The major challenge for nurses in their daily practice is the various issues of ethics and moral distress that they have to contend. Patients and families as well as the administration and leadership within a facility have a way of presenting choices to the nurse in which they restrict or place the nurse in situations where they actually cannot determine what is wrong and what is right (American Nurses Association, 2011a). The decision is made hard by the fact that what the nurse regards as right, may be wrong to the patient or may be out rightly beyond the facility’s policy. Nurses have to weigh these ethical dilemmas from the point where they regard to their actions not as right or wrong but based on the likelihood of harm to the patient. This implies only acting and making decision in such a way that the results will have no harm on the patient.
One major barrier that exists in relation to ethical practice is the distribution of resources within the organization. At times, the unwritten but strict policy within healthcare facilities is that for patients in vegetative state, nurses have to significantly consider withdrawal of life support as an intervention to avoid the suffering of the patient (American Nurses Association, 2011a). The justification of this policy is that we have a role to ensure that patient’s achieve a comfortable death. This in my view contradicts my own values and beliefs in the role of the nurse for patients in end of life. while we are entitle to ensure that patient’s have a comfortable death as an acceptable outcome, it is important to separate this and the fact that we are not in any way entitled to hasten the death of the patient as enough as justification for comfortable death ((American Nurses Association, 2011b).
When the healthcare fraternity ties patient outcomes to resources then it loses the primary objective of affording patients optimal within the available resources. In order to avoid the ethical issues that emanate from such situations, hospitals have to give nurses in end-of-life care the ultimate freedom to make decisions and act without confining them to unwritten policies that seek to manage budgets. This would actually be the wrong platform to help manage resources however limited they may be. End-of life care is actually a unit where nurse shave to deal with emotional turmoil especially in the event of death of a patient. In such cases the nurse may review the care process as a failure and thus result to self-blame for the patient’s death (American Nurses Association, 2011a). This policy is detrimental to the nurse’s health as well as their ability to work within the unit. These nurses have to be allowed to afford patients optimal care to the very end so that death is voluntary and not influenced or facilitated in any way (Washington, 2012).
References
American Nurses Association. (2011a). Code of ethics. Retrieved from http://www.nursingworld.org/Mobile/Code-of-Ethics
American Nurses Association, (2011b). Code of ethics for nurses with interpretive statements. Retrieved from http://www. nursingworld.org/code-of-ethics-preface
Washington, H. A. (2012). The Nuremberg Code, set up to protect the human subjects of research, is being routinely ignored. Retrieved from http://www.slate.com/articles/health_and_science/new_scientist/2012/01/the_nuremberg_code_set_up_to_protect_the_human_subjects_of_research_is_being_routinely_ignored_.html
