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Nursing ethics, self-advocacy, and professional accountability are three essential principles that guide the practice of nursing professionals. Nurses are held accountable for their actions and conduct to ensure that they operate within the established levels of competence when providing care to patients as well as improve their practice to ensure the provision of high-quality, ethical, and safe care to patients. In this paper, a scenario regarding nurses’ ethical responsibilities will be assessed; it includes a complicated dilemma that could test a nurse’s integrity with regards to catering to a patient’s needs that may go against some of the ethical principles of nursing.
Making a Decision
In the scenario, the patient (Mr. Newcomb) diagnosed with a fatal condition asked his nurse to aid in seeing his mistress for the last time. While such a request may not be complicated to arrange, there is one significant ethical barrier – Mr. Newcomb is married, and his wife is always at his bedside, trying to spend as much time with her husband as possible. In such a situation, a nurse has to choose whether to cater to the dying patient’s wish and lie to his wife or to decline the request respectfully.
Despite the fact that the Code of Ethics for Registered Nurses implies support for patients’ decisions even in cases when their families disagree with them, the case of Mr. Newcomb cannot align with this rule since it is not concerned with treatment (CNA, 2017).
A nurse is likely to decline the request by expressing his or her moral obligation of providing ethical care to patients and avoiding deceitful actions that can lead to adverse consequences. However, the nurse must assure the patient that his request would remain between him and the nurse to avoid any complicated situations with his wife: “collect, use, and disclose health information on a need-to-know basis with the highest degree of anonymity possible in the circumstances and in accordance with privacy laws” (CNA, 2017, p. 14).
The knowledge of ethical principles (beneficence, autonomy, non-maleficence, and justice) significantly influenced the decision made in the case of Mr. Newcomb since they guide nursing practice in the context of providing care to patients. If, for instance, Mr. Newcomb asked to administer him more pain relievers while his wife was against it, a nurse would be likely to administer appropriate medication to ease the patient’s pain.
However, the patient’s request was solely personal and went against the general ethical principle of being truthful. This means that Mr. Newcomb’s nurse had more leverage in making the decision of not helping him deceive his wife. It is important to mention that making a solid decision in Mr. Newcomb’s case was hard because the ethical principles of beneficence, autonomy, non-maleficence, and justice did not have a unifying theory to provide a clear guideline on how to act in certain situations (Bishop, n.d.).
For instance, the principle of fairness (treating others equitably and fairly distributing benefits or burdens) can make a nurse more confident in declining Mr. Newcomb’s offer due to the high burden of being responsible for the patient’s cheating behavior. Also, a nurse may harm the patient’s wife by agreeing to the request and thus violate the principle of non-maleficence. However, the principle of autonomy (acknowledging the right to make choices based on personal values and beliefs) suggests that Mr. Newcomb can do whatever he wants, especially due to his severe health condition. Also, the patient could have benefited from seeing his mistress. Despite the fact that the knowledge of the key ethical principles of autonomy, justice, non-maleficence, and beneficence guided the decision, they made the nurse’s considerations even more complicated.
Personal Values and Beliefs
The personal values and beliefs of the nurse in the scenario also contributed to making the decision of not helping Mr. Newcomb see his mistress. Despite the fact that the nurse developed a special bond with the patient, it is essential to understand the value of marriage and the responsibilities it usually brings. Since Mrs. Newcomb is always at her husband’s side and wants to do everything in her power to make him comfortable during his last days, it is disrespectful to consider bringing her husband’s mistress to the hospital.
Strategies for promoting self-care are positive reinforcements that help patients be more conscious of their health situation and thus enhance their autonomy and self-esteem (Bedin, Busanello, Sehnem, da Silva, & Poll, 2014). Three beneficial strategies can include the dissemination of information, patient training, and support networks. Information is essential for helping patients understand their condition, which is especially valuable for those with chronic or fatal diagnoses (Richards, 2012).
Patient training is a strategy that encourages individuals to take action in caring for themselves and be prepared for health prognoses and possible interventions. Lastly, the strategy of support networks is important for self-care because it assesses patients’ needs, available resources, and support mechanisms that could facilitate the improvement of health and contribute to the beneficial self-care strategies that a patient has already implemented.
Bedin, L., Busanello, J., Sehnem, G., da Silva, F., & Poll, M. (2014). Strategies to promote self-esteem, autonomy and self-care practices for people with chronic wounds. Revista Gaúcha de Enfermagem, 53(3), 1-4.
Bishop, L. (n.d.). Principles – respect, justice, nonmaleficence, beneficence. Web.
CNA. (2017). Code of ethics for registered nurses. Web.
Richards, S. (2012). Putting self-care into practice. Web.