NR439 Week 4 Discussion, Ethical and Legal Issues

Week_4 Ethical and Legal Issues Professor and class, Questions for the second article: Discuss the difference between ethical responsibility and ethical dilemma. Houser (2018 pp 49) defines ethical as the study of right and wrong. As nurses, I believe that we are held to a higher standard in providing unjudgmental and unbiased patient care. Ethical issues are a combination of both right and wrong matters. During my years as nursing student I was on rotating at All Children’s Hospital, I took care of a 13yr old cancer patient who was being raised by her grandfather because her mother had died of the same type of cancer. The 13yr old patient wanted to know if the cancer her mother died from was the same as hers. The grandfather refused to inform the patient about the new cancer diagnosis in hopes of protecting her from knowing the life expectancy of the illness. An ethical dilemma is when someone is faced with one or more options or confusion of understanding based on ethics or the lack thereof. In my experience, the ethical dilemmas I see in the hospital setting the most are when patients are actively in the dying process and remain a full code, living will state’s wishes, and the patient is alert/oriented times four. When families refused to honor the alert patient’s wishes, stating they’re pulled through before or their love-one is a fighter. Instead of excepting the patient’s decision to palliative care and comfort measures. I feel this becomes an ethical dilemma for the nurse on behave of advocating for the patient until the families are able to come to grips. The ethical dilemma experience that stands out the most to me as a nurse is when we had a patient who was a DNR went to have a peg tube placed Coded. On the DNR form, there was a box the M.D. needed to check that was specific to include procedures as well. Otherwise, the DNR was null/void during the surgery and the patient was a full code. The patient/family didn’t quite understand that this agreement was a part of the consent. The code was successful; however, the family was upset a review was performed to see if the doctor/s had actually discussed criteria prior to surgery. All my years of nursing I was unaware that DNR was not valid during procedures unless specified on DNR form. Immediately following the dilemma, our facility used this as a teaching moment and completed an in-service with physicians and nurses. Gwen, Reference: Feeney, S., & Freeman, N. K. (2016). Ethical issues: Responsibilities and dilemmas. YC: Young Children, 71(1), 86. Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Sudbury, MA: Jones & Bartlett. Chapter 3 pp 49-73. Hi Carissa, I agree it can be difficult in differentiating between what is an ethical dilemma and ethical responsibility. When advocating on behave for patients can be challenging when physicians are involved. I have experienced a similar situation. The recommendation was for the attending physician and the specialty doctor to communication prior to any procedures being done. This took the responsibility and the dilemma away for the nurse while advocating in the best interest of the patient. This is all too familiar dilemma nurses face. Great post. Gwen,