Today's Health Care Environment Gives Nurses Many Reasons To

Today's health care environment gives nurses many reasons to be conflicted

Today's health care environment gives nurses many reasons to be conflicted. Genetic testing, abortion, and end of life care are just some of the areas in which nurses may face ethical dilemmas. Consider how you feel about the following issues: Respecting the wishes of a suffering client that he is permitted to die with dignity, respecting the health surrogate's wishes regarding termination of life support, or even observing another nurse take two tablets of oxycodone as ordered but keeping one for herself. Then give an example of an ethical dilemma you may have confronted in your own clinical experience or workplace. How did you come to the decision you made? What feelings did you experience while coming to that choice? (If you have not yet faced an ethical dilemma, research one and comment on it, answering the same questions.)

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Often, nurses are placed in ethically challenging situations that require careful reflection on moral principles and professional responsibilities. One common dilemma involves end-of-life care decisions, especially respecting a patient's wishes to die with dignity. In a clinical setting, I encountered a patient suffering from terminal cancer who expressed a desire to discontinue aggressive treatment and focus on comfort measures. The ethical challenge stemmed from respecting their autonomy while also considering the healthcare team's duty to preserve life. Ultimately, I supported the patient's right to make decisions about their own body, advocating for palliative care and ensuring that their wishes were honored, in accordance with ethical principles like autonomy and beneficence. During this process, I experienced a mix of empathy, moral tension, and relief upon knowing I was honoring the patient’s desires. This experience reinforced my understanding of the importance of empathetic communication and respecting patients' independent choices in providing ethical care.

Another common ethical dilemma involves the issue of medication diversion. For example, observing a fellow nurse taking two tablets of oxycodone as ordered but keeping one for herself presents a serious ethical and legal breach. The decision to report or confront the colleague can generate intense feelings, including guilt, fear of retaliation, and professional obligation. In such situations, I believe that adhering to ethical standards and patient safety is paramount. Reporting the incident aligns with the principles of justice and nonmaleficence, emphasizing the nurse’s duty to protect patients from harm. Confronting the nurse directly might have been a difficult but necessary step to ensure accountability and uphold the integrity of the nursing profession. Managing these emotions requires moral courage and a firm commitment to ethical practices, which ultimately preserves trust within healthcare teamwork and prioritizes patient safety.

Researching ethical dilemmas from the literature, one notable case involves patient confidentiality breaches. In one scenario, a nurse witnesses a coworker discussing a patient's sensitive information in a public space. The nurse faces the dilemma of whether to remain silent or speak up. The decision involves balancing confidentiality rights with the duty to prevent harm. Ethical frameworks, like principlism, guide nurses to prioritize confidentiality unless there is a risk of significant harm. The emotional response often involves discomfort and frustration, but ethical integrity demands action to uphold trust and respect for patient rights. Such dilemmas highlight the importance of ongoing ethics education and the development of moral resilience among nurses in the fast-paced healthcare environment.

References

• Beauchamp, T. L., & Childress, J. F. (2013). Principles of Biomedical Ethics (7th ed.). Oxford University Press.
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• Fleming, S., & Jinks, M. (2014). Ethical Decision-Making in Nursing and Healthcare. Wiley-Blackwell.
• Kodish, C. et al. (2018). Ethical issues in nursing. In Nursing Ethics: Across the Curriculum and Into Practice (pp. 22-44). Springer Publishing.
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