Category: Ethics

Disaster Nursing 444

December 7, 2021 / ecarrell

In the event of a disaster, nurses are expected to utilize their healthcare knowledge in addition to communication, teamwork, and proper use and understanding of equipment. Arguably the most important responsibility of the nurse is understanding the chain of command, such as the HEICS (Hospital Emergency Incident Command System). In this model, roles are formally structured with clear lines of authority and accountability, thereby increasing efficacy and patient safety.

It is understandable to see the ethical dilemma given the contradiction of the two ANA provisions. However, I think the best way to answer that is by implementing prioritization, casualty triage, and considering justice and equity. There is no cut and dry answer here, beyond evaluating the situation as it happens and acting accordingly, as nurses deserve priority care just as much as a civilian does.

Death and Dying

November 17, 2021 / ecarrell

Death with dignity has historically been a widely debated ethical issue. I have done several projects on this concept over the course of my schooling and have always maintained the belief that everyone deserves to die when and how they want, especially if they have a particularly aggressive disease. Terminally ill people will find ways to die without the assistance of medical personnel, so I think allowing the option to die with dignity is important to maintain autonomy. I was excited to read about Maine adopting this practice, as previously only a handful of states in America had legalized it.

I don’t think the death with dignity laws clash with “do no harm”. In the case where the patient has six months or less to live, they are 18 or older, and have the mental capacity to make healthcare decisions, I think the healthcare team has an obligation to help them quietly and peacefully end their lives. I think in this case, nurses and doctors would be doing more harm by refusing to assist in a patient’s death than actually following through with it. The nurse’s oath also states that we must devote ourselves to the welfare of our patients, and that includes their happiness. If dying before their brains and bodies start shutting down is what will make them happy, then I think we owe them that.

Pre-Interview Reflection

September 23, 2021 / ecarrell

The health professional I have chosen was a clinical instructor of mine in a previous semester. I chose to write about her because she demonstrated a strong dedication to her practice, a vast wealth of knowledge, and a commitment to learning from her patients and her peers. I could tell that all staff on the unit, regardless of status or rank, were drawn to her and felt comfortable around her. I know that she worked on the unit for several years as a CNA before becoming a nurse, which strengthened her relationship with the staff and helped her to establish herself as a member of the care team.

The difference between formal and informal leadership is the presence of official authority. Formal leadership comes from structure and authority, and it is usually methodically appointed. On the other hand, informal leadership may not have the traits of an official role and may just be a known status that a person has grown into. Often, informal leadership is more of a position of influence rather than a different title. The nurse I chose to write about is more of an informal leader, as she is still very young and relatively new to her nursing role. She has not been formally appointed as a leader on the unit itself, however, I think her status as a clinical educator speaks volumes about her influence in the hospital, as she is clearly a trusted source of knowledge.

I am most interested in learning about how this nurse feels she is supported on the unit, and how she may be able to turn her informal leadership into formal leadership over time. I am curious to find out more about conflicts and ethical dilemmas she has faced, and how her informal leadership role has helped her to handle certain situations.

Ethical Considerations for EBP

August 6, 2021 / ecarrell

Before EBP, my perception of the nurse’s role in ethical practice was veery narrow, and only consisted of concepts like HIPAA, and patient advocacy. However, I now understand that they have a much more involved position. Nurses spend a significant amount of time with all of their patients, which means they know them on the most intimate level. In that respect, they can identify and screen potential patients for research candidacy. Therefore, they also need to make sure that patients and their families have all of the information necessary to be able to make an informed decision about participation. Much of the informed consent process is done by nurses. In terms of the research itself, nurses make sure that data and evidence is well-constructed, has relevance, significance and is valuable. They also assess the quality of the research and work to improve the methods that aren’t efficacious based on their past experiences.

Knowing the process of the research ethics is helpful, as being able to plan and execute a clinical investigation is a very valuable skill in the field of nursing. Clinical research is the reason that modern science is as advanced as it is. Nurses see firsthand what is and what is not therapeutic, and this can become a trial-and-error sort of process in itself. So, it is very important for nurses to be a part of clinical research, as they are the primary data gatherers in the patient care setting. They are familiar with patterns of symptoms and outcomes and have great intuition about their patients.

The Evidence Based Practice course allowed me to get a better sense of what clinical research looks like, as well as what the initiation process entails. I learned that nurses have far more responsibility than I originally thought, but it makes complete sense that we do, as we know the patient care process better than anyone. I feel that my confidence has grown as far as my ability to gather and evaluate journal articles. Being able to identify the strengths and weaknesses of a study is a very good skill to have moving forward!

Assumptions

August 5, 2021 / ecarrell

The nurse’s role in evidence implementation and evidence generation is an important one. As nurses have such a critical and close relationship with their patients, they are the ones that monitor outcomes vigilantly. Therefore, they ensure that research is well-constructed, significant, and valuable. Additionally, since nurses maintain such an intimate relationship with their clients, they can use their experiences to guide clinical research, in order to improve patient outcomes, or evaluate current interventions. That includes identifying which of their patients may benefit from inclusion in a research study. Nurses also make sure that the actions of medical professionals are in conformity with the ethical standards of their practice.

Nurses are also typically the ones to get their patients’ informed consent about clinical research. That means that they are the ones to explain the implications of the study to the patient and their loved ones, meaning that they are responsible for being well-informed about the purpose and details of the research being conducted.