Ethical Issues in Nursing Paper Example

Introduction

Nurses in a healthcare facility face great challenges that make them do extraordinary things. Many have ended up acting they later think and swear not to do again. In most cases, ethical conflicts occur due to imbalances of power where the nurse has little influence on care practices that should be accorded to specific patients. These ethical issues may include patient desires, healthcare provider, care procedure decisions, family disputes, and miscommunications among others. They come up in nursing professions due to the obligation to ‘do good’ (Izumi, Nagae, Sakurai, & Imamura, 2012).

 

Nurses are expected to perform their duties with the interest of the patients at heart. This good will is shortchanged by the competing demands and the complexity of handling other patients’ needs. As moral agents, nurses should have a voice regarding aggressive care, determining life quality of a patient, and use of technology. They end up providing poor care if they just provide services directed by the physicians. This paper explores ethical issues that nurses in end-of-life care circumstances face and the way such ethical issues can be handled without compromising their legal and professional ethics.

Ethics in End-of-Life Care

End-of-life care involves care of patients in final days of their lives or acutely sick patients who cannot get cured. Treating a patient suffering from terminal lung cancer is an example of end-of-life situation that can result in ethical issues. The complexity of end-of-life care has led to the emergence of several ethical questions regarding the required and available care options for such patients. One of the ethical issues that can arise in end-of-life care is communication. In several instances, there is deficiency in communication between the patient and the nurse or doctor in charge.

Dilemma arises when important decisions have to be made by both parties. Lack of proper communication increases uncertainty and anxiety; hence, no decision regarding proper care can be made. Both the nurse and the patient should be able to say the truth about the diagnosis and other relevant information that can help in coming up with the appropriate treatment (Gastmans, 2012). However, an ethical issue arises when the nurse is not sure whether to inform the patient about the serious state of health due to nescience of the way the patient will react on the information.

End-of-life care such as terminal cancer treatment is unique due to the complexity of technology required for effective care. Thus, the situation causes ethical issues that require balancing the benefits of offering the treatment versus the cost involved and the chances of prolonging life (Arries, 2014). Prolonging life to such patients may be increasing suffering to the patient, and one would opt to perform euthanasia. A nurse may, however, be against euthanasia because he/she believes that it is morally wrong and contradicts the medical ethics (Curtis & Vincent, 2010). Withdrawal from active treatment due to unresponsiveness or personal choice is an ethical issue that requires a proper decision to ensure the patient gets the best out of treatment offered.

Another ethical issue in end-of-life care is planning treatment. A cancer patient may not be willing to take a surgery for fear of undergoing and operation or refuse to have chemotherapy due to fear of side effects such nausea or hair loss.

Impacts of Ethical Issues in End-of-Life Care

Nurses who encounter ethical issues need to solve them in a professional and timely manner in order to promote their well-being and improve the general health care system. Ethical issues are likely to cause moral distress, which is normally initiated by institutional constraints. Many hospitals do not allow nurses to take individual decisions on matters of health care. In end-of-life conditions such as terminal cancer, it is impossible to improve the condition of the patient no matter what care is given. This may affect the nurse in charge since the patient eventually dies (Curtis & Vincent, 2010). When a nurse feels that his/her input does not make a difference, the ethical issue may result in serious distress.

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Moral distress may make the nurse experience exhaustion, anger, guilt, and even quit the profession. If not attended in time, a morally distressed nurse can lose the ability to provide the expected care to patients. To overcome moral distress, nurses should master the 4A’s model where they should ask about the nature of the problem, if unaware, as well as affirm the presence of distress and the desire to take care of oneself. Before working on ways to solve the distress, the affected nurse needs to assess the situation in order to identify whether the source of distress is environmental or personal (Ulrich, 2012). The final step in solving moral distress is preparing to take action. This involves preparing professionally and personally to implement strategies that can trigger the changes required.

Nurses facing ethical problems can also have emotional effects. They tend to easily get angry, frustrated, and feel powerless. Being under such conditions, they sometimes avoid their emotions completely. They even physically get affected and stressed having frequent headaches. The effects impact not only their professional but also normal lives.

Dealing with Ethical Issues in End-of-Life Care

Nurses encountering ethical issues find it challenging both personally and professionally; hence, it is imperative to know how to deal with them. Basically, nurses should be able to identify an issue and discover whether it is ethical. In addition, they should be able to define the appropriate steps required to handle them. Given that there can be myriad of procedures undertaken to solve the issues, the nurse should know those acceptable within their workplace and those easily available (Ulrich, 2012). When handling a withdrawal from treatment case, the caregiver should consider using palliative care to ensure that the patient gets the right medication or that withdrawal of treatment is done at the right time. Unresponsive patients should obtain alternative treatment that can give better results.

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If a nurse is not able to provide information to the patient about the current state of health due to fears that it might negatively affect the latter, she/he should first create a good relationship with the patient. This will give an opportunity the patient to trust on the nurse and will be free to share information regarding his health (Gastmans, 2012). In the end-of-life care unit, the options are limited, and some ethical issues that emerge become difficult to solve. A nurse should therefore be able to assess the situation and immediately decide whether to go ahead and solve the problem.

In case a cancer patient requires life support, the nurse will feel conflicted on whether to put all the available resources on a patient who will not survive. The nurse should know that the ethical issue revolves around resource allocation and justice to the patient (Arries, 2014). Gathering information surrounding the ethical issue will provide an avenue where the available options in solving the issue can be identified. If the nurse is in dilemma of putting a cancer patient on support or performing euthanasia, he/she should consider whether supporting the patient to live longer is reducing or increasing his suffering.

Euthanasia will be permitted if the patient has reached a point of suffering that he can no longer tolerate. Therefore, the nurse should collide the dilemma by critically analyzing the state of the patient. When all available options are understood, it becomes easy to take a particular course of action that is in line with ethical beliefs and professional values without undermining the professional code of ethics. All the actions taken should be to the best interest of the patient (Arries, 2014).

Every course of action taken gives outcomes that are unique to the situation. If a cancer patient refuses to take certain treatments due to side effects or fear of undergoing the procedure, the nurse should respect his/her autonomy (Gastmans, 2012). Thus, the nurse will be able to easily solve the ethical issue of treatment options. End-of-life care situations are easy to predict the outcome no matter what action is taken. When a nurse takes the best course of action, the results may not be good but would feel contented that the action was to the best interest of the patient. Most ethical issues experienced during end-of-life care situations are always assessed after the issues have been solved, and similar cases should be laid down for future practice (Ulrich, 2012).

Conclusion

End-of-life care is a sensitive sector in healthcare and requires the ethical issues to be addressed at the appropriate time. Nurses should ensure that they advocate for the needs of the patients and work together as a team to provide appropriate care. Nurses should have sufficient knowledge in handling psychological, ethical and physiological problems in their place of work. It is important to recognize the ethical issues experienced by identifying whether the issue touches on the morals of the involved parties. The nurse should consider the appropriate approach in settling the issues and assess the outcome of the course of action taken in order to help draw a roadmap for solving future ethical cases.

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