Introduction
The nursing industry is all about helping patients at times when they are in difficult situations. If patients are in the hospitals, nurses take care of them. Since they are are exposed to most of the different phases of a person’s life, it is not easy being a nurse in a hospital. They In an industry where they see and experience life and death, as well as the stress that comes with the job, it is no surprise that most nurses feel disheartened, frustrated, or sad in what they do. Thus, it can’t be helped that they feel powerless in their work. This is not good because this powerlessness can affect in how they do their duties, and even cause ethical dilemmas when dealing with patients. Others may not realize it, but it better to do something about this.
Empowerment in the nursing industry is not very common because actions are not that implemented. We have to empower our nurses in the country because it will help in carrying out their duties---especially those who have higher positions who need to show how good of a leader they are. “Empowerment is defined as the ability to get things done and includes a capacity to mobilize resources and to provide support, opportunity, and information” (Regan, Rodriguez, 2011). It is also through empowerment that nurses can deliver safe and high-quality patient care.
The Need for Empowerment
An empowered nurse is very rare in an industry exposed to different obstacles and hardships. In fact, it is possible that empowerment is not much evident because there is nothing done in encouraging the nurses to stand up and have the courage to speak their minds. What most higher-ups in the nursing industry do not know is that powerlessness among nurses is never a good thing for their work. According to Manojlovich, “powerless nurses are ineffective nurses. Powerless nurses are less satisfied with their jobs and more susceptible to burnout and depersonalization” (Manojlovich, 2007, p. 2). In order for nurses to be effective, they researches should focus on how to empower the nurses of today.
Dealing with Patients in Psychiatric Treatment
Nurses deal with many patients. But for this paper, we talk about nurses dealing with different patients in psychiatric treatment. These patients have their own minds and are some of the most difficult ones to handle. Some of the options used to dealing with them are restraint and seclusion---however, these are not good when they are out of control. There are also risks involved, including the potential to harm both the patient and staff members. With this in mind, these options are not enough to cure the patient. When you look at the whole picture, the nurses deal with a lot of stress with these patients---even the older ones. They have to implement some ethical ways to help these patients while showing care for them. In addition, they have to look beyond trying to contain the behavior to get to the root of the problem and come up with ethical and caring ways.
With all of these in their hands, it would be no surprise if some nurses feel powerless and lose hope in achieving their goals. A powerless nurse becomes ineffective and will have a hard time helping the patient. Instead of thinking how to help them, the nurse quits or do not do anything at all. In addition, other nurses might become ineffective too because they see what the powerless nurse is doing.
What they do not know is they can do much better if encouraged well. According to Brown, “nurses have the answers on how to improve the working environment, the flow of work and patient care. Naturally, they are in the best position to see what is going on in the hospital and know what to do about any problems” (Brown, 2013). So if one looks at it, empowered nurses are the ones that can suggest patient-care ways in a psychiatric treatment.
Ethical Dilemma and Empowerment
Of course, there will always be ethical dilemmas when it comes to the empowerment of nurses. For instance, in case higher ups implement ways to empower nurses, there are those who might not agree. Other nurses might take advantage of these ways just to get the high position they want using the easier way. There is also the part when nurses think of patient-centered ways, but others may deem them unfair and un-economical.
It is also in these ethical dilemmas that will prove if a nurse in indeed empowered or not. We get to see how they deal with everyday ethical challenges while still showing patients the care they need and, at the same time, show everyone that they are still human.
For the patients in psychiatric treatments, nurses will face many ethical dilemmas because they deal with patients that have mental disabilities and are difficult to handle. One example is the one from Nursing Explorer: an elderly patient may want to walk without supervision. The nurse desires to promote independence, but the risk of patient injury due to falls may be great. The dilemma is how to balance the contrasting issues (Braitanu, 2015).
Just by this example, it is possible that an empowered nurse can experience ethical dilemmas in the profession. Sometimes, what she suggests and believes may harm or is not okay for a patient that she is taking care of. Every patient in psychiatric treatment is different, so there are some implemented ways that are good for one patient, but bad for the other. Somehow, they are contradicting a bit. But, by teaching the nurses how to become empowered while experiencing ethical dilemmas in the profession, it is possible that nurses could be effective in their work.
Ethical Principles and Empowerment
The nursing profession has ethical principles that they have to abide to in order to ensure that they follow the highest. Some of the principles that the researcher thinks apply to the empowerment are beneficence and non-maleficence. Beneficence mean “to do good”, while non-maleficence is “to do no harm” and should benefit both the nurse and the patient. Nurses have an ethical duty to “balance potential benefits against potential risks and to minimise potential risk to the greatest extent possible” (Nursing and Midwifery Council Code of Standards, Performance and Ethics for Nurses and Midwives, 2007).
As far as understanding this principle, when an empowered nurse has beneficence, it just means that she is compassionate and wants to take a “positive action to help others” and has the “desire to do good” (American Nurses Association, n.d). Considered as the core principle in the patient advocacy of the nursing profession, the researcher thinks that most nurses in psychiatric treatment have this principle because they want to help the patients to be better. An empowered nurse suggest or take actions to help the patients be better without inflicting harm to them. This is where non-maleficence comes in.
In this principle, an empowered nurse will make sure that her patient avoids harm or hurt. In our example above, the facility uses restraint and seclusion on the patients---but there is the potential of the patients hurting themselves because their behavior is being contained. An empowered nurse will not allow these options if it means the patients are getting hurt. Instead of allowing this, the nurse will speak up her mind about and find ways on how to help the patients without harming them.
Indeed, these principles can help in solving the ethical dilemmas nurses experience in psychiatric treatment. When they have these principles, they can be more empowered to do better in their duties and help the patients to get better.
Recommendations
The researcher has already mentioned some recommendations that will help solve the ethical dilemmas. But, there are still some that nurses should do in order to feel empowered while still sticking to the ethical principles.
For one thing, nurses should never be afraid to ask help when they are having a hard time doing their duties. Being empowered does not mean being prideful and not asking for help. It just means that you are still on the stage of learning and asking for help is one way to learn something that you still do not know yet. This will also show your initiation on expanding what you can do by asking for help. In this way, when you gain knowledge from asking help, you can do it on your own next time.
Another recommendation is to be open to criticism, especially when you are suggesting different ways in helping the patient of the facility. An empowered nurse is open to what others have to say and accepts them for as it is. This shows that they want to be one of the best in the industry. This will also show that you are willing to learn through the criticisms of others and take them seriously in order to learn.
Summary/Conclusion
References
American Nurses Association (ANA). (n.d.). Short definitions of ethical principles and theories:
Familiar words, what do they mean?. Retrieved from
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Bratianu, P. (2015). Nursing ethics – ethical dilemmas faced by nurseseveryday. Retrieved from
http://www.nursingexplorer.com/blog/nursing-ethics-ethical-dilemmas-faced-by-nurses-
everyday-47
Brown, L. (2013 February). The empowerment of speaking your mind. Retrieved from
http://www.empowerednurses.org/the-empowerment-of-speaking-your-mind/
Manojlovich, M. (2007 January). Power and empowerment in nursing: Looking backward to
inform the future. The Online Journal of Issues in Nursing 12(1), 2.
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Regan, L., Rodriguez, L. (2011). Nurse Empowerment from a middle-management perspective:
Nurse managers' and assistant nurse managers' workplace empowerment views. The
Permanente Journal, 15(1),.e101-e107. Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138177/
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