2<\/p>\n
POSITION PAPER<\/p>\n
Running head: POSITION PAPER 1<\/p>\n
Position Paper <\/p>\n
Ethical Challenges and Legal Implications<\/p>\n
Nurses are faced with many ethical challenges every day. Along with those ethical challenges there are legal implications that encompass these challenges. The two ethical challenges, as well as the legal implications of these challenges, I chose to discuss are end of life care and incompetent staff. <\/p>\n
End of life care is an ethical challenge nurses in my organization have to deal with from time to time. Autonomy of the patient at the end of life is a very important part of the patients care. Allowing the patient to make their own choice of what is best for them in their care is their right (Denisco & Barker, 2016). Being an advocate for the patient right to choose is the nurse\u2019s ethical duty. Regardless of the patient\u2019s ability to function or how close they are to dying the nurse is required to respect the rights and dignity of all patients or all people in general. A patient\u2019s unique values, preferences, and needs are key components to guide patient centered care through the nursing process. For nurses ethically this can be hard to deal with sometimes due to patient\u2019s families not wanting to honor the patient\u2019s choice to not be resuscitated. With an Advanced Directive, a legally recognized document, on file for the patient this prevents family from overriding the patient\u2019s choice and protects the staff from legal ramifications for honoring the patient\u2019s choice (American Nurses Association, 2015). <\/p>\n
Incompetent Staff is another ethical challenge a nurse in my organization will have to work with. Nurses are dealt with the ethical dilemma of figuring out whether to inform management about the unsafe practices of the nurse or not saying anything at all. This can be a difficult decision if the nurses are friends. Close bonds are made among nurses due to the stressful situations they are placed in on a daily basis. They are a team and rely on each other.<\/p>\n
According to the code of Ethics, it is the nurse\u2019s ethical duty to report the staff member to the appropriate manager as well as notifying the staff member seen doing the questionable care (American Nurses Association, 2015). This also becomes an ethical issue of Nonmaleficence. The nurse is sworn to not cause harm whether they are the one committing the harm or witnessing the potential harm and not reporting it. It is negligence for the nurse to not report the incompetent staff. Negligence is a criminal offence if the patient is harmed or died due to the incompetent care provided. There could be legal action against the nurse that didn\u2019t report the incompetent care seen if the patient is harmed or died (Cherry & Jacob, 2019). <\/p>\n
Role of the MS Nurse<\/p>\n
Ethical Decision-Making Model<\/p>\n
Serving on the ethic committee as a nurse in a leadership role, I would collaborate with my colleagues on the application of a published ethical decision-making model to the ethical problem of incompetent staff. In this leadership role it is important to have an understanding of ethics by being able to model ethical behavior, mentor peers, and implementing policies centered around ethical patient care being provided (Peter, 2018). <\/p>\n
In the ETHICS model there are 6 steps. First, I would identify and evaluate the nurse having the ethical issue. Evaluate whether to inform management about the unsafe practices of the nurse or not saying anything at all. Then I would come up with a course of action (Ling & Hauck, 2016). <\/p>\n
Second, I would think ahead of what possible outcomes there would be for the possible course of action. Possible courses of action would be to confront the nurse providing the unsafe care or notifying management. The outcomes to that would be that no harm comes to the patient and other staff involved in the patient\u2019s care wouldn\u2019t be held liable for being negligent. The nurse could get further education or termination if the unsafe practice is found to be negligent. Another course could be doing nothing at all. The outcome for doing nothing would go against the code of ethics nurses swear to go by. By saying nothing, the patient could be harmed or even potential death could happen by the unsafe practices (Ling & Hauck, 2016). <\/p>\n
Third, would be to enlist help from some of the interdisciplinary team members. I would consult a risk management nurse for questions pertaining to any possible liability. I would consult with the manager on questions about the clinical aspects of the case. The nurse educator would be consulted on questions pertaining to what education is lacking or needed (Ling & Hauck, 2016). <\/p>\n
Fourth, I would gather information such as hospital policies around the ethical dilemma, current regulations, state laws both criminal and civil that pertain to the ethical issue stated above. Referring to the ANA\u2019s code of ethics 9 provisions would be a great piece of literature to refer to (American Nurses Association, 2015). The course of action could either be supported or not supported by the information. <\/p>\n
Fifth, I would calculate the risks and how they affect the stakeholders involved. The risks to the patient would be to be harmed or killed. The family would be at risk of emotional stress due to the patient being harmed or if death occurred due to the incompetence. The nurse would be at risk of being terminated and could even lose their license. The doctor is at risk of possible legal proceedings due to the negligence of the incompetent nurse\u2019s actions. <\/p>\n
The last and sixth step is to select an action. After gathering all of the information provided through the previous steps above a non-bias course of action will be taken. An assessment of the impact on the patient and all involved was taken into account. In this case the most ethical decision would be for the nurse to report the unsafe practices by the incompetent nurse immediately preventing harm to the patient and possible legal action against the staff (Ling & Hauck, 2016). <\/p>\n
The stakeholders involved in this ethical decision-making process would be the patient, the nurse, family, and the doctors involved in the patients care. The stakeholders could be affected and impacted by the ethical decision in many different ways. The impact of the decision could prevent the patient from being harmed or worse killed. The family would not have to worry about the care being given to the patient and be confident that incompetent staff are held accountable if witnessed by other staff. The doctors would be safe from possible legal proceedings due to the negligence of the incompetent nurse\u2019s actions. The nurse will get further education, depending on how bad the incompetence is there could be possible termination or relocated to a less acute floor for further training. <\/p>\n
The role of the interdisciplinary team members throughout the ethical decision-making process is to make sure that all of the stakeholders, the patient, nurse, family, and doctors, have all the current information available to help them make proper ethical decisions. The interdisciplinary team consists of a risk management nurse, the manager, and the clinical nurse educator. The risk management nurse\u2019s role would be to help identify the potential problem of the situation and come up with a plan to address in order to prevent any losses or liability. The manager\u2019s role would be to provide the staff with current work expectations and responsibilities. The clinical nurse educator\u2019s role would be to assist in developing necessary policy, evaluate the level of competence of the nurse and provide recommendations on what type of further education might be necessary. All members of the team will collaborate with open communication and share in the decision-making process. They will all provide any pertinent information about the situation involved in the ethical dilemma. It is important that the ethical guidelines set forth by the hospital will be used in making the ethical decision. One of the most important roles of the interdisciplinary team is to make sure that their focus is on ensuring the safety and quality of patient care (Denisko & Barker, 2016). <\/p>\n
The transformational leadership strategy that the nurse leader could use to promote collaboration among the interdisciplinary team would be to give each team member individual consideration. Being genuine and transparent, paying special attention to each individuals differences, will ensure better collaboration and participation among the interdisciplinary team members. Making ethical decisions based on the greater good of the patient and their outcomes will help the team member focus less on their own personal biases (Peter, 2018). <\/p>\n
Alignment<\/p>\n
My organization\u2019s mission statement is to deliver compassionate, high quality, affordable healthcare and to advocate for those who are poor and disenfranchised (Dignity Health, 2019). In this ethical issue the patient is expecting high quality care so it is our duty to provide high quality care. By ensuring that those not providing quality care are reported and actions in place to ensure it doesn\u2019t happen again, we are honoring our mission statement. I am proud to work in an organization with interdisciplinary collaboration where there is ethical decision making which results in our patients receiving compassionate, high quality patient care. <\/p>\n
References <\/p>\n
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. <\/p>\n
Retrieved from: <\/p>\n
http:\/\/nursingworld.org\/MainMenuCategories\/EthicsStandards\/CodeofEthicsforNurses\/C <\/p>\n
ode-of-Ethics-For-Nurses.html <\/p>\n
Cherry, B., & Jacob, S. (2019). Contemporary nursing: issues, trends, and management (8th ed.). <\/p>\n
Retrieved from: <\/p>\n
https:\/\/wgu.vitalsource.com\/#\/books\/9780323554206\/cfi\/6\/34!\/4\/2\/44\/4@0:18.1 <\/p>\n
Denisco, S., & Barker, A. (2016). Advanced practice nursing: essential knowledge for the <\/p>\n
profession (3rd ed.). Retrieved from: <\/p>\n
https:\/\/wgu.vitalsource.com\/#\/books\/9781284099133\/cfi\/6\/74!\/4\/428@0.00:0 <\/p>\n
Dignity Health. (2019). Mission, vision and values. Retrieved from: <\/p>\n
https:\/\/www.dignityhealth.org\/sacramento\/about-us\/mission-vision-and-values <\/p>\n
Ling, T., & Hauck, J. (2016). The ETHICS model: Comprehensive, ethical decision making. <\/p>\n
Retrieved from: <\/p>\n
https:\/\/pdfs.semanticscholar.org\/13d3\/29ac728e3732849fa6251470457fa5f00dac.pdf <\/p>\n
Peter, E., (2018). Overview and summary: ethics in healthcare: nurses respond. The Online <\/p>\n
Journal of Issues in Nursing, 23(1). doi: 10.3912\/OJIN.Vol23No01ManOS<\/p>\n","protected":false},"excerpt":{"rendered":"
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