Ethics In Nursing, Research Paper Example

Abstract

Nurses must be able to react quickly and accurately in various situations. Regardless of the difficulty they are expected to act in the best interest of the patient, without hesitation. It has recently come to the attention of many that nurses were not adequately trained in the discipline of ethics. There has been a lack of information that has hindered medical decision making over the years. In order to correct the issue, nurses must be trained and well aware of ethics, ethical behavior and how to balance with the desires, as well as care of the patient. In order to implement change, nurses should engage in the learning process, and serve on Ethics Committees. Engaging will not only increase knowledge, but improve leadership and their role in advocating for the patient. Nurses have a duty to place the patients’ needs and health first and oftentimes find themselves leading others to do the same. Improved ethic implementation and training will assist nurses with patient care, leadership qualities and improve the overall medical experience of patients.

Ethics In Nursing

Ethics and appropriate treatment of patients has always been expected from those in the nursing profession. Over the years and with many changes there have been additional expectations placed on nurses. One of the major changes has been additional responsibilities and patient loads, based on a shortage of staff, disaster readiness and advanced technology. As a result of many changes, other issues, such as ethical concerns have also arisen. Nurses are taxed with providing physical, emotional and psychological care, which can sometimes create ethical dilemmas. These burdens oftentimes lead to ethical questions surrounding decisions, preservation of human rights and maintaining ethical practice. This paper will focus on ethics and how Registered Nurses can assist in the implementation and delivery of ethics in the medical setting.

Ethics Committees

Ethic committees are typically made up of individuals that have diverse backgrounds. While the committee members generally hold health care positions, there are sometimes individuals within the community that serve as well. The purpose of the ethics committee is to identify and ensure that ethics are implemented, as well as followed in the clinical setting. Some of the most common goals are promoting the rights and dignity of patients, promoting fair practice and policies, and providing a respectful environment for both health care professional as well as patients.

Registered nurses should dedicate themselves to learning and engaging in groups such as an ethics committee. It is important because nurses are faced with life altering decisions that must be made in a short amount of time (Gastmans, 2013). They are also commonly confronted with family members that may ask them to do or perform something that is out of the normal medical standards. Because the nurse has this role and a rapport with her patients, it is important for this perspective to be addressed as well as considered. A registered nurse can assist in building appropriate and equal treatment for patients that is based on both premises of basic human needs and ethical procedures. Each committee member and position brings a unique learning opportunity that is addressed and considered by the committee. Because the nurse is hands on with patient care and must balance ethics, privacy, confidentiality and consideration, they must be involved in the policies that are created by medical communities.

Leading Health Care Staff

According to Fowler and Davis, in 2008 there were less than 10% of nursing articles or journals that addressed issues regarding ethical behavior or ethics in general (Fowler & Davis, 2013). It is also noted that ethics is addressed in nursing educational programs, but not thoroughly covered. This suggests that nurses are left to make decisions and act ethically without sufficient training or education. Today there is more address and direction regarding ethics; however it is commonly the senior nurse or R.N. that is looked to for direction and decision making. In order to effectively consider the leading role and potential guidance of the senior nurse it is important to understand the relative four principles of ethics for the medical field.

Nurses that are well informed and educated are more able to make appropriate decisions and handle dilemmas. Nurses that have been privy to policies and procedures will encourage ethical behavior and decisions. In addition to the advocating for patients to staff and other professionals, nurses are also advocates to the patient themselves. Many times patients can be in altered states or may not understand their rights or how to exercise them. If a nurse is well versed and understands the process of grievances and other ethical protections, they can better advise the patient.

Plan Of Action For Nursing Ethics

The principles of ethical nursing are justice, nonmalefeance, autonomy and beneficence (ANA, 2011). Nurses advocate for the care, dignity, decision making and justice for patients on a daily basis. They are there to assist the patient in making decisions that could likely affect the rest of their lives. They see these patients in the most venerable positions and are privileged to how the patient feels, reacts’ to care, and their needs in general. This creates somewhat of an obligation for the nurse to advocate for the patient’s needs. This advocating takes place on a number of levels, first to the physician or other treatment team members, hospital administrators, and possibly insurance companies.

While there has been such a low presence of ethics education and information base in the past, a plan must be implemented to address the need. First and foremost nurses should be informed and educated as to their role in the ethics policy creation, daily implementation and follow up. Hospital administrators are aware of ethics and often look for committee members based on their position and ability to make decisions for the medical establishment. In order to assist the process and provide the most efficient and informed ethics committee, nurses should be encouraged to serve as members. This leadership, not only involves the nurse professionally, but it also assists them in exposing issues or potential concerns that could affect or hinder a patient’s potential treatment. Hospital administrators, executives and others all have an important role, however they may not have first-hand knowledge of the ethical and moral situations or dilemmas that happen in urgent care, surgery centers or other medical departments.

In order to carry out this need, staff must be educated about ethics and the importance of their role, the ethical obligations of the facility and patients alike. Since medical staff are required to engage in continuing education, which typically involve some type of ethics training, it may be feasible that the medical facility require some additional and specific training.

Ethical codes are based on decision making surrounding difficult situations that are typically ambiguous (Beauchamp & Childress, 2001). The ethic policies and procedures should be well understood and stated, however there also should be training on the character, reasoning skills and appropriate clinical behavior. After all, there is not one set principle or measure that can be directly spoken or communicated based on each situation that a nurse may experience. Every patient, situation and dilemma is different and nurses must make ethical decisions in each situation, in a quick and ethical manner. This involves the nurse’s ability to make these decisions based on their knowledge and education. This alleviates the possibility of guessing or providing a decision based on their own feelings, emotions or beliefs. There are a number of decisions and situations that nurse may not agree with, however they must act in the best interest of the patient and allow them to make their own informed decision.

It is also important that nurses be well versed in the ethical expectations of the American Nursing Association. Without proper education and information, a nurse may be acting unethically and not even realize it. By exposing them to the ethics committee, they are more likely to be aware of the changes in ethical code and policies set forth by the ANA. An example would be a nurse that is calling a patient a client rather than a patient, which was changed by the ANA in 2001 (ANA, 2001). This means that knowledge assists nurses in making decisions and understanding how their reactions and beliefs can potentially influence or affect a patient.

In conclusion, nursing is a career that has a great many pressures and responsibilities. Along with the most obvious patient needs there are also decision making and other ethical issues that are present. Registered nurses should take initiative to further their education and understanding of ethics, as well as engage in the implementation. As stated earlier, R.N.’s are commonly looked to and expected to lead others in appropriate ways, when dealing with delicate situations. In order to engage and learn more, nurses should be given the opportunity to be both on the implementation side of ethics, but also the advocating side as well. Nurses bring a very educated and experienced approach to the table, and can greatly impact the manner by which patients are cared for.

References

American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author.

American Nursing Association. (2011). Short Definitions of Ethical Principles and Theories Familiar words, what do they mean? Accessed 11 April 2013 Online [http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Resources/Ethics-Definitions.pdf]

Beauchamp J and Childress J. (2009). Principles of biomedical ethics. 6th ed. Oxford: Oxford University Press.

Fowler, M., & Davis, A. (2013). Ethical issues occurring within nursing education. Nursing Ethics, 20(2), 126-141.

Gastmans, C. (2013). Dignity-enhancing nursing care: A foundational ethical framework.Nursing Ethics, 20(2), 142-149.