Ethical Issues While Dealing With Patients Essay

Ethical Issues While Dealing With Patients Essay

Ethical Issues While Dealing With Patients Essay


Ethical dilemma is a decision-making problem between two possible moral imperatives,neither of which is unambiguously acceptable or preferable .One action must be chosen, thereby generating a quandary for the person or group who is burdened with the choice. Example,the ethical dilemma which was encountered is in line of patient autonomy.The patient relatives were refusing to have blood transfusion for their child post operatively, despite the possible consequences ,but blood transfusion was necessary for saving the life of the child.With their refusal almost they created the end of life issue situation. Ethical Issues While Dealing With Patients Essay


In the above scenario the other nurse was trying to leave the case by mentioning that patient and relatives are not willing and are not consenting for blood transfusion.

I was not against the patient autonomy,but my intention was to save the life of the child by explaining the consequences of refusal of blood transfusion.At last, they understood the importance of it ,they have been convinced for the blood transfusion and the child was out of danger.


Nurses face variety of ethical issues while dealing with patients, colleagues, or other health care personnel. Nurses, as a human being, differ from one another and possess their own intellectual and moral values. The ethical dilemmas vary in different situations depending upon the way we address it. Some nurses deal with the situation easily while it would create a dilemma for others. One of the examples of an ethical dilemma that can occur in our nursing practice is when nurses themselves are not properly equipped to complete their duties like nurses who notice their coworker’s lack of knowledge face an ethical dilemma of whether they should bring the issue to their nurse manager (Duquesne University, n.d.). Ethical Issues While Dealing With Patients Essay

For some nurses, it would not be a problem and whistle blow right away, whereas, for other, it would be dilemma between patient care and the loyalty to colleagues and employer. One of my colleagues had a patient who had Ventricular Tachycardia then CODED at the beginning of the shift soon after taking the report. It was found that patient’s potassium and magnesium level been low for the last 12hrs and EKG showing frequent PVCs which was not addressed. The patient was on Lasix injection and the potassium level was not monitored. In my opinion, it happened because of a delay in patent management due to incompetency. My colleague had a dilemma about whether to report it or not because the nurse who gave a report to her was her best friend.

Personally, when I notice the incompetency among peers, I critically analyze the situation and if it is a threat to patient safety, I would report because as per the code of ethics as a patient advocator we are obliged to take action when a patient’s right or safety is endangered (Mansbach.,Kushnir., Ziedenberg., & Bachner, 2014). If it is something, we can help our colleague improve incompetency, I privately talk and advice the best way so that the nurse’s license as well as patient’s safety would not be affected. In that case, I talked to and assessed the knowledge of the nurse who gave the report. She said that she was not so confident to analyze the EKG rhythms and not aware of the protocols of managing patients on Lasix. So, I brought this issue and requested the management for the Inservice education which keeps us up to date in knowledge and skill helping to manage promptly and prevent from reoccurrence of the situation. Ethical Issues While Dealing With Patients Essay

Nursing is an ethically related practice. Ethical issues are becoming varied and complex in nursing because of medical advances as well as the complexities in the health system. The nursing field is full of increased challenges that critically impact the work of nurses. All the areas of the nurse’s practice are faced with ethical dilemmas that impact the patients, the health care institution, and the society. However, nurses have the responsibility of acting ethically regardless of these challenges. They have to choose between two alternatives while providing quality care. The reason is the society expects nurses to act ethically as they practice. Social expectations of a good nurse are changing with the times. Nurses are patients’ advocates, thus have to make ethical decisions to support their patients during daily practice. With the society in mind, nurses have to make ethical decisions regarding patient care to be able to understand and identify ethical issues during nursing practice. The aim of this paper is to determine the ethical issues in nursing and to explore the factors that influence the dilemmas, providing strategies to counter the challenges. Ethical Issues While Dealing With Patients Essay

Ethical problems in nursing are challenging issues that require a moral solution. The moral problem arises when the situation, in which the dilemma occurs, is between the nurse’s values and the norms of other people. Notably, nurses need to make choices on the basis of what is fundamentally right according to the principles of nursing. An ethical problem-solving is an essential part of nursing management (Park et al. 594-595). There are numerous ethical issues that nurses encounter in their workplace. Some of them are quality versus quantity of patient life, pro-choice or pro-life, freedom against control, truth or deception, to use empirical knowledge or personal belief and how to distribute resources. Other ethical issues that nurses face are cultural diversity. Also, caring for people with different traditions and accepting their rituals as well as values is extremely challenging. To ensure access to care for all patients by ensuring affordability and equity can sometimes cause ethical challenges to nurses. Ethical Issues While Dealing With Patients Essay

Quantity addresses the period the patient may live or the persons affected by any decision. On the other hand, quality entails good life of a patient depending on its definition. With the two definitions, the nurse faces difficulty in deciding the best options to take in the patient care. Some therapies can prolong life but compromise the quality of patient’s life. A patient may live longer but may experience major side effects due to the therapy. Pro-choice against pro-life comes into play as the issues affect the decisions of the nurse (Park et al. 596). Nurses assume many positions, mostly based on their values and beliefs. For instance, a nurse may not support abortion, but finds that caring for a patient who has aborted. In this case, the nurse has to support the patient, although both have opposing values.

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Freedom versus control is another issue that nurses face. It is the patients’ right to make choices regarding their health. However, in some instances they make choices that eventually harm them. Can the nurse prevent or allow such decisions? Another issue that nurses have to deal with is choosing to tell the truth or not. The situation occurs when the family members request the nurse not to tell the patient about the real medical condition he or she is suffering. Patients have the right to know everything regarding their medical condition; however, the information can cause them harm. Nurses are concerned that sometimes patients are not fully informed about their condition and the treatment options (Park et al. 597). Additionally, the doctors or clinicians may not present the patient’s voice in the prognosis. Most often, clinicians do not follow the wish of the patient due to family demands. Ethical Issues While Dealing With Patients Essay

Nurses find it challenging to distribute limited resources to the needy patients in the hospital. The decision to choose the neediest patient is left to them, thus sometimes becoming an ethical problem. However, family members may plead that the life support should be used for a medically ineffective patient. The nurse may be forced to consider the cost of maintaining these machines and the lives that could be saved in making decisions. Conversely, the nurse is left with the choice of using empirical knowledge or useing her or his personal beliefs. In some instances, research-based knowledge is sometimes contrasted to beliefs, specifically the religious ones (Butts and Karen 5-7). There are patients who do not accept blood transfusions due to their religious beliefs. However, their condition may desperately need the transfusion to save their lives. The nurse is expected to empathize with the patient, but save the life of this patient as it is his or her right.


Nurses frequently report distresses regarding discomfort in patients, informed consent and having to work further than the common goal. Moral distress comes about when nurses are limited to act in a manner they find right. The American Nurses Association has to respond to its members in dealing with ethical concerns. The top three issues that the association has to deal with are integrating the work environment, genetics, and genomics into practice, mostly, when dealing with palliative care and end-of-life issues. Regarding the work environment, nurses have to report any difficulties in the workplace and any environmental and ethical concerns. The work of ethics is to allow a dialog. Staffing issues as well as patient safety fall in the category of work environment (Butts and Karen 10). Nurses often report that they lack time to attend to patients as intended, that is, help them to adapt, recover or even addressing their emotional needs. Nurse practitioners feel that the health care system does not recognize any of the moral obligations for curing patients. Therefore, nurses feel that most of the times they do not offer patients the needed optimal care. Ethical Issues While Dealing With Patients Essay

Most nurses are distressed by the numerous challenging ethical issues in their practice. Nurses encounter ethical challenges in situations, where what they think is right, sometimes is not always the case resulting in moral distress. Nurses have a moral burden of witnessing sufferings of their patients. However, it is their duty to balance the suffering, the benefit, and complexity of their decisions. Specifically, it is part of nursing to witness the relief of suffering, but sometimes interventions may cause patients to suffer more in the process of restoring health. In most cases, distress results in negative impacts on the nursing practice. Some of the consequences of distress are an increased burnout, job attrition, decreased quality of patient care and decreased job satisfaction (Chernecky and Kathleen 174-175). Therefore, dealing with ethical issues ought to be the foremost concern for nursing leadership. Principles of nursing have guidelines that nurses can use to base their ethical decisions. However, nurses have to balance the knowledge with experiences, values, and beliefs. Ethical Issues While Dealing With Patients Essay

The nurse managers have the responsibility of working towards resolving ethical problems. More so, they have to support ethical decision making of their subordinates. The most important role for nurse managers is to ensure proper application of ethical principles. They have to create working environments that support high ethical standards. The nurse managers need to integrate core values and ethical standards into daily nursing practice. A significant role of ethical nursing management is to ensure that nurses protect the interests of their patients while administering quality care. Nursing programs have to prepare graduate and undergraduate students for clinical practice (Chernecky and Kathleen 176). It is the duty of nurse managers to put ethical resources in place. Every health institution needs an ethics committee that encourages nurses to voice their concerns. The institutions can provide unit-based ethics mentors to help nurses in facing the issues. Ethical Issues While Dealing With Patients Essay

Nurses have to reflect on the way they manage competing obligations in the workplace. Team members have to balance tasks by resetting priorities as patients arrive. In terms of genomics and genetics, the technology ought to be available to all patients. Education on genetic testing technology is essential for nurses to appropriately deal with ethical issues. Ongoing education on ethics is one of the ways of dealing with distress. Education is crucial in ethical competence and creation of strong common basis for ethical thinking in nursing management and practice. Both the society and health care organizations need to engage in an extensive discussion on health care values. On the other hand, health care institutions must incorporate job descriptions with behavior that is consistent with the nursing code of ethics (Masters 117). Furthermore, some nursing organizations have position statements that deal with ethical issues that nurses can use as a guide. Ethical Issues While Dealing With Patients Essay

Good and quality care is dependent on many factors that include organizational culture and competencies. Finding ways to deal with ethical conflicts is vital not only to nurses but also to health institutions striving to improve their outcomes. Evidently, moral distress affects patient care as it is associated with job turnover and employee burnout. However, there are several strategies that organizations can use to address ethical issues that the nursing people face to reduce their moral distress. First, it is by supporting the nursing code of ethics. The code of ethics presents a framework for nursing practice. Nurses need to be familiar with the code and use it to make decisions. The second strategy is ongoing education, where educational programs include ethics content. New employee orientation should include theoretical principles that deal with ethical issues. Creating an environment for nurses to voice their concern is the third strategy. Ethical issues are complex, and everyone’s voice is important in exchanging experiences and values to deal with the situation. The fourth strategy is bringing different disciplines together. Nurses and physicians experience similar suffering (Masters 114-116). Therefore, working together can prove to be beneficial mostly in addressing the increasing moral distress. The fifth strategy is providing nurses with an ethics expert. Ethical Issues While Dealing With Patients Essay

Counseling for nurses troubled by some ethical issues may improve their performance in work. Professional associations have to provide resources that can assist the nursing fraternity in handling ethical issues. Associations, such as ANA, need to publish more articles on ethical issues online and make them available at no cost. The journals on nursing ethics are equally important to nurses as they are dedicated to the topic. Reading articles on the ethical dilemmas that other nurses have experienced can help others in dealing with ethical problems. More information is required together with concrete mechanisms on the manner, in which decisions are to be made for ethically problematic solutions (Fierz et al. 272-273). What’s more, the code of the nursing profession seemingly have limited value in resource allocation. Therefore, clear guidelines are inevitable for nursing management personnel to aid in ethical decision-making.

In conclusion, the paper deals with ethical dilemmas that nurses face in their daily practice. Through all the ethical dilemmas the nurses face, they must make decisions. Nevertheless, many factors affect these decisions. The principles learned in nursing college, personal values, beliefs, and experiences play the major part in making either right or wrong choice. The study has provided an overview of some of the ethical problems the nursing management encounters. The paper indicates that resource allocation as well as quality of care is part of the source for ethical problems. Nonetheless, a research is needed to find principles, values, and codes to guide nurses in making solutions to ethical problems. Ethical Issues While Dealing With Patients Essay

The legal, professional and ethical issues surrounding patients have long been a matter of debate (Baylis, 2010). This essay assesses the state of expectations that surrounds each of these areas in an effort to identify specific elements that provide clarity. Beginning with a base background this evaluation will define each element in order to create a foundation for continued study. Next will be a critical appraisal of the ethical, legal and professional issues that have an impact on a patient seeking assistance. A combination of the elements of this essay will create the capacity to illustrate the strengths and detriments commonly associated with being a patient in the modern system.

In the end, this essay examines past policy, modern practice and future potential in an effort to establish a better understanding of the professional, legal and ethical issues that influence and impact patients. Ethical Issues While Dealing With Patients Essay

2 Patient Issues
2.1 Background
The moment that a consensual relationship has been established between doctor and patient there are critical legal, ethical and professional duties that are required on the part of the professional and expected on the part of the patient (Purtilo, Haddad and Doherty, 2014). A working relationship is enacted when a patient knowingly seeks out a health provider in order to address issues, and is cemented when the provider accepts the patient. After this point the physician and patient role becomes increasingly complex as issues must be continually assessed (Baylis, 2010). The role of patient rights and a physician or administrator duties are subject to change depending on the culture, region or nation that the person resides in (Baylis, 2010). With a distinct view to societal influence the legal and cultural definition of rights and responsibilities will vary. Others contend that a patient’s rights should be universal regardless of the place of residence or status (Corey, Corey and Callahan, 2014). A standardization of policy would reduce many issues that often plaque both patients and management (Corey et al, 2014). A demonstration of the effort to amend the build progress rests in the Declaration of Helsinki that served to lay out a set of ethical guidelines that have come to be highly regarded as a form of basic infrastructure (Purtilo et al, 2014). Ethical Issues While Dealing With Patients Essay

In an effort to address many of the legal, professional and ethical issues that surround the care of patients nations such as the United States have enacted a patient’s bill of rights with the express purpose of protecting and clarifying the role and duties of the health care system (Purtilo et al , 2014). These protections and guarantees create a form of reassurance that many find necessary in order to depend on the modern medical system. Hafferty and Franks (1994) conversely argue that a standardization of legal and professional behaviours will limit the capacity of the staff to respond to the patient’s needs. This argument further illustrates with the increase attention to teaching and adherence to an ethical standard much ability to move forward and progress in the practical world is lost (Hafferty et al 1994). However, the increase in ethical teaching over the course of the past decade has illustrated a benefit to making ethically and morally based business patient decisions (Kraus, Stricker and Speyer, 2011). With sensitive issues commonly addressed in a as regards the patients, an understanding and compassionate assessment and care pattern enhances the entire experience. Ethical Issues While Dealing With Patients Essay

Common elements of a patient’s rights platform will include a right to make independent medical decisions fully informed by responsible authority (Kraus et al, 2011). A patient form consent is a highly sought after protection this area (Kraus et al, 2011). With a clear need to provide a balanced opportunity for treatment, yet allow the provider latitude to accomplish what is necessary there is a delicate adjustment that must be maintained. There is a clear and abiding need to include patient autonomy in any form of care (Kraus et al, 2011). Many in the health care industry have opposed a formalized standard for patient care as an unnecessary burden that would only increase the paperwork and fundamental cost (Stirrat, Johnston, Gillon and Boyd, 2009). In the industry itself, the providers often cite the element of private competition as adequate to continually spur on high standards of patient care. The opposite argument states that patient care has been seen to be lax in environments that do not have adequate oversight to ensure compliance (Ellershaw and Wilkinson, 2003). Occasionally a patient’s care has been diminished by the lax form of care instituted by the institution (Ellershaw et al, 2003). Others point to the continued high standards that are a model of the high end private market as an example of what a positive free market patient care policy should embody (Stirrat et al, 2009). However most utilize the deontological tool to assess and evaluate the benefits of any one care process (Stirrat et al, 2009). Ethical Issues While Dealing With Patients Essay

Morally, the ethical position of a professional caregiver dictates a well-rounded and considered implementation of care that provides a solution to the patient’s on-going issues (Nettina, 2013). The position of non-maleficence, or, ‘first do no harm’, illustrates the proper role of the provider (Nettina, 2013). Further, this form of care creates a perception of beneficence that provides much of the moral standing for care providers (Nettina, 2013). A legal obligation may prevent the caregiver from doing what may be an ethically right act (Ellershaw et al, 2003). This combination of considerations comprises the full range of professional liability that patients are linked to.
2.2 Ethical Issues
An ethical issue that ranks high at every level of care is the capacity for the patient to remain safe while receiving care (Leape, 2005). There is an ethical necessity for the caregiver to do all that is necessary to prevent injury to their patients (Leape, 2005). This broad umbrella of safety expectations has led to an over expectation of comfort and quality of care, which in turn diminishes the perception of care (Hafferty et al, 1994). If in the process of ensuring patients safety something goes wrong, it becomes the ethical responsibility of care giver to identify new method to respond to similar cases (Leape, 2005). Others illustrate the high cost that can quickly be generated from investing resources haphazardly in an attempt to anticipate each and ethical issue (Ellershaw et al, 2003). Ethical Issues While Dealing With Patients Essay

All care providers have an ethical responsibility to take responsibility for mistakes made that impact their patients in any manner (Leape, 2005). The all too common effort to avoid or shift blame away, in order to preserve other clients must not be a consideration during the implementation of ethical patient’s considerations. The full scope of an issue may not be apparent immediately, dictating a delay in admitting fault (Stirrat et al, 2013). This argument is clearly illustrated in the complex issues surrounding ethical considerations in the field of mental health care for patients (Kraus et al, 2011).

Ethically, mentally ill patients should be given the exact same rights and comforts that any other patient would receive (Kraus et al, 2011). Influences that include safety and behavior often have impact on the manner in which care is given (Stirrat et al, 2013). In some situations the question of care comes down to the decision of the provider and their unique approach to the illness. A common ethical dilemma that can lead to other professional and legal issues rests in the question of when to medicate and when to refrain from medication (Nettina, 2013). With a patient’s rights indicating that the best possible method be utilized, is this to be found in the reduction of pain or the allowance of pain in order to treat the larger issue? The ethical and moral questions must be continually addressed by both the patient and the provider in order to arrive at the best fundamental answer (Corey et al, 2014). The converse argument states that the professional knows best and should the person making the crucial decisions (Hafferty et al, 1994). Ethical Issues While Dealing With Patients Essay

2.3 Legal Issues
There are a wide range of legal issues that make providing care for a patient a complex experience (Nettina, 2013). A patient must consider each element of their care in order to ensure that the appropriate services have been rendered. Nettina (2013) identifies the primary sources of legal risk in the nurse’s profession as patient care, procedures performed and the associated quality of documentation. This implies that at any one point a mistake in care may be interpreted as a legal lapse making the provider liable (Nettina, 2013). In order to minimize the exposure to legal and financial process, instruments including risk management systems and the implementation of devices designed to anticipate and reduce the risk of injury for patients (Nettina, 2013). The converse position argue that the financial expense of keeping up with the latest developments in science has a direct adverse impact on the manner in which a small provider can find it difficult to sustain operations (Corey, 2014).

In many nations including the United States and the United Kingdom, the fact that it is illegal to discriminate against a patient based on gender, nationality, religion or any reason allows for every person to find adequate care (Richardson and Storr, 2010). Others advocate for the application of health care after an assessment of insurance and payment abilities (Ellerwshaw et al, 2010). Potentially, those lacking an adequate source of funding for health care have received only marginal consideration, which in turn can quickly become not only an ethical and professional detriment but a legal issue that can diminish overall operations (Richardson et al, 2010). Yet, the provider can cite the case as bringing beyond their capacity and turn a patient away, thereby citing a legal reason to turn away patients (White and O’sullivan, 2012). Ethical Issues While Dealing With Patients Essay

Once treatment has commenced it is legally required to obtain consent of the patient prior to the performance of any treatment that may substantially impact the patient (Bayliss, 2012). This legal right ensures that a patient is informed before possible life altering decisions are made. In some cases a layman patient will not adequately understand the full issue at hand, and therefore the professional associated with the concern should make the call (Kraus et al, 2013). This position of decision making capacity again touches on the elements that are directly related to the ethical and professional policies and positions of the institution that is providing the patient with care. Further, once care has begun, the patient is assured of continuity of care as well as confidentially (Bayliss, 2012). This legal underpinning ensures that an incapacitated patient will not have to make critical decisions immediately or during the procedure.

A primary method of protection for patients and overall control for care providers rests in the legal institution of mal practice (Jonsen, Siegler and Winslade, 2006). Others argue that the institution of mal practice ties the hands of care providers by putting too many hurdles in way of effective care (Hafferty et al, 1994). Still others advocate for a mitigated form of malpractice that addresses the needs of the patient without threatening the entire structure of the provider’s livelihood (Corey et al, 2014). In cases that a providers services can be proven to be less than what was expected by the patient or the institution, there is the opportunity for financial redress. In order to mal practice to be claimed, there must be an existing patient and provider relationship acknowledged on all sides (Jonsen et al, 2006). Ethical Issues While Dealing With Patients Essay

A patient is legally entitled to a referral to a better provider if the first practitioner is unable to meet their needs (Bayliss, 2013). This area touches on the ethical responsibly of the provider to assist the patient in any reasonable manner (Corey, 2014). Others cite the potential for litigation if the referral goes wrong and there are problems for the patient (Hafferty et al, 1994). A continued source of worry for the medical profession is the looming threat of court action over a mistake or oversight on their part (Bayliss, 2013).

2.4 Professional Issues
The entirety of the expected behaviour of any patient related institution is required to exhibit professional and exemplary behaviour (Corey et al, 2014). This expectation is tempered by region, financial issues and the available of competent staff (Urden, Lough, Stacy and Thelan, 2006). Many contend that care for the patient should come before financial or regulatory concerns (Bayliss, 2012). Regional and national political regulations play a large part in the establishment of professional standards as regards the treatment of patients in several areas around the world (Corey et al, 2014). A Professional perception is made up of the ethical and legal considerations that are relevant to the position, again providing a firm indication of the integrated nature of the legal, ethical and professional aspect of patient care (Bayliss, 2012). Ethical Issues While Dealing With Patients Essay


The professional will not neglect the rights of the patient in the pursuit of their goals (Corey et al, 2014). This facet reflects the need for the professional to terminate the relationship at the correct time, for the proper reason. In many cases, some professionals will make a billing cycle longer for the simple reason of increased revenue with little effort (Corey et al, 2014). Others describe this approach as overly cautious and cite the need to be certain of the outcome for the patient before any change of status should be implemented (Bayliss, 2012). This same sense of professionalism is extended to the form of treatment that a patient has the right to expect, with the best choice, not the latest trend being the choice (Stirrat et al, 2013). The patient must be given every component of information in order to provide an informed consent. Anything less than full transparency on the part of the provider is an ethical, legal and professional blunder (Corey et al, 2014). Ethical Issues While Dealing With Patients Essay

3 Conclusion
This essay examines the role of the legal, ethical and professional actions as regards the expectations of the patient. With the evidence presented in this review, there is argument for many issues that touch on all three aspects. Lacking a universal patient’s bill of rights, the issues experienced by patients seeking assistance can vary widely according to region and financial ability. The data presented in the this essay indicates that while the ideal system advocates for a fair and equal patient experience, it is often those that have the financial support that have the best care. Ethical Issues While Dealing With Patients Essay

The evidence presented here provided support for the contention that ethical decisions will benefit the professional and legal standing of the patient provider. By ensuring a high standard of care, the provider is doing everything possible ethically and morally to address the concern. This effort diminishes the potential legal ramifications that centre on the mal practice and court process. The areas of ethics, professionalism and legality correspond to create a complex environment for a patient to navigate. This makes it necessary to ensure a high standard of professionalism within the ranks of the patient provider network. There must be a balance as there cannot be an effort to placate the patient that becomes adverse to the overall treatment. Much like any other industry there is a balance that must be maintained in the relationship between provider and patient in order for the best results to be experienced. Ethical Issues While Dealing With Patients Essay

The modern world has provided patients with new and diverse opportunities for care in nearly every nation around the world. With the areas of professionalism, legality and ethics playing a building role in the way services are provided, there must be a continual and considered approach to each policy in order to ensure the rights of everypatient. In the end it will be the combination of all three aspects that create the opportunity for progress.

Title: Ethical and Legal issues in Nursing paper Student Name: Aleyamma John, RN Course Name/Number: NUR/391 Due Date: Mar 21, 2011 Instructor Name: Dolores Martinez Nurses are facing many legal or ethical dilemmas in their career. Nurses should combine knowledge of ethical and legal aspects of health care and professional values into nursing practice. It is very essential to know what kind of dilemmas nurses may face during their profession and how they have been dealt with in the past. First, it is very essential for the nurses to know the difference between law and ethics. Ethics observes the values and actions of people. Ethical Issues While Dealing With Patients Essay
Past research has discovered that managers react to ethical dilemmas according to the situation. If specific values that are related to ethical behavior can be identified, they would offer strong tools for managers who want to retain high standards of ethical behavior in their society. The issue of ethical decision making has become more important in recent years for a variety of reasons. An understanding of ethical decision making in organizations is more significant to the development of organizational science. Managers engage in decision-making behavior affecting the lives and well-being of others. The individual responds to an ethical dilemma with cognitions determined by his or her cognitive moral development stage. As a nurse it has happened to be an essential need to be conscious of the legal aspects associated with caring and serving people in the health industry today

Working with patients, nurses will have many occasions when they need to call on nursing ethics to deal with difficult situations.

“Every day, nurses in all hospital departments face a variety of ethical issues and they need to reconcile their own values with their nursing professional obligation,” said Marian Altman, RN, MS, CNS-BC, CCRN-K, clinical practice specialist with the American Association of Critical-Care Nurses (AACN). Ethical Issues While Dealing With Patients Essay

“There are a variety of reasons that nurses are not able to reconcile this conflict, such as lack of resources to do so and lack of time. Not addressing ethical issues is a problem. If the nurse ignores the issue, it may lead to burnout and their leaving the unit and/or the nursing profession.”


Nurses who do not heed the nursing code of ethics could also find themselves in legal trouble.

Not surprisingly, nursing professionals who don’t know the code of ethics may face a higher risk of being involved in situations that could lead to disciplinary charges or malpractice litigation, added David Griffiths, senior vice president, Nurses Service Organization, a professional liability insurance provider. Ethical Issues While Dealing With Patients Essay

Every nurse should become familiar with the Code of Ethics for Nurses, developed and released by the American Nurses Association (ANA).

“It’s a framework for helping nurses with issues that might arise,” said Connie M. Ulrich, PhD, RN, professor of bioethics and nursing at the University of Pennsylvania School of Nursing and Medicine in Philadelphia and author of Nursing Ethics in Everyday Practice.

Additionally, Altman suggested contacting “the hospital’s ethics committee, the hospital code of conduct or a variety of educational resources. Some organizations have an ethics consultation service whose members round and proactively assist staff to discuss potential and/or real ethical issues.” Ethical Issues While Dealing With Patients Essay

4 Common Nursing Ethics Dilemmas
1. Informed consent

Concerns that patients and their families have not been fully informed about their treatments or clinical prognosis is a common ethical concern of nurses, Ulrich reported.

“It can create great concern for nurses,” Ulrich said. “Patients feel more comfortable asking the nurse to decipher what was said [by the doctor]. But it’s an ethical issue about how much they should convey.”

This is especially true about end-of-life decision making, she said. But nurses may not be prepared to have this discussion. She suggested building stronger interdisciplinary teams.

2. Disclosing medical conditions

Another example of an ethical dilemma is telling the truth to a patient vs. being deceptive, Altman said.

“Sometimes families request that patients not be told about their medical condition or diagnosis,” Altman added. “The nurse must consider the patient’s right to know. How does the nurse know what the family is saying is true?”

The nurse has an obligation to the patient and the ethical principles of nonmaleficence and fidelity—the obligation to prevent harm and the obligation to be faithful to your colleagues, Altman said, adding, “The nurse’s own value of truth telling must also be considered.” Ethical Issues While Dealing With Patients Essay

3. Incompetence among peers

Another dilemma involving nursing ethics is when a nurse notes incompetence in a fellow health care team member and struggles with speaking up or staying silent, said Sarah Delgado, RN, MSN, ACNP, clinical practice specialist with AACN.
“They may feel the behavior should be reported because of the threat to patient safety but hesitate to do so because it would worsen inadequate staffing,” Delgado said. “Some dilemmas can be framed as competing obligations, such as protecting the patient on one hand and protecting the staff on the other. The principles to consider are nonmaleficence and fidelity.

Resolving what appear to be competing obligations often requires thinking creatively, Delgado added.

“Solutions often become apparent when we stop and consider all the possible actions available to us,” she explained. “Beyond report or don’t report, there may be an option to talk to the individual in question, assess his or her awareness of the incompetence, and encourage further training, education or practice.”

4. Broader ethical issues

According to Felicia “Liz” Stokes, JD, RN, senior policy advisor at the ANA’s Center for Ethics and Human Rights, ANA considers the top three nursing ethics issues as: Ethical Issues While Dealing With Patients Essay

Creating and maintaining an ethical work environment
Nursing’s role in social justice, such as opposing capital punishment
Moral distress and moral resilience.
“The Code of Ethics for Nurses with Interpretive Statements is clear that nurses are bound in their duty to protect human health,” said Ruth McBain on behalf of ANA. “As the guiding voice for nursing ethics in the United States, the ANA feels that it is important to take a strong position on issues affecting human dignity and societal health.”Ethical Issues While Dealing With Patients Essay

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