Description of the Ethical Issue
Generally, implementation of shared governance within a health care environment projects several ethical issues some of which impact the ability of nurses and other health care workers to provide their patients with quality health services. An example of an ethical issue arising with regard to shared governance relates to the issue of patient freedom when compared to the need for nurse control. In this particular case, a nursing team working within a health facility makes the decision to implement a policy focused on increasing the level of control that nurses have towards their patients. The nursing team believed that implementation of this policy would increase the health care outcomes based on the selection of the best possible treatment plan. Having more control over patients would make it easier for nurses to focus on utilization of treatment plans that would have the best possible outcome. However, this is somewhat challenging when trying to provide patients with the freedom of selecting their treatment.
The Constitution provides every patient with the freedom and autonomy of selecting specific treatment plans that one would consider as being viable within a given situation or circumstance. Consequently, this means that making the decision through shared governance, to increase the level of control that nurses have with regard to their patients creates some form of an ethical dilemma for nurses. From an ethical perspective, providing nurses with a higher level of control would mean that nurses would go beyond the expectations projected by their patients in their bid to providing them with quality services. The main question arising from this ethical issue was, to which extent are nurses expected to control the decisions made by their patients with regard to the treatment process?
In this case, the ethical issue arises from a situation where the nature of decisions made by the nursing team, which is a key aspect associated with shared governance, tend to consider only one aspect of health care service delivery. Thus, this led to a situation where the decision by the team conflicted with nursing expectations for the nurses operating within the health facility. In the long-term, this would mean that more patients would receive health services that do not conform to their set of beliefs or expectations, as nurses would have the autonomy of selecting the best possible treatment plan. Consequently, this would translate to an ethical issue, as the services offered do not reflect on what is expected of nursing professionals when dealing with patients.
How the Issue was Resolved
The main aspect of consideration when engaging in a process that would help in the resolution of the issue or challenge experienced is that the decision made by the nursing team does not reflect the interests of the patients, which is one of the ethical issues of concern in shared governance. The resolution of the ethical issue was through a process in which the nursing team engaged in an analysis of the views presented by patients in a bid to evaluating some of the key expectations from the patients’ point of view. According to the views presented by the patients within the health facility, providing nurses with a higher level of control over the patients would lead to a situation where patients would not achieve satisfaction with regard to the health services offered. On the other hand, this would mean that most of the patients would find themselves being exposed to treatment plans that do not conform to their overall needs and expectations. Ultimately, this defined the amendments that the nursing team ought to make in the enactment and implementation of policies that would reflect on the needs projected by individual patients.
Ethical Principles Utilized to Resolve the Issue
The first ethical principle adopted in the resolution of this issue is beneficence where the nurses considered the need for advocating for a process in which the decisions made would reflect on expectations from individual patients. The key aspect of consideration for the ethical principle of beneficence in ensuring that nurses advocate for what is good for their patients. In this case, the decision made by the nursing team created a situation where it was somewhat easy for the nurses to concentrate more of their efforts towards promoting positive outcomes for their patients.
The second ethical principle adopted was justice, which is a principle that expects fair and equal grounds from which patients would operate as part of ensuring that nurses deliver the best quality of health services. In this case, the nursing team adopted the use of this ethical principle, as it ensures that patients not only receive the best quality of services but are also provided with a platform from which to select their preferred treatment options.
What I learned on Shared Governance
The first aspect that I learned from shared governance was that it ensures that all stakeholders involved in the decision-making process account for the consequences of the decisions. Herrin (2004) argues that shared governance results from accountability by decisions meaning that it would be essential for every individual involved in the decisions to experience the consequences associated with the same. Secondly, I learned that shared governance is important in promoting respect for difference opinions as a way of building positive outcomes. The nursing profession has experienced a major challenge associated with lack of participation in the decision-making processes, thus, leading to a situation where the decisions made reflect on perspective. However, shared governance has solved this aspect entirely.
References
Herrin, D. (2004). Shared governance: A nurse executive response. Online Journal of Issues in Nursing, 9(1), 9.
