Nurses commit their lives to the care of the ill and beaten. It is one of the most trusted and ethical professions in the entire world. Occasionally, however, our healthcare heroes will find themselves in a crossroads. There will be complex, murky medical cases with no easy answers. Even in these difficult situations, nurses must stand by the ethical principles of nursing that form the base of this industry. To prepare you for these difficult and stressful situations, this article will go over 4 common ethical dilemmas and how you can effectively navigate them.
One of the toughest problems in nurse ethics is striking a balance between patient autonomy and beneficence. Patients in America are legally allowed to refuse treatment based on cultural and political reasons. Currently, California vaccines mandate provide exemptions for individuals who refuse vaccination on religious grounds. At the same time, however, nurses have a responsibility to do what is best for public health. Unvaccinated patients and their families are more at risk from severe COVID-19 cases and are more likely to transmit the virus onto others.
Ethics in nursing practice places importance on a patient’s free will, but a nurse cannot turn a blind eye to what is best for them. To compromise this dilemma in nurse ethics, they must be willing to strike up a conversation and negotiate with patients. Sharing vital information that could change their mind is especially vital when a patient is clearly misinformed. These situations are the only exception to patient autonomy’s primacy. It can be difficult and exhausting with especially stubborn patients, but this is the only way to reach a balance.
Securing informed consent is one of the core ethical principles in nursing. When presented with a clinical prognosis and potential treatment, some patients do not ask further questions or struggle to grasp the situation at all. As a direct result, patients may end up accepting costly forms of treatment, without crucial information regarding the exact nature of a procedure, potential side effects or the risk involved.
Attempting to acquire perfect informed consent is almost impossible, in this setting. This is where ethics in nursing practice comes into play. Without the training or context, it is hard to grasp all the technicalities of chemotherapy or a craniectomy. Nurse ethics dictates that nurses are responsible for explaining treatment plans as clearly and as thoroughly as they possibly can. They have to discuss the nature of the proposed intervention, the risks inherent to it and available alternatives, before a patient makes their decision. Not doing so means breaking the nursing code of ethics.
Another common ethical issue in nursing is advanced care planning. There are cases where patients face the risk of becoming to incapacitated or ill to make any decisions. This is most common among older populations, but this also includes victims of sudden car crashes, or even patients of chronic illnesses like ALS. When this situation looks likely, patients create advanced care plans with healthcare professionals while they still have their facilities. This lets them accept or reject certain life saving procedures such as ventilators or tube feeding. These plans are shared to patient families via advanced directives, which are legal documents bound by living will and power of attorney.
Ethical issues in nursing arise when dealing with a patient’s close ones. You may encounter families forcefully insisting on or rejecting invasive measures such as tube feeding. No matter what, nurse ethics dictates that a patient’s will must always supersede the family’s. In these situations, nurses are responsible for educating patients and families throughout the entire process. In line with the nursing code of ethics, they need to cover the effects of a treatment, alternative options and its implications, while maintaining a mindfulness for the personal values that could affect their decisions and perspectives.
During the pandemic, nurses have found themselves contending with a lack of resources and inadequate staffing. COVID cases have stretched hospitals to their capacity, while nurses are seeing record turnover as a result of the coming burnout. This ethical issue in nursing is of no fault of their own, as this is just an unfortunate product of the circumstances. Regardless, nurses are still left with a challenging dilemma. There are not enough nurses per patient to address all their physical and emotional needs. Nurses are left trying to sort the priority cases on their workload. This is all they can do while management attempts to correct the course.
Navigating ethical issues in nursing is a taxing process. It can be draining, demoralizing and you are not guaranteed closure. Yet ultimately, it is necessary. To uphold the nursing code of ethics, nurses must learn to compromise and think on their feet. They have to be diplomats in the face of conflict and firm when greeted with confrontation. They need to empathize with a diverse patient group of various beliefs, politics and upbringings. Under the greatest pressure, the diamonds of this industry are formed.