Top ethical concerns to RNs

flyersfan88 · Nov 12, 2015

What do you think some ethical concerns are? We're not going to do your homework for you. Perhaps the search bar at the top could show you hundreds of posts about this.

BirkieGirl · Nov 12, 2015

WOW. NOT homework, but thanks anyway.

twinmommy+2, ADN, BSN, MSN · Nov 12, 2015

https://www.google.com/?gws_rd=ssl#q=ethical+nursing+issues

walkingdeadhead · Nov 12, 2015

Mine is quality of life. I work in education now, but my background is mainly in critical care. With the amount of patients I have who are not going to get better no matter what, it's hard to want to treat, do painful procedures, etc. when I know there will be no improvement, especially when patients can't speak for themselves. There are so many families that ignore the written wishes of their loved ones.

LoveMyBugs, BSN, CNA, RN · Nov 12, 2015

I work in pediatrics, there are tons

Child abuse

Child psych issues brought on by child abuse

Family drama

Child abuse by parents

End of life care in Peds

Custody issues and parents making false accusations against other parent

After age 14 child doesn't have to inform parents regarding their health care

Ummm those are just a few jumping off points

LDAthleteNurse, BSN, RN · Nov 12, 2015

The biggest ethical concerns for me are running full codes on terminal patients or on the frail elderly (95 year old great grand mother who's family wants a full code and EVERYTHING to be done). Such a grisly and brutal ending. Goes completely against my values.

imintrouble, BSN, RN · Nov 12, 2015

Medicating a "comfort care" patient to death in a hospital setting.

If you think it's an obvious answer situation, you've never been in the middle of a room full of sobbing family members, who "just want Mom to be comfortable".

Middle age patients who need specific medicine, supplies, food, equipment, to manage their chronic illness. Then are admitted every other week to the hospital, because they can't afford to pay for what's vital to their care.

Psych patients admitted to the med/surg floor because the hospital has no psych unit, and there are no empty psych beds within a 100 mile radius. Scary!!!

Even is it is homework, I needed to vent.

These are the top for THIS nurse.

Jensmom7, BSN, RN · Nov 12, 2015

Medicating a "comfort care" patient to death in a hospital setting.
If you think it's an obvious answer situation, you've never been in the middle of a room full of sobbing family members, who "just want Mom to be comfortable".
.

As a Hospice nurse, I'm curious; what is your definition of "medicating to death" someone who is dying? Are they having symptoms that need to be addressed? If not, why are they still in a hospital setting, presumably under General Inpatient or Continuous Care levels of care?

Ah, so many questions, so many opportunities for education.

imintrouble, BSN, RN · Nov 12, 2015

As a Hospice nurse, I'm curious; what is your definition of "medicating to death" someone who is dying? Are they having symptoms that need to be addressed? If not, why are they still in a hospital setting, presumably under General Inpatient or Continuous Care levels of care?
Ah, so many questions, so many opportunities for education.

I know exactly what you're asking, but I don't want to hijack the OPs thread. I have no problem medicating a dying patient. None. Zero. I'll do it in a heartbeat. If there are signs of some kind of distress. Some movement, any movement.. Moaning. Something I can point to to justify the 4 mg of Dilaudid the family wants me to give. When the patient hasn't moved, except to breath, for hours.

When the family has specifically said they want Grandpa to "die in the hospital", instead of at home.

Hospice and med/surg are not the same. You and I are both nurses, but the arena we work in is different. With different rules and expectations. Even different laws.

Let me again be clear. I'm talking about the patient whose only movement for hours is their chest rising and falling, and the famly request for pain med/Ativan is to very plainly make them die faster.

Again, in a patient's home the rules are different, than when they're an inpatient in an acute care hospital. You have a family who are all on board with the decision for the loved one to die.

All I have to have is one family member who looks at me like Dr Kevorkian. There are no signs of pain, distress, discomfort, and I push Ativan and Dilaudid, just because it's ordered.

How do I justify that?

LDAthleteNurse, BSN, RN · Nov 12, 2015

Medicating a "comfort care" patient to death in a hospital setting.
If you think it's an obvious answer situation, you've never been in the middle of a room full of sobbing family members, who "just want Mom to be comfortable".
Middle age patients who need specific medicine, supplies, food, equipment, to manage their chronic illness. Then are admitted every other week to the hospital, because they can't afford to pay for what's vital to their care.
Psych patients admitted to the med/surg floor because the hospital has no psych unit, and there are no empty psych beds within a 100 mile radius. Scary!!!
Even is it is homework, I needed to vent.
These are the top for THIS nurse.

I believe this played an active role in accelerating the death of my baby cousin. She was 3 and had been suffering from a myriad of congenital birth defects. After she lost the ability to swallow at 2 years old and required a mickey tube, the doctors informed us that she would eventually lose the ability to breathe on her own. A year later the doctor was right. She caught a really bad cause of pneumonia and the doctor gave her two options: tracheostomy with mechanical ventilation for the rest of her painful life or hospice/palliative care. Thank God her mother chose to provide palliative care and comfort measures. She had been depending on a bipap machine for adequate ventilation, within 45 minutes of its removal she began experiencing agonal respirations. The nurses gave her morphine to ease her breathing efforts. Within 4 hours, she was gone. I believe she was "medicated to death" but this was a kind service to her and our family. We were so happy to see her finally be at peace.

LDAthleteNurse, BSN, RN · Nov 12, 2015

There are alot of things worse than death.