Ethical dilemmas are defined as those situations in which a choice must be made between  two options. Neither option is perceived as an ethically responsible solution. Typically a solution is realized through much thought and discussion, weighing the outcome of both options. 

Medicine in general is fraught with ethical dilemmas. Just because something is allowed by law doesn’t mean it’s morally acceptable to one and all. Many medical professionals find themselves facing situations that go against their principles every day. Conversely, a patient may make a choice that is legally forbidden, however those providing care can see that the decision has personal moral and ethical value to the patient and patient’s family.

So, as a nurse ethical dilemmas are often a part of your work day. From home health to regular shifts in a huge medical center you are never immune to the scenarios which cause you to do a bit of moral “orienteering” relying on your ethics compass to direct you. Finding your way can often be a source of stress and constant doubt. Here are 7 ways to help you deal with ethical dilemmas as a nurse.

7 Tips for Nurses Dealing with Ethical Dilemmas

Understand the Uniqueness of the Dilemma:  Every patient for whom you care comes to you surrounded by a unique set of circumstances. Perhaps the patient is a minor, or a senior citizen with compromised cognitive abilities. The patient may have religious beliefs to which they defer and those beliefs interfere with proper care (i.e. receiving blood), the patient may come from a background of addiction and is adamant about not receiving pain medication. 

These are merely a few examples in a whole world of unique ethical dilemmas. Therefore, each and every one of the ethical dilemmas you face needs to be addressed and reviewed for the individual case it presents. No two patients are alike and the moral dilemma you face is just as unique.

Refer to Code of Ethics:  The American Nurses Association established the Center for Ethics and Human Rights as a way to help nurses navigate tough ethical dilemmas. The value and moral conflicts surrounding many of the life and death decisions nurses face daily needed to be addressed via a point of reference. The Code of Ethics for Nurses with Interpretive Statements, or “The Code” is a much-needed reference guide to help, and to back up nurses in their decisions. 

Although the foundation of nursing remains the same, built on core values, The Code is updated on a regular basis to reflect current status of the U. S. healthcare structure. The Code supports nurses in providing respectful, humane, and dignified care to the individual patients. When faced with ethical dilemmas nurses should first look to The Code for supportive information.

Seek Ethics Education:  For further guidance beyond The Code, look to mentors, supervisors, or even the nurse educators you know from nursing school. Sometimes speaking to someone regarding a moral dilemma can help you gain perspective. Although no two ethical dilemmas are the same you may find that your mentor faced a similar challenge. Experience is a worthy teacher.

Speak Up:  Some nurses may find themselves facing ethical dilemmas that can only be addressed by speaking up. For instance, in the case of a less-than-capable, or caring, physician a nurse may need to take their concern up the chain of command. The personal fall-out can easily cause the nurse to remain silent. However, the patient, or patients depend on nurses to be their voice. It is incumbent upon the nurse to alert those in charge.

Seek Perspective:  Request a family conference if possible. Often times when ethical dilemmas are brought to the forefront in the presence of family members a new perspective is gained by the care team. The family members may offer some influence and aid in addressing the moral dilemma. At the very least you will have a much more clear understanding of your patient and the relativity involved.

Reach Out to Professional Organization/Association:  Professional nursing organizations typically have access to nurse ethicists who can help address ethical dilemmas. The struggle in any of these scenarios is that there are different ideas about what is “right”. A nurse ethicist, or an experienced member of your nursing association, will provide deeper insight based on The Code, as well as the responsibility of all involved.

Seek Counseling:  Sometimes you can’t come to a resolution that doesn’t bring emotional upheaval to you personally. Whether the moral dilemma causes unresolved feelings to surface or rekindles a past event you might be questioning your career entirely. Take a breath and step back. Speak with your supervisor and seek counseling. Most large medical facilities provide counselors. Don’t ignore any personal feelings brought to the surface by this moral dilemma.

Each Dilemma Provides Experience

Ethical patient care is founded on rational science, critical thinking, and educated decision-making. When you’re faced with ethical dilemmas in nursing it’s best to refer to the foundation of patient care, consult your code of ethics, and speak with a professional, either at your place of employment or a trusted nurse mentor. Remember all ethical dilemmas you face only serve to make you a better, more caring, and experienced nurse. And that’s a good thing.


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