Nurses are useful people in the society who help in improving people’s health. At some points, nurses find themselves in difficult situations that require informed decisions. In most cases, the situations they encounter in their line of duty are against their moral or professional morals, but they have to do what is right at that given time, so as to save the life of a patient without necessarily regarding what their morals dictate about such situations. Therefore, in nursing profession, there are ethical dilemmas that nurses encounter, which will determine their roles to endorse the health of the patient, as expected, not only by the patients but also by the patient’s relatives and the larger community.
Summary of the article
Lachman et al. (2012) wrote an article about ‘Doing the right thing: Pathways to moral courage’. The article is about a nurse called Susan who seems to be dissatisfied with the profession of Dr. Shoen. However, she is afraid to speak her fears to other nurses, because she is afraid of the consequences, and she is not even sure how Dr. Shoen will take it. She speaks to a new nurse graduate, Brenda, who speaks to Julie, a charge nurse. Julie asses the patient under Dr. Shoen’s care and after realizing that there is a problem in his treatment, she talks to Susan about the issue. She gives her an advice of using Situation-Background-Assessment-Recommendation (SBAR) technique to approach team members and assess them on their performance, especially after realizing there is a problem on how they handle and treat patients. Susan takes the advice from Julie positively, and uses the SBAR technique to assess Dr. Shoen. After an hour, Susan gets the courage to speak to Dr. Shoen about her patient Mr. Yarrow, and recommends what she thinks is good for the patient, which Dr. Shoen takes gladly without feeling threatened.
Moral and ethical dilemmas
Moral and ethical dilemmas are problems having unsatisfactory resolution. In other words, moral and ethical dilemmas are problems that when solved, they will result to mixed reaction, with some being completely satisfied while others partially or not satisfied at all. In the article ‘Doing the right thing: Pathways to moral courage’ by Lachman et al. (2012), one of the moral and ethical dilemmas lies with Susan. She is well aware that Dr. Shoen needs to impose more sedative to Mr. Yarrow, but she is afraid to tell her because she is not sure how will take it. In addition, she is not in a position to discuss the problem with other experienced nurses because she does not know how they will take her. Dr. Shoen is also faced with a moral and ethical dilemma about her situation with Susan. She has realizes that Susan questions everything she does to the patient, but she cannot ask her what the problem is, but instead, she goes to tell Julie that she is not happy with her. Brenda is a new nurse who cannot understand why Susan lacks the courage to speak her heart, and goes ahead to tell Julie that Susan needs help, instead of telling Susan what she really needs. Julie is also faced with moral and ethical dilemma when she realizes that the patient is not treated as he should, but instead of firing the doctor in charge, she advices Susan to use SBAR technique to address the issue, and recommend the best treatment procedure to Dr. Shoen without intimidating her, or without making her feel inferior or threatened.
Ethical issue in comparison to Georgia’s State Health Laws and regulation
According to the laws and regulation in Georgia, it is mandatory for to keep the records of the patients private and confidential, under Georgia Medical Records Law. In the article, the medical record of the patient was not kept private (Lachman et al, 2012). The medical records of a patient should be kept private, meaning that it should be accessed by the nurse in charge of the patient, and head nurse in the organization. However, from the article, it is questionable how Susan knew the kind of sedation Mr. Yarrow required. To make the matter even worse, Susan talks to Brenda, a new nurse about the patient, and that depicts that she also discloses the patient’s information to her. This is not acceptable as it violates Georgia Medical Records Law. They also went against Health Insurance Portability and Accountability Act (HIPAA) that calls for all nurses to keep the information of their patients confidential, which can also be termed as unethical (Scott, 2000). On the other hand, the fact that Mr. Yarrow’s information leaked to other nurses had some benefits. To begin with, Susan realized that Mr. Yarrow was not getting the kind of treatment he should, and therefore, she speaks to Brenda because she was concerned about his wellbeing. Secondly, Brenda views this as a very big problem that requires an intervention from the head nurse. It is through Susan and Brenda that the problem is addressed in the favor of Mr. Yarrow; hence it was beneficial for other nurses to have the access of patient’s information.
Process of ethical decision making
The ethical decision made was well made, but it would have been more effective if done otherwise. The major ethical dilemma from the article concerns Susan and Dr. Shoen. If I was in Susan’s position, I would go to Dr. Shoen and enquiry why she administered the kind of sedation as she did. I would then revisit the patient’s information, and advise Dr. Shoen on the best prescription to administer, according to my understanding. I would then go ahead and do some research about the case, analyze it in comparison to the patient’s case, then disclose it to Dr. Shoen, so as to improve the wellbeing of the patient without making her feel inferior.
References
Lachman, V. D., Murray, J. S., Iseminger, K., & Ganske, K. M. (2012). Doing the right thing: Pathways to moral courage. American Nurse Today, 7(5), 24-29.
Scott, C. (2000). Is Too Much Privacy Bad for Your Health--An Introduction to the Law, Ethics, and HIPAA Rule on Medical Privacy. Ga. St. UL Rev.,17, 481.
