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