ethics in practice

[nurse2bsuyin]

Hi all! My very first post on allnurses - please be kind!! .

So - I'm a third year/Sem5 student doing an ethics assignment - reflecting on ethical issues surrounding a situation. I have a scenario, I'm just having trouble clarifying which actual ethical issues I'm facing and why...

While on placement I (with another student and the patient's regular carer) witnessed an RN force-feeding a physically impaired patient his meds. She spooned the first lot of meds with yoghurt into his mouth, then shovelled the next spoonful in without giving him a chance to swallow the first lot - she was busy and he was taking too long for her. The patient gagged, and was waving his hands 'stop', but the third spoonful followed the first two, again without waiting. It was awful.

(This all happened quite quickly, and believe me I have done a lot of reflecting about it! Retrospect is a fine thing but I won't get started on that sidetrack here!!)

I need to identify which ethical issues am I facing here??

I think Being Professional, Beneficence, Non-Maleficence and maybe even Autonomy fit in here somehow; I just need help relating how/why these principles relate back to the above situation - any thoughts anyone?

Just looking for an 'in' here really - would be great to get other people's views as a starting point for my own thought process...

many thanks

[emtpbill, ASN, RN, EMT-P]

Without being there and seeing this myself I don't know if I would go as far as saying the nurse was trying to harm the patient.

While the nurse should have waited and been more patient, he/she was probably just trying to get things moving.

[nurse2bsuyin]

Oh, no - I don't believe she was intentionally trying to harm the patient either.

But she was doing harm because patient respect and dignity was lost, also potential loss of trust for nurses caring for him in future, and potential refusal to take meds in future. Also risk of choking.

Another possible harm could be that she is teaching less than best practice to nursing students (NB: I would hope that other students would be just as shocked by her behavior as I was, but the fact that she acted like that in front of students suggests that she thinks the practice is acceptable, therefore there may be others that may not see a problem with it).

(This may actually be the most harmful thing - teaching student nurses bad habits to take forward in their practice, which may in turn be passed on to future students - equates to a lot of patients having bad experiences!)