Essay on Ethical Issues in Nursing Practice

Ethical Challenge in Nursing Essay

At both the Bachelor and Master levels, nursing programs require courses in ethics. Thus, you have likely considered point-of-care ethical dilemmas previously; however, you can never think too much about this important topic. So much of what nurses and other healthcare professionals do daily is based in a foundation of ethics. Providing patient care and ensuring patient safety while enhancing quality and diminishing costs are all ethical practices in which you already likely engage.

A patient-focused approach, which promotes the delivery of safe, quality, and cost-effective healthcare designed to provide positive patient outcomes, represents a fundamental alignment to ethical principles for the delivery of healthcare. In your journey to become a DNP-prepared nurse, you will continue to uphold ethical principles in your nursing practice and will likely serve as an advocate for these principles in all you do.

Resources

Ethics Resources

Clark, K., Rödlach, A., Ballesteros, M., Davis, R., Holmes, L., Miller, J., Minnich, M., & Schultz, A. (2024). The role of doctor of nursing practice programs’ mission, vision, and values statements in the development of students’ professional identity: A qualitative study.Links to an external site. Nurse Education Today, 134, Article 106096.
Fornili, K. S. (2022). Expanded conceptual framework for ethical action by nurses on the “further upstream and farther downstream” determinants of health equity.Links to an external site. Journal of Addictions Nursing, 33(3), 203–214.
Green, C. (2022). Applying the Nightingale pledge in reducing health disparities: A hospital-acquired pressure injury case studyLinks to an external site.. Advances in Skin and Wound Care, 35(3), 180–183.
Khaghanizadeh M, Koohi A, Ebadi A, Vahedian-Azimi A. (2023). The effect and comparison of training in ethical decision-making through lectures and group discussions on moral reasoning, moral distress and moral sensitivity in nurses: A clinical randomized controlled trial.Links to an external site.  BMC medical ethics, 24(1), Article 58.
Torkaman, M., Heydari, N., & Torabizadeh, C. (2020).  Nurses’ perspectives regarding the relationship between professional ethics and organizational commitment in healthcare organizations.Links to an external site. Journal of Medical Ethics and History of Medicine,  13(17), 1–10.

To prepare:

Review the Learning Resources for this week, paying special attention to the various ethical issues in nursing practice that are addressed.
Reflect on any ethical challenges in nursing you have personally experienced.
Select one current ethical challenge in nursing that you have personally experienced—either professionally or as a student—on which to focus for this Blog.
Think about your experiences related to the ethical challenge you selected.
What happened?
How was the ethical challenge addressed by you and the other stakeholders involved?
Do you agree with the approach(es) that were taken?
Would you have done anything differently? If so, what?

Note: Be sure to review the grading rubric for this Blog so you fully understand what is expected of you. To access the rubric, click on the three dots that appear at the upper right of the Blog assignment page, then choose, “Show Rubric.

Address the following in your Blog entry:

Identify the ethical challenge in nursing you selected.
Explain why you selected this ethical challenge and why you think it is important.
Describe the specific situation you experienced. Be specific and provide examples. Explain:
What happened?
How was it addressed by you and the other stakeholders involved?
Do you agree with the approach(es) that were taken?
Would you have done anything differently? If so, what?

Read a selection of your colleagues’ entries.

RUBRIC:

Thoroughly responds to the blog prompt/s. Post provides comprehensive insight, understanding, or reflection about the topic through a focused analysis of the topic supported by personal experiences and/or examples. Personal opinions are expressed and are clearly related to the topic, activity or process identified in blog prompts. The post reflects in-depth engagement with the topic.

Solution Essay: Ethical Challenge in Nursing Assignment

The ethical issue I encountered involved balancing healthcare care quality and cost efficiency, where there was a conflict between providing high-quality care and adhering to organizational policies for cost reduction. I chose this ethical challenge because it highlights the challenges that nurses encounter when they have ethical obligations to prioritize patient welfare while being limited by the organization’s policies for cost efficiency (Torkaman et al., 2020). It raises ethical issues about healthcare equity, distributing resources equitably to patients, providing access to quality care, and avoiding actions that could potentially harm a patient (Olejarczyk & Young, 2019).

In this instance, I was caring for a patient who had complex health conditions and needed to be closely observed and needed additional support to better manage his symptoms. However, the hospital administration had recently implemented a new policy to reduce patient admission times to increase efficiency and reduce costs. The nurse in charge insisted that the patient needed to be discharged quickly since the bed had to be prepared for the next patient, justifying the decision because of the hospital policy change. This raised an ethical dilemma on whether to meet my professional obligation to provide safe, effective, and quality care or follow hospital policy, which would mean neglecting some of the care that the patient needed and could cause his health to deteriorate.

To discuss the ethical challenges, I explained my concerns about the patient’s condition to the nurse in charge, advocating for more time to ensure the patient received adequate care. Although she understood the situation, she also mentioned that she had to follow the administrative policies, emphasizing the importance of following the specified discharge timelines. Eventually, I was allowed some additional time, but this was very limited, so there was not much I could do to help the patients and ensure they received the care they needed.

I do not agree with the approach taken as I was left with concerns about the quality of care he received and how it would impact his recovery. Despite the time allowed for extended observation, I did not do enough to significantly improve the quality of care, and the underlying issue with the hospital policy remained, meaning that a similar incident could happen in the future. The approach conflicted with my professional obligations to prioritize patients’ interests as I felt that I could not uphold ethics due to hospital policy. Such policies place nurses and other healthcare providers in a difficult position where they have to prioritize efficiency and compromise ethical standards of care (Farrell et al., 2020). Although I understand that the policy was a result of limited health resources at the hospital, there should be more flexibility with such policies, ensuring that discharge decisions are made based on a patient’s specific needs.

I would have taken additional steps to better advocate for the patient’s needs. I would have documented the specific health concerns and symptoms that suggested he was not ready for discharge (Olejarczyk & Young, 2019). The detailed notes in the patient’s medical record would have better communicated my concerns to the physician and nurse in charge. After the charge nurse failed to address my concerns, I should have brought up the issue with the physician in charge of the patient’s care, as they would probably have done more to ensure the patient was ready for discharge. Additionally, raising the issue with the hospital’s management to advocate for more flexible discharge timelines would have contributed to changes in the resource allocation policy, ensuring that patients who are most in need receive adequate care.

References

Farrell, T. W., Francis, L., Brown, T., Ferrante, L. E., Widera, E., Rhodes, R., … & Saliba, D. (2020). Rationing limited healthcare resources in the COVID‐19 era and beyond: ethical considerations regarding older adults. Journal of the American Geriatrics Society, 68(6), 1143-1149.

Olejarczyk, J. P., & Young, M. (2019). Patient rights and ethics.

Torkaman, M., Heydari, N., & Torabizadeh, C. (2020). Nurses’ perspectives regarding the relationship between professional ethics and organizational commitment in healthcare organizations. Journal of Medical Ethics and History of Medicine, 13.