Ethical Issues

Turtle in scrubs · Nov 3, 2008

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.

supertrooper8900 · Nov 3, 2008

thanks. anyone else have another experience??

Turtle in scrubs · Nov 4, 2008

thanks. anyone else have another experience??

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

pielęgniarka, RN · Nov 4, 2008

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.

Pediatric Critical Care Columnist · Nov 4, 2008

I find the provision of futile care to be a big ethical issue for me. By futile care I mean high dose inotropes, continuous fluid resuscitation, electrolyte adjustment, frequent lab work and costly antibiotics for someone whose brain has been leaking from every orifice for three days already and has shown no sign of awareness, in an ICU that has been canceling cardiovascular surgeries because of bed and staffing shortages. Or keeping a child on ECLS for 56 days, despite the knowledge that no child with that precise combination of disorders has ever survived. Or performing a liver transplant for the fourth time in a child whose underlying illness is not compatible with longevity.

Another thing that rides on my ethics nerve is the failure of a hospital to consider the safety and well being of either the patients or staff, instead focusing on keeping surgeons happy... surgeons whose main interests are their own incomes (in the mid seven digits per annum) and their statistics (doing >500 procedures a year). So what if there aren't any beds or nurses to care for the patients... the surgery will be a go no matter what. Even if it means transfering an ICU patient to an ICU in another city. What the heck is that!!

erroridiot · Nov 4, 2008

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.

supertrooper8900 · Nov 4, 2008

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...

Dixiecup · Nov 4, 2008

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.

Turtle in scrubs · Nov 4, 2008

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!

supertrooper8900 · Nov 4, 2008

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?

Bortaz, MSN, RN · Nov 4, 2008

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.