Ethical Issues

Going to work, or staying home, when sick.

I know ... it sounds so simple and mundane. When sick we must decide whether to work and risk infecting patients, family and staff, or stay home. If we stay home we don't get paid, and often our fellow staff members are left working short. May of us receive nothing but grief from our employers to work despite the fact we are obviously sick.

In school I grappled over all sorts of much more interesting issues. I've dealt with some of them so far, and although sometimes difficult, generally there is not much for me to decide, and therefore not an ethical dilemma for me.

thanks. anyone else have another experience??

thanks. anyone else have another experience??

maybe if you could tell us what this is for???

oh man, how about when family decides to prolong their dear old parent's life after a massive CVA so they can live as a vegetable sustained by tube feedings for years until the heart finally gives out.

This is not the most serious ethical issue I have faced as a nurse, but it is the most current issue at hand. My new boss of 1 week is ordering staff to falsify records.

She should be reported. If she is reported to the upper management, it will be covered up and I will lose my job.

If she if reported to the BON, I will still probably lose my job.

If I don't report it, I will probably still lose my job, because I don't fit into her agenda of sociopathy.

Turtle in Scrubs:

I am writing a grad school essay and although I can think of tons of ethical dilemmas working as a nurse, I can not seem to find any I am comfortable writing about. I need ideas and was looking for one that is more neutral on both ends, but very controversial.

One thing that bother me as a nurse is charting restraints every 2 hours. Does anyone actually release the restraints?? When you have 8 complicated demanding patients, it simply is not possible, but must be charted. Another example I have is I work in a hospital where high profile people come in all the time and they are treated differently, not as in protection , but as in better rooms, no lines, etc... Anyhow I am looking to write about something that is non-offensive to non-nurses and that dies not come off as complaining...

Spending a half million dollars keeping a death row inmate alive long enough to be executed. I wrote a big paper on it for my ethics class in BSN school.

I agree with you about restraints. We are almost set up to fail on this.

Another thing that comes to mind is witnessing the wasting of pain meds. Not sure how everyone does it, but most people I've seen run over and swipe their finger and leave. In reality we are suppose to watch the wasting of the med.

As a student I saw this as a big problem and of course thought I would never do this. Now... do it all the time.

It probably wouldn't be very interesting or understood by a non-nursing population. I certainly didn't fully understand it until I was in the position.

Hope you find a topic that fits well. Good luck!

Thanks Dixie- Unfortunately it must be something I have experience with and I have never taken care of a prisoner.

Thanks Turtle. I completely agree with you about being sick and working. Personally I would rather work shorthanded than with a sick nurse. I always seem to catch what is going around.

And thanks to the others with suggestions. Any other suggestions out there?

I'm a student still. The biggest issue I've faced is a classmate trying to get me to do his homework for him. Ahem.

I've run into several and have actually had to report a few to our ethics committee. The ethical dilemmas I see most frequently are related to DNRs, tube feedings and pain control. I've seen families come in and rescind a DNR on a patient who clearly state in their living will and on their MOLST form that they with for DNR status. Unfortunately for them, if they are unable to make a decision, the family can try to reverse it. I was also ordered to place a NG tube down one gentleman to start tube feeding. The family was adamant but the patients living will clearly stated he did not want any kind of feeding tube. I notified the doctor and told him I would not place the tube until morning when the doctor could speak with the family. The patient had continually pulled out his NG tubes previously and that was enough evidence for me to hold it. The worst case I've seen though (and one we still talk about today) was the case of an 84 year old woman with metatstic bone ca. The tumor was pushing though the skin on her hip and oozing out continually. The poor woman was in excrutiating pain, crying and moaning all night. The daughter absolutely did not want this woman medicated for pain. She said that when she visited her mom during the day, mom was too doped out on pain meds. So every day they would d/c the pain meds and every night we would call and get a one time order. It was so bad that the doctor actually threatened to sign off the case because he was so upset with the daughter. The daughter also insisted that mom be place on antibiotics (the cure all for everything) and eventually convinced the doc to move her to the ICU because her respiratory status was failing and she wanted mom tubed. The poor woman cored soon after moving to the ICU, after the daughter left. From what I heard, it was a "slow core" and the woman finally got her peace.