kayla hopper, kerri jo mcdaniel, alex rodriguez, baylee stephens, kailey sweatman, & samantha...

Kayla Hopper, Kerri Jo McDaniel, Alex Rodriguez, Baylee Stephens, Kailey

Sweatman, & Samantha Trupp

ETHICAL DILEMMAS IN THE WORKPLACE

Students will be able to understand ethical terms and how they relate to their future-nursing career.

Students will utilize the ethical decision-making process to resolve ethical dilemmas that may be faced in the workplace.

OBJECTIVES

Autonomy: freedom and ability to act in a self-determined manner.

Non-maleficence: obligation to do no harmBeneficence: actions taken to benefit & promote the

welfare of other people Justice: refers to fairness, treating people equally and

without prejudice, and the equitable distribution of benefits and burdens

ETHICAL TERMS

Fidelity: agreement to keep promises and is an obligation to follow through with care off ered to clients

Responsibility: willingness to respect obligations and follow through on promises

Advocacy: refers to the support of a causeAccountability: ability to answer for one’s own actionsConfidentiality: mandates the confidential protection

of clients’ personal health information

ETHICAL TERMS CONTINUED

A situation in which an individual is compelled to choose between two actions that will affect the welfare of another person and both actions are either:Reasonably justified as being good,Neither action is readily justified as being good, or

The goodness of the actions is uncertain

WHAT IS AN ETHICAL DILEMMA?

Primary guide that ensures nurse’s perform quality nursing care and adhere to the ethical obligations of the profession.

Should be consulted when questions arise about correct practice or behavior

The American Nurses Association reviews and revises the code regularly to reflect changes in practice

CODE OF ETHICS FOR NURSES

Bill of Rights for Registered Nurses Awareness of these rights may provide nurses with a sense

of comfort in voicing their advocacy for patients as well as for themselves

Patient’s Bill of Rights This document reflects the increasing emphasis on patient

autonomy in health care and defines the limits of provider influence and control

International Council of Nurses Code for Nurses Points out issues of universal importance to all nurses

OTHER RESOURCES

Distinguish between fact, opinion, and values.

Ask the question. Is this an ethical dilemma? 1

Verbalize the problem. 4

Clarify values.3

Gather information relevant

to the case.2

Identify possible courses

of action.5

Negotiate a plan.6 Evaluate the plan over

time.7

HOW TO PROCESS AN ETHICAL DILEMMA

DescriptionWhat happened?

FeelingsWhat were your

feelings?

EvaluationWhat was good and

bad about the experience?

AnalysisWhat can you learn

from the event?

ConclusionWhat could you

have done differently or in

addition?

Action PlanIf it happens again

what would you do?

The Reflective Cycle

(Gibbs, 1988)

QUESTIONS?

Burkhardt, M.A., & Nathaniel, A. K. (2008). Ethics & issues in contemporary nursing. New York: Delmar Cengage Learning.Butts, J.B., & Rich, K.L. (2008). Nursing ethics across the curriculum and into practice. Massachusetts: Jones and Bartlett.Finkelman, A. (2012). Leadership and management for nurses: Core competencies for quality care . New Jersey: Pearson.Potter, P.A., & Perry, A.G. (2009). Fundamentals of nursing. Missouri: Mosby Elsevier.Zerwekh, J., & Garneau, A.Z. (2012). Nursing today: Transition and trends. Missouri: Elsevier Saunders.

REFERENCES

Distinguish between fact, opinion, and values.

Ask the question. Is this an ethical dilemma? 1

Verbalize the problem. 4

Clarify values.3

Gather information relevant

to the case.2

Identify possible courses

of action.5

Negotiate a plan.6 Evaluate the plan over

time.7

HOW TO PROCESS AN ETHICAL DILEMMA

Nurse Sarah has a large patient load today and is in a rush. After pulling all of her morning meds, she forgets to read the armband of one of her patients and proceeds to give the wrong medicine. After this, Sarah goes up to Joe, her colleague, to tell her what happened and asks him not to tell the charge nurse. Although the medication error was not life threatening, it was still a mistake. Ethically, what should Joe do? How could this have been avoided? What ethical dilemma is Joe facing?

SCENARIO 1

When the floor is really busy charge nurse Susan always helps out by taking a couple of patients. Over the past few months, nurse Emily has noticed that the patients Susan takes are always on narcotics. A few times when Emily has gone into the break room, Susan has been either napping or has seemed dazed and confused. One day, Emily answers a call light from a patient who hasn’t received pain medicine all day. Emily proceeds to check the MAR and sees that it was charted as given. She suspects that Susan has been pocketing the narcotics. What should Emily do in this situation? What is the ethical dilemma Emily is facing? What kind of protocols could be put in place to prevent this in the

future?

SCENARIO 2

The critical care unit has recently implemented a pay for performance policy in which nurses receive incentives when patients do not develop a bedsore or nosocomial infection while under their care. Nurse Kyle has documented turning his patient every two hours and that there are no signs of skin breakdown. His patient is transferred to the medical surgical floor, and the nurse on this floor discovers that the patient has a stage II bedsore, contradicting what Kyle charted. Kyle has been falsely documenting in order to receive incentives. What should be done about this situation? How can this be prevented in the future?

SCENARIO 3