Posted: July 30th, 2023

Navigating Ethical Dilemmas in Nursing Practice: A Personal Account

Describe a situation of ethical dilemma that you have experienced as a registered nurse in practice and how it was resolved.

Submission Instructions:

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources within the last 5 years.

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Navigating Ethical Dilemmas in Nursing Practice: A Personal Account

Introduction

As a registered nurse, the ethical dimensions of healthcare practice are an integral aspect of our daily responsibilities. Ethical dilemmas frequently arise when delivering patient care, where the interests of patients, their families, and medical professionals may diverge, leading to challenging decisions. In this article, I will recount a situation of ethical dilemma I encountered during my nursing practice and detail the resolution process that ultimately upheld the principles of beneficence, autonomy, and justice.

Ethical Dilemma Scenario

The incident occurred in a critical care unit where I was assigned to care for Mr. Johnson, a 68-year-old patient suffering from end-stage heart failure. Despite receiving the best available medical treatments, Mr. Johnson’s condition continued to deteriorate. His family had expressed their desire to continue aggressive life-sustaining interventions in hopes of a miraculous recovery. However, the medical team believed that prolonging such interventions might only cause further suffering without improving Mr. Johnson’s quality of life.

The Ethical Conflict

The conflicting perspectives between the family’s wishes and the medical team’s professional judgment posed a profound ethical dilemma. The principles of beneficence, emphasizing the promotion of patient welfare, and autonomy, advocating for the patient’s right to make informed decisions, seemed to clash in this scenario. The family’s steadfast determination to pursue aggressive interventions, despite the limited likelihood of success, challenged the medical team’s duty to act in the patient’s best interest.

Additionally, the principle of justice, which calls for equitable allocation of resources and care, came into question. Prolonging aggressive treatments for Mr. Johnson might potentially impede the allocation of resources to other patients who might benefit more significantly from them.

Ethical Analysis

The first step in resolving this ethical dilemma involved engaging in comprehensive ethical analysis. We convened an interdisciplinary ethics committee, comprising medical professionals, ethicists, and patient advocates, to review the case in-depth. This committee’s involvement brought diverse perspectives and expertise to the table, ensuring a robust and thoughtful analysis.

The committee evaluated the medical evidence, prognosis, and potential outcomes of aggressive interventions. Simultaneously, they acknowledged the values and beliefs of Mr. Johnson’s family, seeking to understand their emotional and psychological needs during this challenging time.

Resolving the Ethical Dilemma

The resolution process was iterative and included several stages of communication and negotiation. As the primary nurse caring for Mr. Johnson, I actively facilitated open and compassionate discussions between the family and the medical team. It was crucial to maintain an empathetic and non-judgmental approach while promoting clear and transparent communication.

During these discussions, we took the time to educate the family about Mr. Johnson’s prognosis, the limitations of aggressive interventions, and the potential consequences for his quality of life. At the same time, we ensured that the family felt heard, supported, and empowered to participate in the decision-making process.

Ultimately, the ethics committee played a vital role in guiding the conversation towards a resolution that honored Mr. Johnson’s autonomy while preserving his dignity and minimizing suffering. The family gradually came to recognize that the best course of action would be to transition to palliative care, focusing on symptom management and comfort measures, thereby aligning with Mr. Johnson’s expressed values and wishes.

Conclusion

Encountering ethical dilemmas in nursing practice is a reality that demands thoughtful reflection, ethical analysis, and effective communication. In the case of Mr. Johnson, the resolution process involved interdisciplinary collaboration, active engagement with the family, and a commitment to upholding the principles of beneficence, autonomy, and justice.

As registered nurses, we bear the responsibility to navigate complex ethical challenges with integrity and compassion. By fostering a culture of ethical awareness and open dialogue, we can ensure that ethical dilemmas are met with transparency and a commitment to patient-centered care.

References:

Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.

Johnstone, M. J., & Kanitsaki, O. (2018). The ethics and practical importance of defining, distinguishing and disclosing nursing errors: A discussion paper. International Journal of Nursing Studies, 81, 133-139.

O’Mathúna, D. P., & Gordijn, B. (Eds.). (2017). Empirical ethics in healthcare: Challenges and multidisciplinary perspectives. Springer.

Park, M., Kjervik, D., Crandell, J., & Oermann, M. H. (2017). The relationship of ethics education to moral sensitivity and moral reasoning skills of nursing students. Nursing Ethics, 24(6), 684-694.

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