Published Apr 17, 2002
I have this town hall assignment that I have to do in my Mental health rotation. I need some examples of how nurses are specially prepared to handle ethical dilemmas. Please help. :)
Genista, BSN, RN
I don't know if nurses are "specially" prepared, but we are definately exposed to ethical dilemmas routinely every day. It is a rare day when I don't have some "neighbor" or "good friend" or even a "close relative" inquiring about the detailed and personal medical information on my patients. I have to be able to preserve & protect confidentiality while maintaining a professioanl attitude with the public. Here's an article that may help, or you can try any search engine and look up nurses & ethical dilemmas...
Good luck w/ your assignment!
How about a slow code, with the DNR/I not signed by the physician. Thank God I never encountered this but many tell me they have!
How about that prn morphene order for your hospice pt.?
i dont think there is a nurse anywhere who hasnt come across or been involved in an ethical dilemma at some stage in their nursing career, due to the complex and diverse role of the nurse, we need to be aware of the fundamentals of ethics and the principles that underpine the actions we take.
i have always found Verena, Schudin (1992, 1993, 1995) to be of immense help to me when i was faced with an ethical problem, also Stephen Wright of the United Kingdom has written several books on ethical problems and how to deal with them.
also if you go to your nursing library and get a couple of good nursing ethic books, these will help you promote evidence based practice.
as nurses we are faced with a barrage of situations for example:
1) do not resuscitate -- looking at the patient and quality of life, in the event of cardiopulmonary arrest,
2) giving of information -- confidentiality clause,
3) truthfulness, fairness, justice, righteousness etc etc.
in the united kingdom and northern ireland, we have a professional code of conduct to adhere to and the fundamental focus remains on safeguarding the interests of individual patients and clients. to maintain confidentiality of all patients. the patient remains the nurses first priority. in addition, there is never a right or wrong answer to give because of the complexity of the situation and from which perspective is viewed, always to act with the patient, for the patients best interest.
hope these aspects help you.
I think that, if nurses are "specially prepared" it is because we spend real time in the trenches caring for real people.
If you unquestioningly believe that life in itself is good and should be sustained at all costs, a few months, years, decades in the nursing "trench" is sure to let you see the flip side of that. The flip side is that medical science is pretty d*** good at sustaining life irrespective to quality of life.
So I think professional nurses have the ethical background, they have professional background and they have the experiential background to understand the desperation that might lead someone to one to want to stop treatment, request assisted suicide, want to dc a feeding tube.
Philosophers, religious leaders, extremists in the pro or anti anything arena can AT TIMES lead pretty sterile lives and often do not appreciate the day in and day out misery that some patients experience to the extent that a clinical nurse can.
Certainly, clinical nursing has lead me to question whether there is a place for physician assisted suicide (and there was a very good thread on this topic about 3 or 4 months ago) and led me back around the other way to feel that patients should always be able to trust that their nurse or doctor will always care for them in a positive way and not decide to send them on to death prematurely. We are often the patient's last advocate. at the same time, that thread that I referenced showed nurses resoundingly in favor of good pain relief care even if it did hasten death.
So, if we are indeed, "Specially prepared" it is because we've been there, seen that, done that.
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