6 hours ago, at 7:06 AM
As nurses we take a vow to practice by core values, principles and with ethical standards. The American Nurses Association outlines a vital tool that speaks to the foundational values of nursing and it is the Code of Ethics. The Code of Ethics is a vital tool for nurses, and it speaks to nurses always providing consistent human, respect and dignified care. The Code has nine provisions that speak to the values and commitments 1-3, the boundaries of duty and loyalty in 4-6 and in 7-9 describes the duties of the nurse that go beyond each individual patient encounters (ANA, 2019).
Over the years in nursing I have been faced with situations where ethical issues took place. One of the first situations I ever encountered was when I received a young patient that had overdosed on opiates and ended up being in a vegetative state and ventilator dependent. Due to her being on the younger side she did not have any advanced directives in place, so her future was to be decided by her parents who were separated and unagreeable with the next step. There were several arguments that took place that sometimes would end with security escorting them out. One parent wanted her taken off life support stating she had no quality of life, the other refused. It came down to important decisions just for placement of a peg tube due to poor prognosis and she needed adequate nutrition, one parent said no the other wanted one placed. This complex situation made it very difficult for all involved in the care, I remember one day I called the Doctor after being yelled at by one of the parents and stating to him we need an emergency ethics meeting. This meeting took place rather quickly involving all interdisciplinary teams, legal team, palliative and a DCF representative who end the intervened with the parents and helped both parties come to the best decision of the patient.
ANA. (2019). Ethics and Human Rights. Retrieved from https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/ethics-topics-and-articles
6/19/19, 11:34 AM
Nurses face ethical issues often and in my current environment this is a relatively common occurrence, especially working with the Rural Health Initiatives. One issue that has increased in the clinic setting is patients coming in or being brought in with opioid addiction symptoms. I could say due to the increase in HIV patients we see, but this is not accurate. Individuals have come in with some of the typical symptoms: poor coordination, physical agitation, poor decision making, slurred speech, irritability, mood swings, and even euphoria. They come in requesting pain medications sweating, shaking complaining of insomnia due to their pain management provider discharging or “firing” them. We’ve had to call the police due to threatening physical violence, running after a provider and even holding a provider in a room. The patient got in front of the door when the provider tried to exit and would not move. Nevertheless, the company is getting narcan to be administered inside of the clinic settings. This was just told to us on yesterday. Of course we did not agree to this because it puts patients to sleep, then when they awaken they are very agitated and physically abusive. “The American College of Physicians policy statement on the prevention and management of substance use disorder as a treatable chronic medical condition included the following recommendations: (a) expand naloxone access for overdose prevention to opioid users, law enforcement, and emergency medical personnel; (b) improve access to medical-assisted treatment, and; (c) lift barriers that limit access to medications for treating opioid use disorder, such as methadone, buprenorphine, and naltrexone.”
Social Issues Impacting the Nursing Workforce. (2018). Journal of Nursing Regulation. Volume 8, Issue 4, Supplement,
Pages S20–S27. DOI: https://doi.org/10.1016/S2155-8256(18)30023-1.
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