Ethics

Ethics

Introduction

Ethics by definition is a set of rules that guide in decision making while morals are one’s principles or code of conduct that they have set for themselves to guide them in decision making in day to day lives (American Nurses Association, 2010). Although the two words can be used interchangeably, morals are usually set by external forces and involve discerning right from wrong based on the societal expectations, traditions, socialism and the upbringing of an individual. Both morals and ethics are however governed or ruled by a set of laws which are passed by the constitution; these rules should be abided by, by every citizen in any given state or country. ‘The rules guide personal relations with other citizens or strangers in keeping peace and unity among them despite various individual differences (Merridith, 2012).

Morality is the basis of any society cultures and ethics provides a way to justify one’s decisions. The justification uses the legal laws and standards set by that community or society. In this paper, we shall consider both moral and ethics in discovering various ways one can apply either while adhering to the set of laws formulated in an individual community, institution or state they live in.

Dilemma Encountered

A dilemma is any difficult situation that has several choices to make in which all outcomes are both undesirable and unequal (www.dictionary.com).Ethical issues always occur in our day to day life whether in school, at the office, in choosing which food to take during lunch hour excreta. One of the most vulnerable places where dilemma can occur is in the hospital where important and timely decisions are made, and their outcomes depend on whether life is saved or lost. The choices one makes during such situation depends on their personality, moral values, and principles that they hold dearly in life hence the hospitals has to have a series of dos and don’ts in which a nurse is supposed to consider when making decisions which will be applied in the case of the court ruling.

In the hospital environment, various forms of dilemmas can occur. For example, making decisions for an unconscious patient, administration of drugs to a patient who has refused medication but is in dire need of it. Other dilemmas are ignoring the remarks of another colleague and doing otherwise to save a patient’s life, the idea of life support and so forth.

Personally, I had an encounter with a situation earlier on this year when I volunteered at a hospital located nearby my home. The nurse on duty in the intensive care unit where I love to work was over loaded with responsibilities, so I decided to help since there was very few staff compared to the nursing care required in that unit. While I was performing a bed bath to a patient in that unit, one of the cardiac machines connected to the patient next to me indicated ventricular fibrillation. Ventricular fibrillation is a severe cardiac condition that requires immediate intervention. I, therefore, called for help from other nurses and medics to assists in the resuscitation of the patient by applying the various steps in cardiopulmonary resuscitation.

I started preparing the electrodes and attaching them on to the patient for defibrillation. One of the nurses instructed me to stop the process as it was the relatives’ wish for their patient not to be resuscitated. This came from the fact that the patient had stayed in the intensive care unit for more than 3years consecutively. It was a confusing moment as I watched the patient struggle through the pain using the least energy that they had to fight. I saw the need of trying to resuscitate the patient since for three years that was the first time the patient had an effort in movement no matter how minimal it was. It was however clear on the patient’s file that no resuscitation should be done so the question is should we have done something to save the patient’s life or we abide by the patients will which did not adequately represent the patients preference?

Moral, Ethical and Legal Implications Utilized

The main ethical issue was whether to comply with the patients’ wish or to go against it and provide basic resuscitation as stated above. The moral implication was profoundly influenced by my Christian values and upbringing which demands that in no situation should I kill. This made the situation worse since not administering necessary resuscitation steps was equal to killing the patient. On the other hand, I highly value and respect the patients and relatives wishes that no form of resuscitation should be done to the patient and I wouldn’t like to go against their desire to fulfill my own beliefs.

The hospital and nurses’ code of conduct demands that in a case of signed consent from the closest relatives and a certified permit by the court of law, the wish of the families should be respected. The implementation of the requests should be done despite the nurses views on the situation as the relatives are the ones in control of the patients decisions (Sonia, 2012). The nurses work in to facilitate the patients comfort and let them rest in peace due to natural causes.

My role as an agent in that situation was to incorporate the nurse’s code of ethics and taking a leadership role in advocacy. I was supposed to coordinate for team work to facilitate a comfortable environment for the patient. I upheld the principle of non-maleficence which is the act of not harm Benjamin and autonomy which refers to respect one’s opinion and decision (Noddings, 2013). I performed the necessary routine nursing procedures which included keeping the patient comfortable by adjusting the oxygen mask and elevating the bed to facilitate easier breathing through the ventilator machine.

I was also expected to provide medication as per the prescription in addition to monitoring and recording vital signs every 30 minutes so as to give the relatives a clear of how their patient was fairing on. All of this was done to ensure that the patient was very comfortable and the received optimal primary nursing care until the time the patient would breathe their last. Also, the nurse in charge and I adhered to the hospital’s code of conduct by communicating with the closest relatives and discussed with them about the change in condition. We confirmed that we were doing our best to keep the patient comfortable as we waited for their arrival at the hospital.  We also informed the doctor on call to confirm the diagnosis so that we would come up with a holistic care plan for the patient together with other colleagues.

Leadership Styles Identified

The dilemma gave me a chance to evaluate which type of a leader I am a student nurse and also as a team member and according to how I handled the issue I classified myself as a democratic leader – Taller. A leader who involves other team members in decision making through discussions(Nahavandi, 2016). I incorporated team leadership through calling the nurse on duty who mobilized critical care nurses and other medical staff to discuss and air out their views on the situation before any action could be taken.

The leadership style was the best to use in that situation since it provided a chance for me as a volunteer not to engage in any breach of the code of conduct. This could have happened if I had facilitated resuscitation by myself and later realized that it was not the relatives wish hence forcing me to face the law in court. The use of team leadership style of leadership ensures that the care plan that we came up with was holistic and made sure that conservative management was maintained without breaching the relatives wish during nursing care.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

References

American Nurses association.(2010).Nursing: scope and standards of practices. Silver spring, Md: American Nurses Association.

Kippenberger, T. (2002).Leadership Styles. Chichester: Capstone Pub.

Nahavandi, A. (2016). The Art and Science of Leadership -Global Edition. Pearson.

Noddings, N. (2013). Caring: A relational approach to ethics and moral education. Univ of California Press.

Sonia, A. (2012).The Patient and The Practitioner; Health law and Ethics.

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