personal vs. professional

  1. Hey I'm currently a nursing student.I was wondering if anyone has ever had to do anything that they didn't think was right morally.I have a friend of mine that is a nurse and she says that's the hardest part of it.
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  2. 19 Comments

  3. by   Rustyhammer
    If you think it's morally wrong, don't do it!
    -R
  4. by   caliotter3
    Often enough to make one wonder. Usually involves covering up something by keeping your mouth shut or rewriting documentation. It depends on the situation and just how badly you want your job. Another criteria is your knowledge that the employer will do their best to destroy you should you "screw" them and/or leave without doing their bidding. And future employers will side with them. There is no reward for being morally straight.
  5. by   caliotter3
    arm1077

    Please don't think that nursing is the only line of work where one is asked to compromise themselves for their job. We just like to think of ourselves as being engaged in a morally upstanding endeavor. However, reality, notwithstanding the practice act's admonition against moral turpitude, is often different than the ideal. A lot of institutions have ethics committees to address some of the ethical problems healthcare workers might be called upon to face. I took a course in philosophy where we spent a good deal of time discussing and studying ethics but never really coming to definitive answers.
  6. by   Youda
    RustyHammer always keeps it short and sweet!
    Be true to yourself. If it doesn't feel right, it isn't. At least not for you.
  7. by   CATHYW
    originally posted by rustyhammer
    if you think it's morally wrong, don't do it!
    -r
    what rusty said is it, in a nutshell! just tell your manager or the nursing supervisor if you are asked to do something that is against your ethics standard. the supv. type person will usually find someone else willing to do whatever you feel is wrong. sad to say, but true!
  8. by   pebbles
    caliotter3, Re-writing documentation???? That crosses the line in my book. If your facility expects this of you, I would question the integrity of your management and talk to the health department monitoring agencies.... What type of documentation are you talking about?

    As far as covering up... doctors have made mistakes, and nothing is ever said to the pt. I have been pressured in this context to keep my mouth shut. That to me, was ethically wrong - I think the pt should be told what happens when anyone makes mistakes with their care. But I didn't feel it was my place to blab about someone elses actions when I wasn't there and didn't witness anything.

    Other than that, I have had very few moral conflicts in my work environment. I wonder where the ethical problems exist in other people's facility... never have I been pressured by a manager to do something immoral or unethical.
  9. by   live4today
    I agree with Rustyhammer! Short answer...sweetly put...honestly told. :kiss
  10. by   midwestRN
    When I read this question, I thought in another direction. We once had a IDDM, ESRD, bilat amputee, elderly, confused (normal for pt), with bed sores the size of pie plates, that we coded for 45 min. and got back to live out more painful days. I have a moral problem with this. But we did "everything we could" for the pt.
  11. by   whipping girl in 07
    Ditto midwestRN. Sounds exactly like a patient we coded a few months ago. That's exactly what I thought about when I saw this thread, but since no one went in that direction, I figured they must not have been talking about the same thing I was thinking about.

    I've seen docs show up for codes and ask, "Are you sure this patient is a full code?" before intubating them, based on how the patient looks (really old, really unhealthy, amputations, etc). Of course, no one looks that healthy when they're not breathing, but you know what I mean! I've seen many a patient that we've coded that it seems unnecessary and prolonging their inevitable death at best, and downright cruel at worst.
  12. by   Agnus
    Calittoer3,
    that is the problem with ethical dilemmas; there is no one right answer. It depends on the ethical principal you lean towards.

    However, altering documents is not just a moral problem it is illegal. There are ethical dilemmas and then there are things that are leagally wrong, and there is a difference. If it is something that is illegal there is no dilemma, and it is reportable to law enforcement athorities.

    Failure to report is usually a crime for nurses as well since most states make us designated reporters for adult and child abuse.

    If it it purly an ethical issure and is not covered in your professional or personal code of ethics they you must weigh out the issue, for your self. This is what ethics committies do.

    An employer who cannot respect my code of ethics and my desire to stick by it is not an employer whom I can affored to work for. No job is that important or necessry to my or my families survival. No employer is powerful enough to destroy me or my ability to make a living. Yep! there is always the possibility I may never work as a nurse again but they can't stop me from working all together for sticking to my moral principles.
    Last edit by Agnus on Sep 30, '02
  13. by   -jt
    <I was wondering if anyone has ever had to do anything that they didn't think was right morally.>

    Everyday! I work in ICU & I dont think its morally right or any kind of right to intubate an 80 yr old end stage alzheimers/lung cancer pt whose quality of life is bedbound in a nursing home & now has pneumonia and sepsis. Yet this is what we're doing. What is the pts prognosis? Practically nil - yet the family "wants everything done". And so the doctors order vasopressors, every tube they can think of for every orifice, so many big gun antibiotics that they fill several pages of medexes, etc etc etc - just so nobody can sue them for not trying. Apologizing to the pt, I have to carry out all these orders because the family cant let go & I have to be the one poking, prodding, causing discomfort when I should be making the pt comfortable & allowing him to get on with his journey his way. This kind of thing is happening everyday. I think its completely wrong to put an obviously end stage pt thru this rather, than to say "family, we HAVE done all there is to do for this pt - there is nothing left to do that will change anything. Its time to let him be."
    Last edit by -jt on Oct 1, '02
  14. by   deespoohbear
    i will never alter documentation. if needed, i will add an addenum to the notes if i forgot to chart something that is significant to the pt's care or something the family/pt said, did. otherwise it stays just like i wrote it. i once had a doctor scratch out my charting (i had charted that a pt had refused a bronchial aspirate-which they did on their own accord). i charted "pt declines to have bronchial aspirate done." this doctor actually had the nerve to scratch out in the nurses's notes my documentation and write above it "pt denies refusing bronchial aspirate." fortunately, respiratory heard the pt refuse too but man was i pi$$ed off! i showed the altered chart to the don and of course it was just blown off. i was told "he is going to retire in a few months." you could find yourself in hot water for rewriting documentation!!

    i have also been involved in pt's care that i felt was futile. the one that really gets me is when the patient has an advance directive that states they do not want a feeding tube, don't want intubated, don't want cpr, etc.. and the family does it anyway!! and you are basically screwed at that point if the family member has durable healthcare poa. tv shows do not do us any favors either by having every patient that suffers a cardiac arrest survive the ordeal, and walk out of the hospital 2 days later like nothing happened.

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