Moral Dilemmas

[happyhelpert]

when a patient presents with something that is in conflict with your own moral code, how do you best handle the situation and meet your professional obligation to care for the patient?

[nghtfltguy, BSN, RN]

well.... this is kinda fun..

to the original poster.... you are a *writer*

correct???.... you are not a nurse?

there are many different ppl here that have many obtuse opinions...and many that have many *personal* opinions...

i suggest you let people have their own choices....

[Bugaloo]

We have had HIV+ patients on our unit, and I have had some nurses say to me, "I wonder how they got it?" To me, that is the patient's business, not ours. If they choose to share that info with us, fine. Otherwise, it should not affect the care we give.

[Blee O'Myacin, BSN, RN]

when a patient presents with something that is in conflict with your own moral code, how do you best handle the situation and meet your professional obligation to care for the patient?

honestly, when you get your patient assignment and accept report, you are legally bound to give that patient compentent care to the best of your ability in accordance with the policy and procedures of your facility and bon regulations.

that doesn't mean that you are condoning or accepting anything, just taking care of a fellow human being in need. sure, it would sicken me to take care of a known child molester, and i hate dealing with beligerent criminals in the er who are rude to the cop who brought them in with "incarceritis", but i still do exactly what's expected of me in my professional capacity.

my moral and ethical dilemmas deal more with end of life issues and how poorly informed the public in general is about how death is a natural process that can be put off for awhile with medical intervention, but just because we can do something, doesn't mean that we always should do something.

with the scenario you are describing, you get that l&d patient. your job is to monitor the patient and the baby, and provide the ordered interventions, not get involved with the personal lives and choices that this family decided to make. as long as no one is being physically harmed, it is way out of line to put our own biases onto the way that our patients may choose to lead their own lives.

blee

[dream'n, BSN, RN]

I just remind myself that everyone has a right to live his or her own life as they see fit. And that everyone has something about them that someone else could judge.

One thing I do think that would be hard for me is working with child molesters. But if I had one as a patient, I could act professionally, but I think that would the hardest personally.

[Becca608]

Even though I"m just a widdle student, I have come across this ample times. As a Catholic I'm against birth control, but am often asked for education on the methods, I'm also against pre-marital sex, but people are going to do it whether I like it or not, so I just offer education or tell them where to get education, I don't actually hand out BC. I have much lesser conscience pangs discussing BC then I know I would if a lady got pregnant because she didn't have access to said BC and you dont' have to be a genius or an OBGYN to figure out what most people do if theyr'e pregnant when they don't want to be.

As for homosexuality, I have gay friends, and they know how I feel, but it doesn't mean I'm nasty about it, I give out education, or where to get said education and let people do what they want, since they're not going to do what I want. Plus, I think, if this was my best friend [who's a lesbian] would I want her being treated like this?

The way I look at it, is Jesus hung out with tax collectors and prosititutes without judging them, if he can, then I better gosh darn try. Its all about the do unto others thing. Professionalism just happens to be the extension of that into the not-personal life.

Being Catholic, I also run into alot situations that I simply don't agree with. But like Jesus said, "He who without sin should cast the first stone'. I am not perfect and neither is my lifestyle. I know I need to make lifestyle changes because I'm sitting up at 1AM knowing I have to go to clinical in 5 hours. Why? Because that one patient that my classmates were fussing about could very easily be me in a few years. I think I will leave the judgement to those who think they are perfect.

[HM2VikingRN, RN]

Judge not lest ye be judged....

I am here to provide the very best care that I can to my patients...

[TazziRN, RN]

the way i look at it, is jesus hung out with tax collectors and prosititutes without judging them, if he can, then i better gosh darn try. its all about the do unto others thing. professionalism just happens to be the extension of that into the not-personal life.

you sound like a wonderful person, the ideal christian, and you will make a terrific nurse!!!!!

[KaroSnowQueen, RN]

As a nurse, I have taken care of many prisoners (shackled by the ankle to the bed, with a guard in the room). I don't know what they did or why they did it unless they tell me. I can't say that I feel real great taking care of someone in shackles, but that is not the patient's problem. My job is to take care of him or her and keep my feelings to myself. I treat them no differently than the mayor's wife, is she were to be my patient.

The only thing I have had a problem with is pre-care of abortion patients. I have asked to not take care of them before or during the procedure, as I feel that would be contributing to the procedure, which I am highly NOT in favor of. However, I have given care post procedure, and I am very kind and helpful to these ladies, as I feel they deserve good care no matter what my thoughts are, and their personal life is none of my beeswax.

[queenjean]

I guess I've come to learn that EVERYONE can be judged by others. On any given night I can have 6 different patients, and I'll bet if I dig deep enough, I can find something within their moral fiber that doesn't sit well with me. And conversely, all six of them could do the same to me. I'm certainly not perfect, not even close.

It doesn't really matter what I think of them. I'm there to provide them with the best care I can. I have provided care for some pretty disgusting individuals in my time, and I'm sure that will continue. On the basis that they are a fellow humans, they deserve respectful, competent care. And I will provide it to the best of my abilities.

[LiverpoolJane]

I feel like I have a confession to make - my original response was that I tried to be non-judgemental. I have reason to be reminded of a patient I nursed as a newly qualified nurse about 12 yrs ago. He was grump to say the least but I could put up with that, I had also recently completed a course in aromatherapy and when time allowed I would offer hand / foot massage to the patients. He was one of the ones that I would treat - he really benefited from these, he would relax and sleep well after having his feet massaged. He was a chronically ill man but was getting better and was due for discharge soon. After being home on weekend leave we had a phone call from his GP who basically said that she didn't want him discharged as he had a very long history of domestic violence that had resulted in his wife having hospital treatment on occasions and on the home visit had again been violent towards his wife. I had never known a case of domestic violence before this and was really disturbed by it, to the point that when he asked me if I could massage his feet I would always make excuses and I also confess to being abrupt with him after that and couldn't look him in the eye. I confess further - and I know this is going to get me shot down in flames - to feeling some some frustration towards the wife for staying with him and allowing this to happen to her. I also couldn't understand why the grown up children could allow this to continue.

That was a long time ago and I am a little more clued up about the dynamics behind domestic abuse and the reasons why the person being abused feels powerless and unable to get out of the situation they are in.

Thankfully I have not encountered this same senario since so I cannot comment on how I would deal with it now.

[leslie :-D]

one time i assisted w/a pedophile in dying.

we know these people are sick, but this.guy.was.SICK.

but since our med'l dir brought him in, our hands were tied.

very difficult case, and all nurses had refused to care for him.

so i took him....not ideal, since i come w/a hx of yrs of sexual abuse.

days later, as he was rapidly deteriorating, he asked me if he was going to hell.

i just looked at him, his face human for the first time- frightened, vulnerable...

and quietly told him i didn't know what God's plans were:

but was confident he'd be going to a place where no other children existed.

that, regardless of his sins on earth, i personally did not believe people are punished in the hereafter.

rather, it was a time of reflection, understanding, healing and ultimately, growth.

it was a rough death for him....and me.

but he died much more human than when admitted, and w/hope.

i think we both healed a little bit, that day.

leslie

[LiverpoolJane]

I really admire you for being able to do this - I'm also happy that it may have allowed you to face some "demons" and as you state were able to grow from this experience. I don't know if I would be that strong.

one time i assisted w/a pedophile in dying.

we know these people are sick, but this.guy.was.SICK.

but since our med'l dir brought him in, our hands were tied.

very difficult case, and all nurses had refused to care for him.

so i took him....not ideal, since i come w/a hx of yrs of sexual abuse.

days later, as he was rapidly deteriorating, he asked me if he was going to hell.

i just looked at him, his face human for the first time- frightened, vulnerable...

and quietly told him i didn't know what God's plans were:

but was confident he'd be going to a place where no other children existed.

that, regardless of his sins on earth, i personally did not believe people are punished in the hereafter.

rather, it was a time of reflection, understanding, healing and ultimately, growth.

it was a rough death for him....and me.

but he died much more human than when admitted, and w/hope.

i think we both healed a little bit, that day.

leslie