Every day, in healthcare facilities across the country, nurses face ethics concerns. The way the nurse handles such precarious situations is rooted in a combination of guidelines. The nurse’s code of ethics, as created by the ANA, provides the framework for dealing with many of these concerns. Also, specialty organizations for nurses provide a particular code of ethical behavior, that directly addresses common predicaments faced by nurses in specialty fields. The healthcare facility typically provides a set of practice codes by which to adhere.
As the terrain of healthcare changes, it can be difficult, especially for nurses, to navigate without a clearcut understanding of expectations and behaviors pertaining to ethical dilemmas. Unfortunately, in healthcare, as in life, morally sound judgments are not always so easy to render. And, just as in everyday life, when you’re faced with these situations, you may not have time to fully digest the ramifications of any judgment you must make.
Although it’s impossible to predict the dilemmas you’ll face, there are 3 common areas of ethics which cause issues for nursing staff. Recognizing, and preparing for, these incidents, will allow you to, ultimately, provide the highest quality of patient care, without fear of repercussion. Standing firm in your decisions is important in any environment, but in the healthcare field, it’s imperative to have a code of conduct on which to rely.
Ethics Issues in Patient Care
The biggest area of ethical concern for nurses has to do with patient care. The healthcare provider/patient relationship is sacred.Trust must be maintained between the patient and the nurse in order for caregiving to be successful. The areas that most commonly call ethics into play are as follows:
Patient Confidentiality- Above all else, you must honor the confidence your patient has placed in you. There is a legal and moral expectation of confidentiality, and, when your patient feels able to share with you it cements the nurse/patient bond. Beyond providing the information as it pertains to medical care, you must honor your obligation and protect patients’ rights of confidentiality at every turn.
Being Honesty with Your Patient-Maintaining your patients’ trust in you is essential to providing proper care and treatment. In addition to keeping confidences, it’s imperative that you are honest with your patient at all times. Nurses have an obligation to their patients to make sure they understand their diagnosis and are given correct information. Work with the physician to ensure the rights of the patient to know and understand their condition, treatment options, and all medications prescribed to them.
Sometimes, as in the case of an elderly, or compromised, patient, family members may have considerable say. In these situations, the patient may be perceived as having a limited understanding of his or her diagnosis and treatment options. The clinician needs to arrange a family conference, so that the family members are involved in the patient’s care plan, and that the patient understands to the best of his or her ability.
Maintaining your Patients’ Autonomy-From informed consent, to advance directive, your patient’s freedom to decide the course of his or her care should be held in the highest regard. Unless the patient is incapacitated, you must obtain their consent for any and all procedures. Respect the right of the patient to refuse, or halt, treatment, medications, and even hospitalization.
The patients’ dignity, and integrity, is the nurse’s responsibility. In addition to providing thoughtful and necessary care, you must respect your patient’s authority in all aspects of his or her healthcare. At some point during the admission process, an advance directive should have been introduced and explained. If your patient has an advance directive in place, respect his or her choices and ensure that the directive has been documented by the healthcare facility.
Ethics in a Changing Landscape
Of course, there are multiple issues you may confront which will impact your professional code of ethics. The fluid nature of nursing and the constant changes in healthcare mean nurses must regularly re-evaluate certain practices. It can be frustrating, no doubt. But, with a grounded understanding of the basics of medical ethics, you can handle these three patient care related issues in a confident and respectful manner.
Photo credit: UC Irvine via Visual Hunt / CC BY-NC-ND