should not make promises they cannot reasonably keep. An example if this would be telling a patient they will be pain free after a procedure, however complications arise that supersede this promise, such as hemodynamic instability or finding the medication regime which will keep the patient pain free when the initial regime is not keeping the patient pain free (Wacko Guido, 2020). Justice Treating all patients equally and fairly is the definition of justice (Varkey, 2021). This also includes treating all patients appropriately. All patients should be offered equal access to treatment. Justice recognizes the basic dignity of all patients the nurse provides care for (Wacko Guido, 2020). Self-Assessment Quiz Question #1 A patient asks a nurse to explain the side effects of a medication. The nurse accurately does this. Which ethical principle is the nurse working under? Discussion: 1. Susan would be violating 1) autonomy, 2) beneficence, 3) nonmaleficence, and 4) veracity. The patient has the right to determine what will happen to their body (autonomy). The woman has the right to choose if she wants treatment or not, and if she wants treatment, what type. Susan is obligated to “do good for the patient.” How could she being doing “good” for the patient (beneficence) if the patient does not know why the treatment is being given. Also, Susan is obligated to do no harm (nonmaleficence). Given the side effects of treatment, Susan could be doing harm that the patient does not want. Finally, Susan will most likely be lying to the patient and violating truth-telling or veracity. Every patient has a right to know what is going on with their medical care and determine what type of medical care to receive. a. Veracity. b. Justice. c. Autonomy. d. Nonmaleficence.
“harm” (pain) is outweighed by the long-term outcome of improved healing of the wound. Veracity Veracity means to tell the truth (Wacko Guido, 2020). A nurse is obligated to provide truthful answers to patients and families’ questions in an understandable manner. Also, a nurse is obligated to inform the patients and families what is not known at this time related to the care received. Veracity can be violated in a number of ways, two of which are telling of falsehoods and not providing all the information concerning alternatives to treatment. The third way is not usually thought of, but it is the use of medical terms and jargon that the patient or family does not understand. All information provided to patients and caregivers needs to be in a format that is understood. Providing information using more patient-centered language can assist with meeting this ethical principle. Also having the patient and family describe in their own words the information provided can help clarify any misconceptions and misunderstandings that may be present (Wacko Guido, 2020). Fidelity Fidelity is the principle of keeping any promises or commitments made to the patient and family (Wacker, 2019). This is one of the core principles of the nurse-patient relationship. Nurses Case study 1 Susan is a new RN on an oncology floor. She is caring for an 88-year-old woman who has undergone several tests for night sweats and weight loss. The patient is very alert and mentally intact. The test results have shown that the woman has Acute Myeloid Leukemia (AML), which in adults has a very poor prognosis. Her two adult children do not want their mom to know the diagnosis and want every possible treatment to be given to their mom. They ask Susan not to answer any of their mother’s questions about the diagnosis or treatment that she is going to receive. Susan is distressed by this request. Question: 1. If Susan honors the children’s request, which, if any, ethical principles are Susan violating?
NURSING CODE OF ETHICS
patient’s. Nurses must work to resolve such conflicts in the best interests of the patient. 3. Nurses must promote, advocate, and work to protect the health, safety, and rights of the patient . This means that nurses must guard the privacy and confidentiality of the patient as well as protect patients participating in healthcare research. Part of the protection aspect of this provision includes basic education and continuing education standards. For example, nurse educators must ensure that basic competencies are achieved. Nursing professional development specialists, in conjunction with nurses, must work to ensure that continuing education activities are designed and implemented to facilitate ongoing competency of licensed nurses. Nurses must also actively participate in the development of policies and review mechanisms designed to promote patient safety. Finally, nurses must be alert to instances of inappropriate or questionable practice and report such behavior to appropriate higher authorities within the employing institution or agency or to an appropriate external authority. 4. Nurses are responsible for their individual nursing practices, including the appropriate delegation of tasks, to ensure optimum patient care . This means that RNs are responsible not only for their own actions but also retain accountability for tasks that are delegated. Nurses should be aware of and adhere to the six “rights” of delegation (this is discussed later in this course).
The American Nurses Association (ANA) has taken these basic ethical concepts and incorporated them in the Code of Ethics for Nurses. The following summary highlights and paraphrases critical points of the ANA’s Code of Ethics for Nurses (American Nurses Association, 2015). It is meant to serve as a brief introduction. For detailed information about the code, access the ANA website at https://www.nursingworld.org/coe-view-only. The code is divided into nine provisions (American Nurses Association, 2015). 1. The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person. Nurses must practice with compassion and respect for all patients regardless of social or economic status, personal attributes, or the nature of health problems. Inherent in this provision is an emphasis on respect for the worth, dignity, and human rights of all persons. A person’s worth is not influenced by disease, disability, functional status, or nearness to death. All patients have the moral and legal right to determine their course of care. This is also referred to as self-determination and forms the basis for informed consent in healthcare. 2. The nurse’s primary commitment is to the patient, whether that is defined as an individual, family, group, community, or population . The primary commitment is to promote the best interests of the patient. Nurses must examine their own beliefs and values to identify any conflicts between their beliefs and values and those of the
Page 79
EliteLearning.com/Nursing
Book Code: ANCCUS2423
Powered by FlippingBook