Caring for Patients While Respecting Their Privacy, Essay Example

Introduction

In order for nurses to apply the nursing code of ethics starts they must adopt a moral and ethical philosophy. In essence, the nursing code of ethics is a shared set of beliefs, principles and values which govern the way nurses treat, care and interact with patients.  One of those organizations that help nurses make sound ethical decisions is the American Nurse Association (ANA) Code of Ethics (2015). The nursing code of ethics is a critical part of the commitment to the nursing profession and the compassionate care of the patient. In the career of a nurse they will be faced with legal and ethical situations that will test their professionalism and integrity. The professional nurse plays an important role in the quality of care and the successful recovery of patients. It is the responsibility of the nurse to behave and display their learned ethics to ensure the patient has a positive outcome. The ethical problems faced by nurses are the most difficult because there is fine line between the legal and ethical situations. The legal situations are in black and white however, the ethical situations require sound judgement from the nurse. The adherence to these legal and ethical rules are not always clear cut. The nurse is held accountable for promoting and advocating for the patients benefit while protecting their health care information and the rights of the patient. In addition, nurses have to make critical decisions on who confidential information can be released to while being accountable for protecting the welfare, integrity and safety of the sick. The nurse must provide unbiased and safe care while remaining compassionate, ethical and caring to better patient outcomes. The nurse champions the right of the patient by standing up for patients’ rights. The primary goal of this paper is providing a clear understanding of the nurse’s code of ethics and how adherence can improve the nurse’s ability to make ethical decisions.

Legal and Ethics

The legal issues that surround the privacy of the patient information is on the forefront of the nursing industry. The hospitals and insurance companies have problems with protecting healthcare information under the Health Insurance Portability and Accountability Act (HIPPA), however, its starts with the nursing care to protect that information. The HIPPA act requires the nurse to protect the patients’ health information at all times (Allnurses.com, 2015). The legal aspect is important when a patient’s illness is shared with unauthorized parties. The nurses is responsible for keeping the patient’s information should be confidential while only releasing what is medically necessary.

The aim of the nursing code of ethics is to integrate the protection of the patients’ rights along with providing the confidentiality under the law. The professional nurse can expect to be faced with many different types of legal, ethical and professional decisions which can be challenging. The nurses has the duty to safeguard the patients’ rights with respect to the patients private medical information(Millar & Erickson,2005).The legal ramification can be as simple as not providing the patient with the correct dosage of medicine Prescribed by the physician. The nurse’s code of conduct is an excellent guideline that helps the nurse in situations that may be unethical. The best example is the physician wrote an injection prescription for a patient for 100 milligrams. However, the nurse mistakenly gave the patient 10 milligrams. The nurse is at the end of her shift before she finds out that the dosage was not enough for the patient. It would become a legal issue if the nurse leaves the hospital without alerting the physician and other nurses about the injection error. A well trained nurse would prefer to admit the mistake rather than be arrested later or lose her job because of a medical error.  The American Nurse Association (ANA) Code of Ethics (2015) guidelines state that nurses have a standard of excellence they must uphold because they can influence the patients outcomes, thus they must be morally and ethically sound even when they make a mistake.

Ethical Decisions & Guidelines

In 1996, the Health Insurance Portability and Accountability Act (HIPPA) was implemented to ensure healthcare data is protected. The nurses have the responsibility as a business partner under HIPAA to be held accountable for protecting the patient’s confidentiality and privacy while insuring the personal medical information is not breached. In the new technology age, the patient information is transferred electronically, different medical systems across many hospitals share information and the confidential information is transferred to different practitioners and providers. The nurse must balance the confidentiality of the patient and how much medical information can be ethically released to the next facility to treat the patient.

The landscape of nursing is has new challenges such as learning all the new technology such as electronic physician orders, bar-coded medication software and complicated hand held medical devices. In a study by Agrawal (2009), found that the new technology has lessen the number of medication errors however, the nursing industry needs additional training for the nurses on the utilization of these new technologies.

The best example is the patient’s medication which is prescribed by the hospital physician. The physician requires the patient to take a pain killer every 4 hours however, the previous shift nurse was giving the patient pain medicine every two hours. This ethical decisions affect the patients care because the shift nurse was not following the physician’s orders. The nurse must report this incident to her supervisors and make the correction to the pain medicine along with the physician’s collaboration.

The nurses have supporting guidelines from the American Nurses Association (ANA) Code of Ethics (2015) that was developed as a benchmark for practicing nurses to follow while they provide quality care to patients. The ANA has ethical courses and guidelines that help nurses with ethical decisions such as Ethics and Human Rights, Professional Standards and Application of Ethical Decisions (World Health Organization, 2015). The nurse is bound by each states nursing practice laws however, they all share the same expectations for nursing to exhibit moral ethical values at all times. The nurses are constantly challenged with making ethical decisions concerning the life and death of the patients in their care however, it is important that nurses adhere to ethical standards, quality of life, confidentiality and promoting the rights of the patients.

Preservation of Integrity

The preservation of integrity of the patient is not an easy task and sometimes misunderstood by the nursing industry. The simple task of leaving a curtain open exposing the patient to the public while the patient is trying to heal. The nursing code of ethics by most hospitals advocate protecting not only the patient’s confidentiality with medical records but protect the patient’s physical location from open access. The patients are required to complete an HIPPA disclosure document with the names of people and providers that can have access to their healthcare information. The nurse must be aware and honor that patients request for confidentially, privacy and any other request concerning the patients care.

The Atlanta Legal Aid Society stated that many times unwelcome visitors are allowed because they have received the patients room information from the operator at the hospital information center (Atlantalegalaid.org, 2015). The patient has left specific instruction that only the immediate family will be allowed in the room. The nurse on the previous shift did not tell the nurse on the next shift about the patient’s wishes. The patient gets sicker because the person that was allowed was her neighbor instead of family. The primary point is the nurse is responsible for allowing the patient to receive a safe and confidential environment while keeping the patients integrity in tack on every shift.

The preservation of the patient’s integrity is connected to positive outcomes. The patient deserves to be in control of their medical care and make choices that help them mend quicker. The nurse has to ensure that the different healthcare providers and nurses respect the integrity, privacy and decisions made by the patient.

Moral Issues

The moral issues that a nurse will encounter are very difficult because there is a fine line between what is morally and ethically correct during the care of a patient. It is the nurse’s duty to help and protect the patient whenever these types of issues happen. The best example is the patient has made a dying declaration that only her spouse may visit in her last moments. However, while she has faded into a coma, her children show up that got a military release to be at their mothers besides before the patient passes. The husband is so happy that the children were able to see their mother in those last moments. The nurses have to make a difficult moral decision because the mother has written her Last Will and Testament on record. It is morally wrong for the nurse to let the children in the room before the mother passes. Yes, it would be legally and morally wrong to allow the children in the room contrary to the patient’s wishes. The nurse that understands the meaning of the nursing code of ethics must follow and accept the patient’s last request. The husband is arguing that he can override that decision allowing the children in the room.

However, the nurses were all told by the mother on many occasions that her children do not deserve to be there in those last moments, she only wants her husband. The husband argues his is the legal guardian as her spouse but does not have a Power of Attorney. The moral issue is, should the nurse let the children see the mother or should she follow the patient’s last dying declaration before going into a coma? The nurse has sworn to respect and honor the patient under the nurse’s code of ethics while honoring the wishes of the patient regardless of personal feelings, social states, nationality or religion.  In this situation, the nurse must follow the patients last written and signed declaration, however, she could soften the blow by allowing the children in to see the mother after she has passed. The declaration stated she wanted her husband at her bedside in her last moments, she did not say they could not visit her after her death.

Conclusion

The nursing code of ethics is an invaluable tool that must be utilized by the nursing industry. The nurse has the responsibility to protect a patient’s confidentiality while ensuring that each patient’s private healthcare information is kept confidential.  The nurse will face legal and ethically issues that will impact the quality of care however, they have guidelines from American Nurses Association (ANA) Code of Ethics that help with making the right decision.  The nurse should be prepared to address legal and ethical issues by using the nursing code of ethics to make the best decision. The preservation of the patient’s integrity should be adopted by every nurse because keeping the patient’s integrity in place will help the patient recovery process.

References

Allnurses.com. (2015).HIPPA violations. Retrieved from http://allnurses.com/hipaa-nursing-challenges/hipaa-violations-290326.html

American Nurses Association (ANA) Code of Ethics (2015). Nursing Code of Ethics. Retrieved from http://www.nursingworld.org/codeofethics

Agrawal, A. (2009).Medication errors: prevention using information technology systems. British Pharmacological Society.67 (6), 681-686

Atlantalegalaid.org. (2015).Patients Room demands. Retrieved from http://www.atlantalegalaid.org/fact5.htm

Millar, S. & Erickson, J. (May 31, 2005). Caring for Patients While Respecting Their Privacy: Renewing Our Commitment”. OJIN: The Online Journal of Issues in Nursing. Vol. 10 No. 2, Manuscript 1.

Word Health Organization (WHO). (2015). Nursing code of ethics. Retrieved from http://www.who.int/topics/nursing/en/