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Explain the statement, “What may be an ethical dilemma for one registered nurse may not be an ethical dilemma for another registered nurse.” Be sure to define an ethical dilemma in the course of your discussion. Describe a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. (Be sure to respect and maintain patient and colleague confidentiality.)
An ethical dilemma involves a situation where a person is faced with deciding between two different choices or actions that will have an effect on another individuals well being, in which both choices or actions can be justified or argued as being good, equally as bad, or equally uncertain. (Butt, 2016).
An ethical dilemma for me is what I have witness throughout this hole pandemic, I believe it’s were seen most patients die in my whole career. It has definitely brought the most questioning and doubt when doctors wanted to keep family wishes but patients were either too far gone in their treatment or the complications were to extensive. I have had brain dead patients and families refusing to withdraw care for weeks and us nurses keep having to take care of this Covid patients for weeks exposing ourselves even further to respect their wishes.
An ethical dilemma is defined as a situation in which a person is constrained and duty-bound to make a decision that will result in consequences that can affect the wellbeing of an individual. The action based on the decision is reasonably justified as being good. All actions presented is justified as being good and the goodness of the action can be uncertain. In the end, an action must be chosen and the people responsible for the decision and action is often loaded with the choice (Butt, 2015, pg. 55). In the statement presented above, “What may be an ethical dilemma for one registered nurse may not be an ethical dilemma for another registered nurse” means that each individual has their own set of principles and morals ingrained in them and that what one ethical issue to one person may not be so for another person. One challenging situation that I faced was, working in a nursing home during night shift when I came in to start the shift, I was alerted by the CNA that a patient was placed in 4 point restraints without a physician order because she was wandering and trying to get off the bed. The intent of the previous shift was probably for safety purposes and to prevent a fall but it was not appropriate to restraint the patient without a physician’s order or for staff convenience. As the incoming nurse that night, it was my duty to report it to my supervisor and to the DON. An incident report was furnished and notification to the family was done.
As healthcare professionals, we are often faced with ethical dilemmas in which we must make justified ethical decisions. According to Butts (2016), in order to make justifiable ethical decisions healthcare professionals need “to know themselves and their motives, to ask good questions, to challenge the status quo, and to be continual learners.” One way in which health professionals can achieve this is applying “The Five R’s” in their own nursing practice. The Five R’s are read, reflect, recognize, resolve, and respond, and allow for the improvement of our reflection and decision making skills (Butts, 2016). When faced with ethical dilemmas at work, I find myself reflecting on my own beliefs and values, reflecting on others beliefs and values, and place myself into other people’s shoes in order to view things from different perspectives. As a nurse we must be as unbiased as we can be and always act in the best interest of our patients. In my nursing practice, some of my own personal values include integrity, open mindedness, honesty, compassion, empathy, respect, loyalty, and kindness. I have come to recognize that these personal values have shaped who I am as a person and are values I hope the people I surround myself with value and hold dear to them as well; in fact, in my society, I recognize the same values in others as they are the same values that are useful in society today. When making choices and decision-making, I find myself being very open minded and take various opinions and perspectives into account. Overall, I believe the values I hold dear to me do in fact influence the choices I make as they are the way I view the world and what I value most when it comes to the relationships I have with others. As far as the topic of choices, I believe there are various factors that can limit ones choices. Some factors that limit choices in the nursing field include government regulations, inexperience, administrators or authority figures, and health care policies and procedures. At times, limit to choices can feel as though you are not able to unlock your fullest potential or provide the best quality care for your patients; however, some limit to choices are needed to provide order and to prevent mistakes. As a nurse, it us our duty to advocate and protect our patients and at times that includes limiting the choices of others. For example, if a physician orders a medication that would cause more harm than good to the patient, it is our duty to limit our patients’ choice of taking that medication by speaking to the physician about it first before ultimately letting the patient decide for him or herself. In healthcare, we often see health care organizations or the government limit people’s choices. I believe that limitation is needed occasionally to regulate actions of the healthcare field; however, to a certain extent. Currently the government limits resources to our patients depending on health insurance such as Medicaid, Medicare, HMO, EPO, and PPO patients. I do not believe these kind of limitations are fair to the people because it allows those who can afford the best health coverage to receive the best care whereas those who cannot afford it to receive poor care. Lastly, the assumption that those in health care are drawn to the profession because of an inner compass that is composed of a strong moral framework guides them can be dangerous because not everyone goes into healthcare for the right reasons. Furthermore, this assumption may lead others to believe everything a healthcare professional says must be honest, unbiased, true, and in the best interest of the patient in which assuming this to be true would be like assuming every individual is good and has the right intentions, which is not always the case.
Personal top five nursing values are compassion, humility, trustworthiness, accountability, and curiosity. I value all these attributes considering my primary goal of promoting care and patient dignity at all times. Examples of societal values are justice, honesty, responsibility, and giving back or contributing to a good course. As a nurse, I attempt at all times to make evidence-based decisions by consolidating knowledge from personal clinical understanding, patient preferences, as well as research evidence (Nam et al., 2017). My choices are based on evidence-based research and most of the time match my values. Justice and giving back remain useful in society as they promote equity. I am obligated to perform my duties as a nurse, which could limit my choices. Limits to choices are good since they hinder one from overriding professional responsibilities to assert personal values. As a nurse, I do not limit a patient’s choices but ensure that they understand all available options. Rules and regulations should be primary factors of limiting people’s choices without which there could be chaos. It is dangerous to assume that a strong moral framework directs healthcare workers and yet they should be guided by evidence-based research on healthcare matters as opposed to thoughts on morality.
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