The conflict arises because the decision not to resuscitate could be seen as not promoting the well being of the patient and an omission on the nurse’s part, causing detrimental consequences (Rumbold, 1999). On the other hand, clause seven of the ‘Code of Professional Conduct’ states that a nurse should “recognise and respect the uniqueness and dignity of each patient and client and respond to their need of care” (UKCC, 1992). The nurse who does not comply with a patient’s wish to die with dignity and not to be resuscitated, could be seen as violating this clause (Rumbold, 1999). There are several viewpoints regarding the use of cardio-pulmonary resuscitation (C.P.R.). One such viewpoint is that it
How the ANA Code of Nursing Ethics would influence a final decision in each case study. With the patient with the hemorrhagic stroke, it is our responsibility to discuss with the patient’s family possible options in which they would feel comfortable taking. According to the Code of Nursing Ethics, “the nurse’s primary commitment is to the patient, whether an individual, family, group, or community” (ANA Code of Nursing Ethics). With the patient having no advanced directives, the decision is much harder to take. Ethics committees can be useful in this situation, because they can help explain the patient’s situation and provide possible answers to those hard questions.
According to Garity (2005), “The nurse’s ability to collaborate with patients, families, and multi/ intra-disciplinary health care professionals in the successful resolution of such dilemmas can affect the quality of health care” (p. 11). The nurse has an ethical obligation to give every patient the same level of compassion, care, and respect regardless of the nature of the illness (Chitty & Black, 2010). Whether or not the nurse agrees or disagrees with the decision that Marianne’s family has decided on, the nurse must ethically abide by the family’s wishes and provide the highest quality of care for her. The nurse’s highest level of commitments is for Marianne at that point. Although competing demands of patient, family, and physician have risen, the nurse’s first priority is always providing care that ensures patient safety and protects the best welfare of the patient.
The patient is a minor and may not comprehend the severity of her diagnosis. The nurse as an adult needs to tell the parents so that the patient does not experience harm. The principle of autonomy is another principle that I would use to justify my position in this case. Autonomy is the ability of a patient to give informed consent and make their own decisions (University of California San Francisco School of Medicine, 2008). Because this patient is a minor she is not mature enough to understand all of the implications of her diagnosis and treatment.
Nurses are relied upon to advocate for our patients dignity, privacy, confidentiality, improper and incompetent care. The case of Marianne is a good example of how the ANA code of nursing ethics could help a patient that can't make convey their needs the healthcare team. The stroke has left Marianne unresponsive and without an advanced directive the healthcare team has no way of knowing what her desires would be for the plan of care. Her husband and children are in disagreement with which direction to go in regards to her care. The ANA code of ethics has provisions in place to assist in a decision for this case.
Communication skills, family centred care and compassion are necessary attributes for a nurse to have, in order to develop and maintain therapeutic relationships with pediatric clients. Nursing pediatric patients while having many similarities to nursing those of other age groups brings unique challenges due to the young age of the person. Nursing babies and children takes a special kind of nurse. One who is sensitive to the needs of the whole family. Skills in how to communicate effectively with both the pediatric patient and their parents are important for a nurse to foster to maintain good therapeutic relationships.
Speaking to a loved one about end of life decisions is never easy, and in most cases is not discussed until someone has been diagnosed with a terminal illness. When a loved one is faced with a poor prognosis, the family is confronted with important decisions on how to provide end of life care for them. The nurse can be instrumental in helping the patient and family decide whether they want to stay in the hospital, or go home for their final days. Helping the family set up an advanced directives is important so the family is aware of the patient’s wishes in the event that they can no longer make their own decisions. It also reduces any anxiety that the family members may be feeling if the patient has their wishes laid out for them to follow.
It becomes burdensome when the terminal client, has no advanced directive and the loved ones that are to make decisions are in disagreement with each other. The Nurse Practice Acts and Code of Ethics for Nurse’s can help with dealing with ethical and legal issues in Nursing. An example of a malpractice case is a nurse as a witness in a malpractice suit that involved harm to a client. The case is against the healthcare institution, and a nurse whom she knew was overtly negligent. On previous occasions, it is noticed this nurse violating standards of care.
There are so many different ethics situations that could arise in nursing, for example, bringing hospice in for a patient who needs it, but doesn’t want to admit it or bringing social services into a situation where a patient might be being abused. The advice this RN gave was to stay open to the situation and diplomatic. Sandy also said don’t hesitate to use your authority if need be. It is our duty as a nurse to make sure the well being of your patient is being met. Completing this assignment gave some insight into the real world of nursing not just what you see on TV.
The American Nurses Association Code of Ethics for Nurses and the International Council of Nursing Code of ethics are important within the healthcare environment. Both sets of professional ethics allow nurses to develop a better understanding of the role ethics in the nursing field. Within the healthcare environment, both codes focus on nurses and their relationships with patients. The primary values include integrity, respectfulness, and supportiveness. These values should also be extended to not only patients, but families and co-workers.