing what might be deemed unprofessional, the ethical dilemma must be solved. Mr. Smith was treated with IV antibiotic against his will, hence denying him his legal right as a patient to refuse drugs. This was probably an illegal move by the MDT and ethically was out of order. Therefore, it is important for nurses to know that ethical dilemmas are a must and situations might be complex with the difference in legislation and code of conduct but being ethical is neither being right nor wrong, because situations can be controversial. References Basso Musso, Liliana. (2012). Nursing and the resolution of ethical dilemmas. Universidad de Antioquia: Facultad de Enfermería. Benjamin, M., & Curtis, J. (2010). Ethics in nursing: Cases, principles, and reasoning. Oxford: Oxford University Press. Bezerra do Amaral, Juliana, Menezes, Maria do Rosário de, Martorell-Poveda, Maria Antonia, & Cardoso Passos, Simone. (2012). 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