Reflections on Developed Expectations and Abilities

When I learned of the title of this course I had to shutter. Ethics can be very controversy and I have very strong opinions and beliefs that may come across as offensive. Through discussions with my peers, I have developed new outlooks on my responsibilities toward my patients, my organizations, society and most important myself. Let's look at my patients, my ethical responsibilities that have developed deal with keeping my personal feelings hidden from my patients so I do not influence their decisions. My patients are always my most important priority regardless of my personal feelings. There have been several situations where I had to really take a step back and evaluate my feelings on factors affecting my patients care. But, I feel I have always been able to separate myself and beliefs from the situation challenging my autonomy. My responsibility to my patient and their family members reflect strongly on my organizational policies and my duties to practice by them. I believe that our organization has our best interest in mind when they incorporate policies to guide us and provide us with support. My ethical responsibilities to my organization require me to act professional and always do the right things know matter how difficult it may be sometimes. Sharing my experiences with my peers was very enlightening to me and helped me to clear up some of the gray areas that seem to always trouble me. The discussions helped me see that everyone is faced with ethical issues daily and we need to use the recourses provided to help us resolve the issues. This course has also helped me realize that I might be too active with my own personal feelings and this could cause me not to provide the appropriate advice for my patients. My ethical responsibilities to society developed more with this course and our discussions. I began to think broader in terms of different outlooks the communities can have on providing health care. There is still a big part of me that insist certain therapies should not be brought into the hospitals without proper education and training. But through our discussions I began to see how close minded I was and that bothered me. I have always thought myself to be a pretty well rounded individual that did not close herself off to new ways. The therapies just happen to be one are that I closed myself off from and refused to listen to how society would use this to help patients. So I guess that in developing my ethical responsibilities I should sit and listen the next time there is talk of bringing something new into the community hospitals.

Legal and Ethical Guidelines

Standards of care may be viewed as the level or degree of quality considered adequate by a given profession. Standards of care are the skills and learning commonly possessed by members of a profession. (Guido, 2006) My understanding of relationships between legal and ethical guidelines stems from our readings and discussions throughout this course. As professionals we must comprehend and be ready to deal with all aspects of these areas. We have been trained in both areas to practice by the guidelines laid out for us. This training should be reinforced and reintegrated in various stages of a nurse's career. As the laws are constantly changing, the training must be constant and efficient at regular cycles to guarantee that existing information is obtainable. To make certain that the current training is adequate and the patient's rights are being completely addressed both legally and ethically. With the increasing numbers of legal and ethical dilemmas in patient situations today, health care providers are considering guidance with decision making. Perhaps one of the best solutions for both long-term and short-term issues is the creation and use of an institution ethics committee. (Guido, 2006) There is a great difference between legal and ethical rights of our patients. Both are extremely important when providing care for your patients. We have to pay much more attention to our ethical views because our values may differ greatly from the patients. When it comes to legal issues we have procedures or legal principles to help direct us through a situation. If our values or ethical concerns cause conflict when caring for a patient, we have the option to remove ourselves from the situation. As health care professionals we are compelled to act according to ethical and legal standards. Our ethical guidelines refer to the moral standards that are considered to govern health care. Our legal obligations are based on the traditional ethical standards of good medical practice. After review of all information provided and learned from this course, I have a lot of new areas of understanding when it comes to my ethical views and the legal aspects involved in giving my patient the care without compromising their own values and beliefs. I have also learned to be more open to cultural differences that could cause conflict in my care and also cause legal issues for my facility. This ethical and legal views class has really opened my eyes to a lot of areas I may have previously been misguided. I will continue to review all policies and guidelines for any facility I work for and seek out all resources available to me to avoid or resolve any ethical or legal conflict with my patients.

Responding to Ethical Situations and Avoiding Moral Distress

The course has more than enhanced my ability to respond to ethical situations and help me avoid moral distress. When we had to write a discussion paper on an experience that caused us moral distress and then pick a model to determine how we can be guided through the situation to decrease or eliminate the moral distress, I was amazed at how well it works. Even though I still have very strong emotions for my aunts and uncle who died of cancer, I can see how the model would help me to understand how I can remove my feelings from the situation and set them aside so I can care for my patient without becoming to sensitively involved. Having a guideline to help determine what it is about the situation you need to work through is very helpful. I knew dealing with certain patients would upset me and I would have a difficult time staying objective. When I took the situation and applied it to the model, I was able to break down each area of concern and work through how I would handle this situation again. I learned how I could evaluate and identify my issues with this dilemma. I also learned that I could outline my options of a particular situation and use this data to resolve my dilemma. When making ethical decisions, nurses need to combine all the elements using an orderly systematic and objective method. (Guido, 2006) The model I found to be the most affective for me was the moral model. It really helped me comprehend how I could care for my patient and not cause moral distress to myself or my patient. I feel my most important role is to be my patients advocate and I don't feel I can do the appropriately if my feelings and views are clouding my judgment.

References

Burkhardt, M. & Nathaniel, A. (2002). Ethics & issues in contemporary nursing (2nd ed.) New York: Delmar.

Volker, D. L (2003).Is there a unique nursing ethic?. Nursing Science Quarterly. 16(3), 207-211

Rushton,, Cynda H. (2001).The 4A's To Rise Above Moral Distress. American Association of Critical Care Nurses. Vol. 17 No. 1, 13-25.

Guido, Ginny W. (2006) Legal & Ethical Issues in Nursing, 4^th Edition. New Jersey: Delmar.

Teles, Ashton, Roberts, Tzoneva (2001) The Role of the Instructor in an E-Learning Collaborative Environment.