Why Ethical Training is Important for Nurses

It is essential that when a person decides to become a nurse that he/she completely understand the ethic principles and how the principles guide our behavior to help our patients and not cause harm to our patients. Sometimes we get so caught up in what is right and wrong that we forget to maintain our ethical manner.

Case Study-

My case is a very challenging patient who is 36 years old and is a cocaine addict. She frequently visits the ER and has been flagged as a frequent flyer with a substance abuse problem. This story is sort of like the boy who cried wolf. One of her visits to the ER was actually a serious one but she was already labeled a bad egg. During this visit she had complaints of leg pain and swelling. A nurse practitioner saw the patient and diagnosed her with a DVD. She had been in the ER two days ago with similar complaints and the NP thought she had a pretty good workup by the ER doctor. The ethical issues in this case are the fact that the woman was labeled and judged and not looked at seriously. She does have a terrible history but just knowing she is a drug addict can alarm most medical personnel that she could have some health issues just simply from the use of cocaine. The ER staff should have taken into consideration that there is a problem and she was just there two days ago with similar complaints and that there was a possibility that the symptoms were getting worse. The doctor should have been a little more thorough in his assessment and workup of this patient when he did see her. Her family doctor and mother was called by the NP to help this patient resolve her issues and convince her to stay in the hospital and get the care she needed. (Burkhardt & Nathaniel, 2002)

Conflicting Action

One issue that is considered a conflicting action is the ER nurse should have been more open to the possibility that something could really be wrong with this patient irregardless of her history. Sending her to the fast track and judging her by her chart flag was not a very ethical decision. The nurse should not be affected by the patient's individual differences, background, attitudes or beliefs. (Burkhardt & Nathaniel, 2002) The nurse did not present herself as this type of nurse and was affected by her patient's background and differences.

The NP should have been more aware of her patient's complaints instead of relying solely on the information the chart gave. Unhealthy life styles are part of the whole person and should be taken into consideration when contemplating the care of a patient. (Burkhardt & Nathaniel, 2002) The doctor that saw the patient previously should have been more aggressive with his workup and possibly the DV would have been discovered. The hospital is very lucky that nothing serious happened from the DVT and caused major health issues or death.

Ethical Principles Violated
One of the main ethical principles I feel was violated by this ER staff was Nonmaleficence. This principle relates to us acting in a manner that does not harm our patients. (Burkhardt & Nathaniel, 2002) This staff did not attempt to act in a way that would not cause harm to this patient. The members of this staff acted completely the opposite. Autonomy is the second principle I feel the staff violated. Autonomy has four basic elements that we need to completely understand. First the autonomous person must at all times be respected. Secondly the person must be capable of determining personal goals. Thirdly the autonomous must be able to initiate or understand a plan of action. Fourthly the person must be able to free act on the choices they make. (Burkhardt & Nathaniel, 2002) The staff violated all aspects of this principle as they treated this patient like a drug addict instead of a patient. They actions caused harm to this patient because she was not treated and thoroughly worked up only a few days before. They were completely unaware of this patient's personal goals and ability to determine a plan of action. The staff was wrong in what they did and there are a lot of ethical issues involved with their actions. However, as an ER nurse myself; I can fully understand how this can happen and how often it does happen. We see the same people day in and day out through the ER attempting to drug seek. Truly it does become very frustrating to medical staff when you're trying help people and they are trying to abuse the system.

References

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

University of Washington, (1998). University of Washington School of Medicine . Retrieved January 9, 2007, from Ethics in Medicine Web site: http://depts.washington.edu/bioethx/

Ethics and Humanities Links (1996).The Program in Society and Medicine. Retrieved January 9, 2007, from Ethics and Humanities Links Web site: http://www.med.umich.edu/psm/resources.html