A final influence in the case of both of these cases, as with case one, Marianne could not make her decisions, as a patient advocate, the code ethics states in provision 1.3, “The nurse respects the dignity and rights of all human beings irrespective of the nature of the health problem. The worth of the person is affected by disease, disability, functional status or the proximity of death. This respect extends to all who require the services of the nurse for the promotion of health, the prevention of illness, the restoration of health, the alleviation of suffering, and the provision of care to those that are dying” (American Nurses Association, 2001, p. 3). It is the responsibility of the nurse to provide education and emotional support to the family. In the critical thinking exercise, our responsibility is to protect the patient, “When called into court as a witness, the nurse has a duty to assist justice as far as possible.
http://www.enotes.com/code-ethics-nurses-reference/code-ethics-nurses Definition A code of ethics is a guide for an individual or group to follow in making decisions regarding ethical issues. Description In the broadest sense, ethics are the principles that guide an individual, group, or profession in conduct. Although nurses do make independent decisions regarding patient care, they are still responsible to the profession as a whole in how those decisions are made. From the earliest concept of nursing, the proper behavior and conduct of a nurse was closely scrutinized. Florence Nightingale wrote of specific issues of conduct and moral behavior.
When providing patient care in the healthcare field, as professionals, nurses need to be prepared for the challenges that might arise on the hospital setting. Being prepared can make challenges or situations in the nursing field less difficult or provide less resistance for decisions to make in delivering the best quality of care. Whether it is caring for a minor in labor or a same sex couple in the hospital being evaluated, special protocols must be implemented to provide the highest quality of care. As in the case of Rachel who is a minor unwed and in the early stages of labor admitted to the hospital, accompanied by her parents who has not been given meds or been seeing by the physician on duty who happens to be attending another emergency. Where clearly has brought a difficult situation to the healthcare team of the hospital raising ethical and legal issues in all aspects due to the fact that the parents of the pregnant teen have refused any assistance and the nurse assigned has complied silently.
According to the ANA code of ethics, the RN’s primary commitment is to the patient and to protect the health, safety, and rights of the patient. The RN also collaborates with other health care members to meet the needs of the patient. “The nurse plays a central role in creating an environment of mutual trust and respect among all health care professionals by engaging in an open dialogue and claiming a place in the shared decision making about patient care.” (Lachman, 2009). Therefore, it is important to consider the physician’s belief system, as there are a number of medical professionals who “…refuse to deliver care that runs contrary to their moral or religious beliefs, asserting a ‘right of conscience’ or ‘right of refusal’.” (Stein, 2007). In the second case study regarding the malpractice and negligence of a nurse, the primary obligation according to the ANA code of ethics is to the patient.
The husband wanted to save his wife, but on the other hand, their children belief that their mom wants a quality of life with dignity. When a nurses engaged such a complex ethical situation, the Ethical Committee resources included multidisciplinary groups that are needed to assist patient and family. Based on statutory law, patients have the right to make a decision to withdraw or withhold any treatment (Blais & Hayes, 2011). In the case study of Marianne, the patient do not have advanced directive on file, therefore, the statutory laws are not against family's decision related to her care. The nurse can only educate and provide information and be the patients' advocate.
Elements of Caring According to Watson’s theory of caring there are three different elements that a nurse must recognize to provide such care. The first is carative factors; this takes into account that the nurse must be self-aware of her own judgment and emotional barriers to connect intimately, and at the same time preserving the patient’s dignity in a professional manner. The second element is the transpersonal caring relationship (Lachman 2012); it reviews the conscious and moral commitment to make a longstanding connection with the patient. The final element is the caring occasion or moment, this involves knowing and being able to recognize the right time, right place and the right situation in which caring can take place. Case of Caring Lachman (2012) describes a scenario in which a nurse proves competent in being a patient advocate and providing a level of care exclusively for this individual.
The eligibility for licensure is determined by each state board of nursing, usually involving completion of an approved educational program. The importance of the Occupational Safety and Health Act (OSHA) is that it was passed to improve the work environment in areas that affect workers health or safety. The scope of a Good Samaritan Laws protect a health care professional from liability if she stops to provide aid in an emergency. In most states there is no legal requirement for a nurse to help in an emergency, but if a nurse does provide care, liability is limited unless there is evidence of gross negligence or intentional misconduct. These laws do not apply to employed emergency response workers.
A clear solution to this dilemma would be if the patient had a DNR (do not resuscitate) advance directive. Unfortunately the patient does not have one and the family refuses to assign him one. According to the American Nursing Association’s code of ethics “The nurse’s primary commitment is to the patient, whether an individual, family, group, or community; as well as, The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient”(as cited by Potter & Perry, 2013, Pg. 288). In this scenario the family is now the voice of the patient and it is the nurse’s responsibility to carry out their wishes.
But you aren’t able to; you have to do what is required of your job. Ethical decision making is a skill that can be learned, based on an understanding of underlying ethical principles, ethical theories or systems, a decision making model, and the Nursing Code of Ethics. The nurse is legally responsible for using their knowledge and skills to provide for the safety and comfort of their patients. The nurse is also ethically responsible for acting as a patient advocate to safeguard patients’ rights. Each situation has to be assessed; the nurse may use the Six-Step process in assessing their ethical dilemma.
Henry is not so convinced and as the procedure looms closer he asks his nurse to help him make a decision on whether or not to go ahead with the procedure. The conclusion will involve how the nurse negotiates with Henry and what outcomes will be possible for Henry and his daughter. It is the responsibility of the nurse and multi-disciplinary teams to identify and protect vulnerable patients. Defining what is vulnerable is very difficult; The Department of Health (DOH ) describe a vulnerable adult as “a person aged 18 years and over, who is in receipt of or may be