Description of nursing practice and ethics
Nurses at all levels and areas of practice experience and encounter a vast range of ethical issues in their execution of day to day tasks. Over the previous three decades, there have emerged impressive global scholarships on nursing ethics providing all-inclusive thoughtful critiques of the types of issues nurses encounter and the processes that may best be employed for handling them. The consideration of ethical issues is a vital element of providing care within the therapeutic nurse- client connection. Nurses usually encounter ethical situations in their everyday practice.
Nurses at all levels and areas of practice experience and encounter a vast range of ethical issues in their execution of day to day tasks. Over the previous three decades, there have emerged impressive global scholarships on nursing ethics providing all-inclusive thoughtful critiques of the types of issues nurses encounter and the processes that may best be employed for handling them. The consideration of ethical issues is a vital element of providing care within the therapeutic nurse- client connection. Nurses usually encounter ethical situations in their everyday practice.
Comprehension and communication of clients’ values and beliefs, and their own aids nurses acknowledge ethical situations and work through them whenever they happen. Ethics practice standards centers on the values and expectations of ethical conduct and performance for nurses. Practicing nurses often engage in making ethical decisions in the course of their work, though they may be consciously unaware of it. Since they are involved with basic human events of life’s processes, they face the numerous ethical and moral issues surrounding these events (Kathleen, 2009).
Whereas hardly in a situation to control the acts of others, nurses have to decide what their own ethical acts should be in a multitude of situations entailing births, deaths, and suffering. Nurses have to support and sustain patients who are facing hard ethical choices. As advocates of patients and ever present caregivers, nurses also have to support patients who are experiencing repercussions of ethical choices for and about them by more powerful agents in the healthcare delivery scheme. The extent to which nurses are involved in ethical issues in the workplace, how efficiently they have been able to deal with them, and the degree to which their formal education has prepared them to deal effectively with ethical and human rights issues encountered during the course of their work still remains a sensitive subject.
How nursing practice and ethics impacts professionals and healthcare organizations
Ethical aspects and dilemmas are always present in healthcare settings. An ethical dilemma arises in nursing practice when a healthcare professional is compelled to make an alternative between two actions that affect the well being of a sentient being and both actions may be reasonably justified as good. The reason is that neither action is readily justifiable as good, or the goodness of the actions is uncertain. One action has to be selected, eventually generating a predicament for the individual or group who must make the choice. Nursing ethics impacts on healthcare professionals through moral suffering. Moral suffering is the disquieting feelings of anguish or uneasiness that nurses experience whenever they find themselves in situations that are morally unacceptable or when forces beyond their control deter them from influencing or altering these apparent moral circumstances. Suffering may happen since nurses believe that situations must be altered so as to bring welfare to themselves and others, or to eliminate the suffering of themselves and others (Farber, Blustein & Dubler, 2007).
Moral suffering mar result from several sources, like disagreements with institutional policy such as compulsory overtime that nurses believe is insufficient for their psychological wellbeing. It may also stem from disagreements with physicians, patient families and nurses themselves engaging in things that are ethically unacceptable such as covering a patient error made by a close colleague (Kathleen, 2009). Nursing practice and ethics may also affect healthcare organizations through whistle blowing. The main duty of nurses is to offer excellent healthcare. Health professionals serve the public when they can be candid and honest without reluctance. Nevertheless, nurses do not always feel free to speak out about their quality of care concerns without fear of reprisal and retaliation. Whistle blowing is a warning issued by a member of former organizational member to the public about a grave wrongdoing created or concealed within the organization. Healthcare organizations that engage in unethical acts may be exposed to public, which will reflect them in bad light. In states that do not have a whistle blower protection, nurses are faced with a choice between keeping quite to keep their jobs and protect the healthcare institutions or speaking out to enhance patient care (Daniels & Daniels, 2004).
How nursing practice and ethics impacts on patients and families
Nurses face another ethical dilemma when it comes to patient information and their families. Nurses may deny telling the truth with regards to a patient’s medical condition, especially when they know it may cause harm and discomfort on the patient and his/ her family. The American medical association described therapeutic privilege as the practice of withholding patient medical information from patients in the idea that revelation is medically contraindicated. When health nurse exercise therapeutic privilege, they found their opinion on the facts collected from the records of the patients and their contacts with the patients, family members and other healthcare experts. Nurses may avoid telling the truth regarding diagnosis information because: they may be trying to safeguard patients from depressing and disheartening news, they do not know the reality, or they state what they know to be incorrect regarding the circumstances rather than confess all they know to be correct (Butts, 2007).
There are several positive impacts arising from nurses telling the truth, particularly when patients are in progressed stages of a diagnosis. With the full knowledge of the sickness process, patients will make fully well-versed choices, be set for the upshots, have more evocative discussion with family members, and make the most of momentous dealings during the remaining part of life. Nurses are left with a complex choice to make, particularly when a patient wishes to discern the full truth and disclose only part of the truth, or none of it to the patient. Irrespective of how disappointing the news will be to patients and families, nurses have to analyze every circumstance cautiously with deliberation and wisdom before making any decision on the extent of disclosure. A clear comprehension of the communication that has occurred between the nurse and patient and family members adds to the nurse’s decision on the extent of shared disclosure (Kathleen, 2009).
Case example on nursing care and ethics
The aspect of nursing practice and ethics is so critical that sometimes nurses may lose their jobs. Ethics in nursing is a subjective issue, and no matter where nurses work on their varied roles, they are faced with ethical choices that can impact them negatively. The aspect of ethical dilemma is made worse by the verity that there is no “right” explanation to an ethical quandary. Ethics entail doing “good” and causing no harm. However, how a nurse defines what is ethical may vary differently from one person to the other. In Missouri abortions case, Doe v, Poelker, caregivers have a right to refuse to engage in abortions and may refrain from taking part in abortions as an issue of conscience, spiritual beliefs, or moral certainty. In Doe v. Poelker, the city was ordered to acquire the services of physicians and personnel who had no moral objections to engaging in abortions. The city was required to pay the plaintiff’s lawyers’ fees as a result of the gratuitous disregard of the needy woman’s right and the continuation of a policy to disrespect and/ or evade the US Supreme Court’s rulings on abortion (Pozgar, 2012).
Significance of nursing practice and ethics to healthcare organizations
The aspect of widening scope of concerns addressed by health care ethics committees is a new consideration. Increasingly, clinicians and healthcare institutions have come to acknowledge that how an organization makes decisions directly affects the quality it delivers. Every organization gains from an ethics committee composed of interdisciplinary professionals and consumer representatives. Accreditation groups mandate healthcare organizations to set up an ethics committee that evaluates inquiries and looks into allegations arising within the organization. Potential ethical inquiries that ethics committees unravel are whether program examination and monitoring of patient outcomes can ethically serve as the basis for making decisions with regards to allocating resources to clients. Due to the new and competing scientific and economic essentials, the doctor-patient relationship no longer controls the clinical dynamic; administrators and managers formulate and implement strategies that limit the available options and the ability of doctors and patients to make choices about them. The reaction to the ever rising healthcare costs has been a fresh milieu in which medical practice is managed by organizations that enforce financial discipline on clinical decision making. Whilst fiscal concerns remain significant in the changing healthcare system, other elements like the heightened interest in the quality of care, have also led to greater managerial control of clinical decision making. Apparently, the more and more outstanding instruments of quality assurance and measures of clinical efficiency have been motivated by both financial considerations and the need to enhance clinical practice (Farber, Blustein & Dubler, 2007).
Recommendations
The doctrines of the right and the good usually vary with each other in circumstances where “ethically confounding healthcare decisions have to be made”. The objective of medicine is to make sure that the best upshot possible for every patient, though healthcare givers approach this objective within a network of varied expert sets of morals, institution-specific plans and value perspectives. Therefore, new ethical perspectives must be found by looking at the future, as well as reflecting back on the antique ethical thoughts. Every exploration for the “good” has to take place through dialogue and exchange of ideas of all involved parties. Dialogue among researchers, healthcare professionals, quality assurance experts, institutional representatives and the public will help to center on attention on the mounting intricacy of moral decision making in the contemporary healthcare setting. Making ethical places for discourse within healthcare organizations is vital in order to offer prospects for reflection and conversation about fortification of all in the health care society and to make sure and enhanced patient care.
Whereas hardly in a situation to control the acts of others, nurses have to decide what their own ethical acts should be in a multitude of situations entailing births, deaths, and suffering. Nurses have to support and sustain patients who are facing hard ethical choices. As advocates of patients and ever present caregivers, nurses also have to support patients who are experiencing repercussions of ethical choices for and about them by more powerful agents in the healthcare delivery scheme. The extent to which nurses are involved in ethical issues in the workplace, how efficiently they have been able to deal with them, and the degree to which their formal education has prepared them to deal effectively with ethical and human rights issues encountered during the course of their work still remains a sensitive subject.
How nursing practice and ethics impacts professionals and healthcare organizations
Ethical aspects and dilemmas are always present in healthcare settings. An ethical dilemma arises in nursing practice when a healthcare professional is compelled to make an alternative between two actions that affect the well being of a sentient being and both actions may be reasonably justified as good. The reason is that neither action is readily justifiable as good, or the goodness of the actions is uncertain. One action has to be selected, eventually generating a predicament for the individual or group who must make the choice. Nursing ethics impacts on healthcare professionals through moral suffering. Moral suffering is the disquieting feelings of anguish or uneasiness that nurses experience whenever they find themselves in situations that are morally unacceptable or when forces beyond their control deter them from influencing or altering these apparent moral circumstances. Suffering may happen since nurses believe that situations must be altered so as to bring welfare to themselves and others, or to eliminate the suffering of themselves and others (Farber, Blustein & Dubler, 2007).
Moral suffering mar result from several sources, like disagreements with institutional policy such as compulsory overtime that nurses believe is insufficient for their psychological wellbeing. It may also stem from disagreements with physicians, patient families and nurses themselves engaging in things that are ethically unacceptable such as covering a patient error made by a close colleague (Kathleen, 2009). Nursing practice and ethics may also affect healthcare organizations through whistle blowing. The main duty of nurses is to offer excellent healthcare. Health professionals serve the public when they can be candid and honest without reluctance. Nevertheless, nurses do not always feel free to speak out about their quality of care concerns without fear of reprisal and retaliation. Whistle blowing is a warning issued by a member of former organizational member to the public about a grave wrongdoing created or concealed within the organization. Healthcare organizations that engage in unethical acts may be exposed to public, which will reflect them in bad light. In states that do not have a whistle blower protection, nurses are faced with a choice between keeping quite to keep their jobs and protect the healthcare institutions or speaking out to enhance patient care (Daniels & Daniels, 2004).
How nursing practice and ethics impacts on patients and families
Nurses face another ethical dilemma when it comes to patient information and their families. Nurses may deny telling the truth with regards to a patient’s medical condition, especially when they know it may cause harm and discomfort on the patient and his/ her family. The American medical association described therapeutic privilege as the practice of withholding patient medical information from patients in the idea that revelation is medically contraindicated. When health nurse exercise therapeutic privilege, they found their opinion on the facts collected from the records of the patients and their contacts with the patients, family members and other healthcare experts. Nurses may avoid telling the truth regarding diagnosis information because: they may be trying to safeguard patients from depressing and disheartening news, they do not know the reality, or they state what they know to be incorrect regarding the circumstances rather than confess all they know to be correct (Butts, 2007).
There are several positive impacts arising from nurses telling the truth, particularly when patients are in progressed stages of a diagnosis. With the full knowledge of the sickness process, patients will make fully well-versed choices, be set for the upshots, have more evocative discussion with family members, and make the most of momentous dealings during the remaining part of life. Nurses are left with a complex choice to make, particularly when a patient wishes to discern the full truth and disclose only part of the truth, or none of it to the patient. Irrespective of how disappointing the news will be to patients and families, nurses have to analyze every circumstance cautiously with deliberation and wisdom before making any decision on the extent of disclosure. A clear comprehension of the communication that has occurred between the nurse and patient and family members adds to the nurse’s decision on the extent of shared disclosure (Kathleen, 2009).
Case example on nursing care and ethics
The aspect of nursing practice and ethics is so critical that sometimes nurses may lose their jobs. Ethics in nursing is a subjective issue, and no matter where nurses work on their varied roles, they are faced with ethical choices that can impact them negatively. The aspect of ethical dilemma is made worse by the verity that there is no “right” explanation to an ethical quandary. Ethics entail doing “good” and causing no harm. However, how a nurse defines what is ethical may vary differently from one person to the other. In Missouri abortions case, Doe v, Poelker, caregivers have a right to refuse to engage in abortions and may refrain from taking part in abortions as an issue of conscience, spiritual beliefs, or moral certainty. In Doe v. Poelker, the city was ordered to acquire the services of physicians and personnel who had no moral objections to engaging in abortions. The city was required to pay the plaintiff’s lawyers’ fees as a result of the gratuitous disregard of the needy woman’s right and the continuation of a policy to disrespect and/ or evade the US Supreme Court’s rulings on abortion (Pozgar, 2012).
Significance of nursing practice and ethics to healthcare organizations
The aspect of widening scope of concerns addressed by health care ethics committees is a new consideration. Increasingly, clinicians and healthcare institutions have come to acknowledge that how an organization makes decisions directly affects the quality it delivers. Every organization gains from an ethics committee composed of interdisciplinary professionals and consumer representatives. Accreditation groups mandate healthcare organizations to set up an ethics committee that evaluates inquiries and looks into allegations arising within the organization. Potential ethical inquiries that ethics committees unravel are whether program examination and monitoring of patient outcomes can ethically serve as the basis for making decisions with regards to allocating resources to clients. Due to the new and competing scientific and economic essentials, the doctor-patient relationship no longer controls the clinical dynamic; administrators and managers formulate and implement strategies that limit the available options and the ability of doctors and patients to make choices about them. The reaction to the ever rising healthcare costs has been a fresh milieu in which medical practice is managed by organizations that enforce financial discipline on clinical decision making. Whilst fiscal concerns remain significant in the changing healthcare system, other elements like the heightened interest in the quality of care, have also led to greater managerial control of clinical decision making. Apparently, the more and more outstanding instruments of quality assurance and measures of clinical efficiency have been motivated by both financial considerations and the need to enhance clinical practice (Farber, Blustein & Dubler, 2007).
Recommendations
The doctrines of the right and the good usually vary with each other in circumstances where “ethically confounding healthcare decisions have to be made”. The objective of medicine is to make sure that the best upshot possible for every patient, though healthcare givers approach this objective within a network of varied expert sets of morals, institution-specific plans and value perspectives. Therefore, new ethical perspectives must be found by looking at the future, as well as reflecting back on the antique ethical thoughts. Every exploration for the “good” has to take place through dialogue and exchange of ideas of all involved parties. Dialogue among researchers, healthcare professionals, quality assurance experts, institutional representatives and the public will help to center on attention on the mounting intricacy of moral decision making in the contemporary healthcare setting. Making ethical places for discourse within healthcare organizations is vital in order to offer prospects for reflection and conversation about fortification of all in the health care society and to make sure and enhanced patient care.
