7 Ways to Deal With Ethical Dilemmas As a Nurse

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.

There is no telling when an ethical dilemma will arise. Regardless, the best nurses know how to address such issues before they escalate. These nurses are willing to devote the time, energy, and resources to investigate ethical dilemmas and their impact on all involved. They work in lockstep with stakeholders to achieve optimal results.

The best nurses do not shy away from ethical dilemmas, either. They understand that 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 seven ways to help you deal with ethical dilemmas as a nurse.


7 Tips for Nurses Dealing with Ethical Dilemmas


1. 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.

To understand the uniqueness of a dilemma, get insights from all parties involved. Learn as much as you can about the dilemma. From here, you can work with all parties to find common ground between them. This can ultimately lead to a resolution that works well for all sides.

Don’t expect a dilemma to disappear on its own. Rather, a dilemma can persist, particularly if the parties involved in it try to ignore the issue. By opening the lines of communication regarding a dilemma, you can bring it to the attention of everyone involved in it. This can lead to communication and collaboration relating to the dilemma. It can also result in a speedy and effective resolution.


2. Refer to the 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.


3. 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.

The more you learn about ethics, the better off you will be. As you gain insights into ethics, you can confront dilemmas head on. This can help you become a key contributor in resolving dilemmas any time they crop up. It may open the door to new career opportunities in nursing as well.


4. 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.

When you bring up an ethical dilemma, consider how you will do so in advance. You should involve appropriate stakeholders and set aside time to speak with them. This allows you to get insights you can use to resolve the dilemma with precision and care.

Follow up with anyone you notify about a dilemma. Ideally, the issue will be addressed right away. However, if you find the dilemma goes unresolved for an extended period of time, continue to move the issue up the chain of command. This ensures the dilemma gets the attention it deserves.


5. 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.

When meeting with family members, remain patient and understanding. Explain the dilemma in detail and offer insights into it. You should listen to what family members have to say and how they feel about the dilemma. Together, you and family members can explore potential solutions.


6. Reach Out to Professional Organizations/Associations

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.

Share as much information as you can about your dilemma with a nurse ethicist or an experienced member of your nursing association. This helps paint a picture of the dilemma and the factors involved in it. You can then generate insights into possible solutions to resolve the dilemma. Plus, you can get insights you may be able to use to prevent similar dilemmas from arising in the future.


7. 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.

Also, don’t wait to meet with a counselor. Once you consult with this individual, you can get help as you explore ways to resolve the dilemma. The counselor can provide tips and guidance for conflict resolution. This professional can help you build confidence as you try to find the best possible resolution as well.


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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