Ethical Dilemma in Nursing - the Nursing and Midwifery Board of Australia - Essay Example

ETHICAL DILEMMA IN NURSING By Name Course Instructor Institution Location Date Introduction The Nursing and Midwifery Board of Australia is a professional body that offers guidance to nurses and midwives through giving a range of professional standards that help define nurses’ behaviour and practice (Nursing and Midwifery Board of Australia 2011). Such professional standards include the codes of ethics, conduct, professional boundaries guides as well as standards of competency. This particular body gives emphasis on how nurses and midwives should be professionally accountable. In general, the nursing profession is governed by professional codes, policies, and practice standards. Nevertheless, it is inevitable for a nurse to be assigned responsibilities that he or she may consider risky or unsafe. For instance, a nurse being asked to take care of patients in a specialty in which he or she is unfamiliar with or even being assigned to patients with the highly communicable infectious disease. In such situations, the nurse is expected to apply the concept of ethics so as to either accept or decline such an assignment. This paper considers one of the ethical dilemmas in the nursing profession as well as the implications of the decision made based on the dilemma. Ethics policies The Nursing and Midwifery Board of Australia has a code of ethics developed specifically for nurses so as to help guide them when conducting their day to day nursing responsibilities in a way that is in line with quality in the nursing profession as well as the moral well-being of the profession. Ethics policies are intended for nurses in all contexts of the nursing profession as well as in all aspects of decision making. Ethics policies are designed in most cases, to help nurses in making decisions in situations with ethical challenges that arise. The profession has to be governed as it deals with the lives of people and this calls for ethics and quality to be applied at the same time (Nursing and Midwifery Board of Australia 2011). Professional codes There are various codes of ethics that govern decision making and the general practice of nursing as set by the Nursing and Midwifery Board of Australia. These codes include the requirement that nurses ought to value quality of nursing care, value respect, and kindness, value people’s diversity, access to quality, value informed decision-making, value the culture of safety in the profession, ethical management of information including confidentiality, and also value a socially, ecologically and a sustainable environment that helps promote the health and well-being of people (Nursing and Midwifery Board of Australia 2010). Practice standards The Nursing and Midwifery Board of Australia has set various professional standards for the nursing practice aimed at ensuring that professional nurses have in mind the constituents of the general practice of the nursing profession. In Australia, the standards of practice for nurses are comprised of: thinking critically and analysing the practice, engaging in professional relationships, maintaining the capability of the nursing practice, conducting assessments, developing a plan for the training, evaluating outcomes so as to inform the practice, and finally, providing a safe and a responsive quality nursing practice (Nursing and Midwifery Board of Australia 2011). Paper purpose The purpose of this paper is to consider one ethical dilemma in the nursing profession on whether refusing a patient allocation is an option for a registered nurse. In such a case, the decision made by the nurse may have implications for his or her practice as a healthcare professional. This, the possible implications will also be highlighted in the paper. Also, this paper will also highlight the possible response to the Director of Nursing or the Nursing Midwifery Board of Australia as a result of the decision made. All this will be done as per the regulatory standards. Codes of ethics and policies as set by the Nursing and Midwifery Board of Australia (Nursing and Midwifery Board of Australia 2015; Nursing & Council 2012). Is refusing a patient allocation an option for a registered nurse? If so, why? If not, why not? The professional and ethical responsibilities of nurses give them the professional right to accept or reject any patient allocation or assignment that puts either or both of the patient and the nurse at a serious risk of harm. I believe that registered nurses in Australia have the professional right and obligation to raise any issue that may arise regarding patient allocation that puts them or the patients at a risk for harm. For example, a registered nurse has the right to accept or decline the responsibility of being asked to offer nursing care for patients in an area of specialty that you as a nurse is unfamiliar. In such a case, the possible outcome is that the nurse may be forced to give the wrong care to the patient which may increase the risk of the patient. Nursing is a very unique profession that requires quality nursing care, thus, a nurse who has not specialized in a given area may not be in a good position to provide quality healthcare of the highest degree. In another case that may increase the chances of risk for the registered nurse is a situation where the nurse is allocated to an assignment where the patients have highly infectious communicable diseases such as Ebola or the Zika virus which are prone in the African continent. In such a case, the chances are that the nurse may easily contract the same disease hence risking his or her life. In such cases, the nurse may feel obliged to decline to refuse such allocations, although the Nursing and Midwifery Board of Australia may not be in support of the nurse’s decision, hence bringing serious implications on the nurse as well as on the nursing profession as a whole(Barry &Edgman-Levitan 2012). One of the major codes of ethics set by the Nursing and Midwifery Board of Australia is to value the quality of the nursing practice. This particular system may be used by the nurse when refusing a patent allocation depending on whether the assignment was given increase or reduces risks for the patient. For example, when the nurse is given an allocation in which he or she is unfamiliar with, the chances are that he or she may not be in a position to offer the best care for the patient, and this may be used as a strategy to decline the patient assignment given. It is crucial to note that professional codes, ethics policies and practice standards by the Nursing and Midwifery Board of Australia are created so as to help registered nurses in making the decision in situations that have ethical dilemmas such as this one. The issue of objecting a patient allocation assignment by a nurse is considered a moral dilemma since the decision made by the nurse may be detrimental to his or her career in the nursing practice. For the nurse’s decision to be accepted by the Nursing and Midwifery Board of Australia, he or she has to provide adequate evidence in written form and be able to defend his or her decision before the Director of Nursing or the Nursing Midwifery Board of Australia. In most cases, nurses tend to accept any assignment give to the for fear of being sacked or relived from their duties, and this is often considered as a compromise to the nursing profession. I believe that the nursing practice is all about quality and that nurses should not compromise it by being forced to do the assignment in which they are unable to or which may increase the risk of chances for both themselves and the patients. The Nursing Midwifery Board of Australia was created so as to help registered nurses in making ethical decisions that do not compromise the whole practice. The board has several codes of ethics and professional standards that are aimed at assisting nurses in ethical dilemmas such as this one. It is thus necessary for all registered nurses in Australia to familiarize themselves with everything stated in by the board so as to ensure that they can defend themselves when faced with such complex decisions to make (Nursing and Midwifery Board of Australia 2015). Refusing a patient allocation is an option for a registered nurse in Australia. One of the professional codes of ethics, as stated by the Nursing Midwifery Board of Australia, is to value the culture of safety in the profession. If assignments value the culture of security, then any registered nurse is obliged to object it, but he or she has to have the right materials or evidence to defend his or her action before the Director of Nursing or the Nursing Midwifery Board of Australia (Kennedy et al., 2015). A nurse manager will always be ready to allocate a nurse to any assignment believing that he or she is ready, willing and able to successfully execute the task. The work was given may in a way risk the nurses’ life as well as the patient’s, yet he or she goes ahead to accept the allocation. This is considered as unethical and not in line with the ethical decision making as stated out by the Nursing Midwifery Board of Australia. Refusing the allocation is more ethical than accepting the task, and yet the decision is against the codes of ethics and policy standards highlighted in the introduction art of this paper. For example, one of the practice standards stated is on providing a safe and a responsive quality nursing practice, and if a patient allocation is not in line with this, then the nurse is obliged to refuse it (Nursing and Midwifery Board of Australia 2015). How you will you respond to complaints made about you to the Director of Nursing and Nursing Midwifery Board of Australia as a consequence taking such an action? In a situation where the nurse refuses a patient allocation, the nurse manager may be forced to report the same to the Director of Nursing or the Nursing Midwifery Board of Australia. The nurse manager believes that nurse should do all the assignments given to them and if they happen to refuse of object, then they are reported to the Director of Nursing or the Nursing Midwifery Board of Australia who is then supposed to summon the respective nurse and then hear his or her story before making a final decision (Nursing & Council 2012). If the nurse does not defend his or her decision well to the extent that he or she justifies the decision made, then the chances are that he may be relieved of his duties in the practice. Patient allocation considered as one of the major reasons as to why nurses leave the nursing practice or are discontinued from their roles after they refuse certain assignments and fail to defend themselves before the board. A registered nurse in Australia, who is highly informed of ethical decision making based on ethics policies, professional codes and practice standards as set by the Nursing Midwifery Board of Australia will be able to defend his or her decision making successfully before the Director of Nursing or the Nursing Midwifery Board of Australia (Cashin et al 2016).For example, one provision of the professional code of ethics states that registered nurses should value the quality of the nursing practice. This particular code may be used by the nurse when refusing a patent allocation depending on whether the assignment was given increase or reduces risks for the patient. For example, when the nurse is given an allowance in which he or she is unfamiliar with, chances are that he or she may not be in a position to offer the best care for the patient and this may be used as a strategy to responds to complaints as given to the board by the nurse manager. What the nurse should do is to go to the director or the Nursing Midwifery Board and state categorically and with evidence that the patient allocation would compromise the general quality of healthcare as it would not be his or her area of expertise. The nurse should have the necessary ethics policies, professional codes and practice standards at his or her fingertips for a successful defence before the director or the board (Schneider & Whitehead 2013). What the nurse needs to do is to defend his or her decision-making based on ethical decision making as set by the Nursing Midwifery Board of Australia. Before the nurse goes before the director of nursing or the board, he or she has to be well informed. For instance, he has to go before them knowing that nurse and patient safety is very crucial in the nursing practice and is clearly stated out as part of the standards of the nursing practice (Schneider & Whitehead, 2013). If the nurse goes to defend his decision with this in mind, he will be able to quite it and there is now the Board can convict him or her of abandoning his or duties. For example, if the nurse was assigned to patients suffering from highly infectious communicable diseases such as Ebola, whose outbreak is majorly in Africa, he or she is obliged to decline the assignment as ethical decision making allows him to do so as the execution of this task increases the risk of contracting the same disease (Board of Australia, 2015). However, if the nurse is not well informed on the provisions of the code of ethics and practice standards, he or she may not be able to defend their decisions successfully before the and this may risk his career. Similarly, the decision made, whether to accept or decline patient allocation, always has an implication to the nursing practice. For example, if the nurse receives a patient assignment in which he or she is not familiar with, the chances are that quality of healthcare will be compromised and this affects the nursing practice. On the other hand, if the nurse declines the allocation and then fails to defend the decision well before the board or the director of nursing, then he or she may end up losing their jobs as professional nurses. Thus, ethical decision making is very crucial when it comes to the nursing practice as the implications may be devastating for the nurse, nurse manager, the board, patient and even the entire nursing profession (LeMone et al. 2015; Nursing & Council 2012). Conclusion In conclusion, this essay has analysed the ethical dilemma on the decision of registered nurses of refusing a patient allocation. This is considered an ethical dilemma as the decision to be made is very complex and may have implications for the nurse as a health care professional. For example, refusing patient allocation may risk a nurse losing his or her job depending on how he or she defends his decision before the Director of Nursing or the Nursing Midwifery Board of Australia (Nursing & Council 2012). In essence, this paper concludes by stating that refusing patient allocation is an option for a registered nurse but still, may have serious implications for the nurse and the nursing profession. Two major examples of cases when the nurse may be justified to refuse patient allocation have been given in this paper. These examples are a nurse being asked to take care of patients in a specialty in which he or she is unfamiliar with or even being assigned to patients with highly communicable infectious disease. How the nurse can defend his or decision before the nursing director or the body has also been highlighted. The decision on whether to accept, refuse or object patient allocation should be done based on ethics policies, professional codes and practice standards stated in the Nursing Midwifery Board of Australia. Essentially, ethical decision making is very crucial when it comes to the nursing practice as the implications may be devastating for the nurse, nurse manager, the board, patient and even the entire nursing profession. Bibliography Barry, M.J. &Edgman-Levitan, S., 2012, Shared decision making—the pinnacle of patient-centered care. New England Journal of Medicine, 366(9), pp.780-781. Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Cox, D., Kerdo, E., Kelly, J., Thoms, D. & Fisher, M., 2016. Standards for practice for registered nurses in Australia. Collegian. Goethals, S., de Casterlé, B.D. &Gastmans, C., 2013, Nurses’ decision-making process in cases of physical restraint in acute elderly care: a qualitative study. International journal of nursing studies, 50(5), pp.603-612. Kennedy, C., O'Reilly, P., Fealy, G., Casey, M., Brady, A.M., McNamara, M., Prizeman, G., Rohde, D. &Hegarty, J., 2015, Comparative analysis of nursing and midwifery regulatory and professional bodies' scope of practice and associated decision‐making frameworks: a discussion paper. Journal of advanced nursing, 71(8), pp.1797-1811. LeMone, P., Burke, K., Dwyer, T., Levett-Jones, T., Moxham, L. & Reid-Searl, K., 2015, Medical-surgical nursing. Pearson Higher Education AU. Nursing and Midwifery Board of Australia 2010, ‘A nurse’s guide to professional boundaries’. Available from www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx[05 January 2015]. Nursing and Midwifery Board of Australia, 2011, ‘National framework for the development of decision-making tools for nursing and midwifery practice’. Available from www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Frameworks.aspx [05 January 2015]. Nursing and Midwifery Board of Australia, 2015, ‘Supervision guidelines for nursing and midwifery. Available fromwww.nursingmidwiferyboard.gov.au/Registration-and-Endorsement/reentry-to-practice.aspx[25 September 2015]. Nursing, A. & Council, M., 2012, Code of ethics for nurses in Australia. Canberra: ANMC, 2002. Schneider, Z. & Whitehead, D., 2013, Nursing and midwifery research: methods and appraisal for evidence-based practice. Elsevier Australia. Read More