Ethical dilemma

Nursing Students General Students

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last course, i had seen an incident that put in my mind a big question about right and wrong things in the field of nursing practice.

the incident was about administering morphine injection to a patient diagnosed as multiple myeloma and complains of pain all over his abdomen and flank areas.

while the staff nurse m.a was preparing the morphine ampoule, it falls from her hands and broken, i saw the incidence so i informed a senior staff about it and she suggests taking it to the pharmacy and bringing new one, but m.a refused to take it to the pharmacy to avoid the process of reporting including writing accident report.

m.a said" why i have to bother my self, i am sure that he will ask again for morphine, so i will sign in the medication sheet like i gave him and since the patient is having due distalgesic q 6 hrs, i will give him his due distalgesic and after 4 hours if he asks again i can give him morphine injection".

when i heard her i get shocked, i was staring at her and thinking who she will left the patient in pain, the patient was not my assign that day, but i knew him, the distalgesic will not relieve his pain.

because i am student the nurse ask me to take the distalgesic for him to avoid facing him, but i explain for her that this is not professional and violate nursing ethics and i refuse to take the tablets, so she took the tablets for him and when he asked her about the injection she said "morphine injections are not available now, so i will give your due distalgesic now and if they supply morphine, sure i will give you the injection".

can u help me to find literatures about this ethical dilemma and i will be very thankful ..

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Specializes in ER.

Unbelieveable. Report it up channels.

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Specializes in MPCU.

Just to clarify, where is the dilemma? You need to be in a situation where upholding one ethical principle violates another ethical principle. I don't see where any ethical principle was upheld by the nurse. Except, in a sorta twisted way, the principle of justice. If you consider distributive justice as a legitimate part of justice in that setting. The nurse taking the time to waste and replace could be used to care for someone in more need (along those lines, but it is hard for me to support). Of course, I always seem to miss the obvious.

Taking the med to the patient as requested would not be unethical and would allow you to uphold the principle of self determination by informing the patient of the true circumstances.

As to literature, it may be difficult to find current research showing the ethics of charting a med that was not passed.

You do not need literature to report the incident. The issue could be more complicated. Doing the whole correct process could make little difference as to when the patient gets his morphine, because of the time to replace the med.

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it maybe not an ethical dilemma, but it is an ethical issue ..

it's deception to sign not given med. and it's unfair to leave

patient in sevre pain without situable painkiller for him ..

plus reporting in our field, will keep us legally safe ..

Thank u for every body answers ..

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it's unethical and illegal (falsified documenting).

definitely bring this up the channels.

nsg instructor, cn, nm, don...

whatever it takes.

no reason for pt to suffer r/t nurse's mistake.

leslie

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Wow...I would feel the need to report it to someone. Was this during clinicals? If so, I would have absolutely mentioned it the instructor...there were several things that we mentioned, such as skin breakdown from transfering by a PCT who was VERY rough with the patients. It is our duty to make sure all patients are taken care of and while I won't run and tell on every little thing, when it is something like that, I would almost feel I HAVE to tell someone!

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Specializes in ER/Ortho.

My aunt died two years ago with multiple myleoma. It was a horrible death, and a horrible way to die. She was in extreme pain all the time. Even after they gave her morphine she still had breakthrough pain, but it was better than before the morphine.

You need to take steps to inform supervisors, and others of what is happening to protect the poor patients who cannot protect themselves. You are a nurse, and its your job to do that.

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Specializes in Trauma, Teaching.

Absolutely unacceptable.

First thing to do if you haven't already, is tell your instructor. Do not let this go.

Question: you said "staff nurse MA". An MA is an aide trained to pass meds, as opposed to a licensed professional. Which was she?

Either way, it was an extremely callous thing to do.

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Specializes in med/surg, ER.

YOU, as a nurse, even a student nurse, are the advocate for this patient!!! That patient was IN PAIN! If there is a lawsuit, YOU could be liable as well because you knew what happened and did nothing about it. REPORT IT IMMEDIATELY! Document, document, document what happened.

This kind of thing really ticks me off. There was no reason for except for laziness, callousness and complete lack of ethics and compassion.

Sorry for the rant, but multiple myeloma is extremely painful and those patients who have it suffer tremendously.

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it's unethical and illegal (falsified documenting).

definitely bring this up the channels.

nsg instructor, cn, nm, don...

whatever it takes.

no reason for pt to suffer r/t nurse's mistake.

leslie

Agreed on all counts. You should run not walk and make your instructor aware of this situation. That should have been done the second this happened. Document everything. The employee broke the law in addition to acting in an unethical way.

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jbudd ( m.a ) is just an abbreviation of her name ..

hello every body ,, this situation does not happen in usa, it happened in bahrain people are not aware of their rights and the 1% who will sue any doctor will loose.

the politic of the "survival of the stronger" is the dominant

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Specializes in Trauma, Teaching.

I see.

Nevertheless, the patient really needed the pain med whether or not this nurse wanted the hassle of paperwork or not.

I don't know the legalities in Bahrain, but you should still tell your instructor about it! This isn't about sueing, its about that nurse and all the future people she will "cheat" out of their proper care.

Good luck.

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