Assignment Title: Professional Development 1
Module: NUR 2-6-3
This story is going to present a situation experienced in placement that presented me with an ethical dilemma and question nursing practice. A patient in a semi-conscious state had difficulty in maintaining his basic needs, particularly fulfilling nutritional requirements. The patient required nasogastric (N.G.) feeding to meet these requirements, however the patient became restless of the tube and pulled it out on a regular basis. Even though the decision was made to reinsert the tube every time, it became apparent the tube was never going to stay in. The decision was then made to fit a bridle to anchor the N.G. tube to prevent the patient from pulling it out. The bridle was a sure way to prevent removal of the N.G tube and ensure nutritional support maintained at adequate level.
Due to the patient constantly pulling out the N.G. tube showed their refusal of this particular intervention. Inserting the bridle took away their choice. Although the patient was making good progress, he was not well enough for intrusive procedures such as having a Percutaneous Endoscopic Gastric (P.E.G.) feeding tube fitted, nor was he a candidate for Total Parenteral Nutrition (T.P.N.) infusion, due to abnormal blood analysis. The ethical dilemma then lies with the patients’ autonomy vs. a nurses’ paternal instinct to act in their best interests.
This assignment will consider the statement “…ignorance of the law is no defence and the nurse should be aware of the limits which the law imposes on her, and also the power it gives her” (Dimond 2005). It will try to give interpretation of this statement by mentioning the situation above throughout, which highlights a number of ethical and legal dilemmas - while maintaining confidentiality by protecting the patients’ identity using obscurity (NMC 2004). These ethical dilemmas identified will be discussed firstly introducing how the Nursing and Midwifery Council...