What primary relationships do you see between legal and ethical issues faced by nurses in their practice? How would you explain these relationships to others?

What would you say are at least two ethical dilemmas that are often faced by nurses in their daily practice? Explain how accountability and responsibility play a role when nurses face with these dilemmas. One of the most well known ethical dilemmas that nurses can face in their career is their patient's belief system. One example is the familiar dilemma of when a patient has a strong religious belief that interferes with sound evidence base medical practice. For example Jehovah Witnesses forbid blood transfusions under any circumstance. Even when it's the difference between life and death, the answer will always be no blood transfusion. Most knowledgeable and experience nurses will attempt to explain the necessity and benefits of the blood transfusions, but it's also understood that it's the nurse's job to support patient's rights. Nurses often face unique challenges because of the amount of time they actually spend with patients and their family. Nurses are typically the ones who actually witnesses the patient's or family's struggle to make crucial decisions. Most often nurses are engaged with the patient and their family more than any other healthcare provider. One key fact to recognize is nurses bring with them their personal values, which at times can be in direct conflict with what their patient wants. Nurses need to find a way to reconcile their moral values with the obligations of their profession. Nurses should never forget that patients have the right to refuse medical treatment. It is the nurse's responsibility to support their patient's right to make that medical decision. Nurses are accountable and responsible to provide compassionate safe quality care with dignity and respect. When doing so it ensures the patient will have an open line of communication between the nurse, physician and family which ultimately helps with the final decision making process. Another dilemma example within daily nursing practice includes staffing needs and patient safety. It can be ethically distressing to not have enough staff or resource to give compassionate safe quality care with dignity and respect to patients. How can the nurse deliver quality care when the nurse is understaffed and the demands are too high to meet. My hospital wants nurses to know they have a voice and its their responsibility to make sure its being heard. My hospital has a Clinical Ethics Committee .The Clinical Ethics Committee was established in response to a need of our physicians, staff, patients and their families. We wanted to have an in-house resource, in an advisory role, for any possible ethical decision-making in the face of dilemmas which are often posed by contemporary ethical issues. The goal is to help guide what is best for the patient. It can be used for ethical issues such as patient rights and patient safety relating to staffing. This committee does have access to legal counsel and will seek legal guidance as appropriate to the situation. Nursing is represented on this committee and all hospital staff are educated about this committee during orientation and annual training.

Patient safety and staffing issues. The ethical dilemma faced by nurses include everything from speaking up about hoaw staffing shortage impacts direct quality of care.

Nurses must be fully aware of patients' rights in all settings, ages, and developmental abilities, and be willing to advocate for them and to collaborate with others in finding solutions to ethical issues. Recommendations - the American Nurses Associaton recommends that: 1. All nurses advocate for human rights of patients, colleagues, and communities. 2. Nurses advocate for the ethical and just practice of nursing by creating and sustaining environments that support accepted standards of professional practice, since the practice environment and rights of nurses influence the practice and moral context of nursing. 3. Nurses strengthen practice environments by refusing to practice in ways that would create a negative impact on the quality of care 4. Where such conditions exist, nurses enlist the assistance of their professional organizations to assist in improving conditions of nursing practice (ANA, 2001). 5. Health care agencies pay close attention to potential for human rights violations as they relate to patients, nurses, health care workers and others within their institutions. 6. Health care agencies support policies and practices that actively maintain environments that assure ethical nursing practice, and the upholding of human rights and methods for reporting violations and taking action to prevent it from happening again. 7. Nurses in every practice setting serve on ethics committees, work to promote the discussion of ethics and human rights among colleagues and engage in political action to clarify and promote health policy that increases access to and equality of care. 8. Nurses attend to and are aware of conflicts of dual loyalty to patients, health care institutions, employers, and agencies that provide payment for services (ANA, 2001). 9. Nurses work collaboratively within the profession and with other health care professionals to create moral communities that promote, protect, and sustain ethical practice and the human rights of all patients and professional constituents (ANA, 2003). 10.Nurse educators embrace the concepts of justice and caring as guiding principles in teaching students about ethics and human rights within the provision of health care everywhere from local communities to the greater global community, etc. (ANA, 2010). I think understanding these guidelines will help you as a nurse to know how to resolve these issues when they arise.

ANA (2010) Position Statement Retrieved from: http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/irresolution's/ANAPositionStatements/alphabetically/Nursess-Role-in-Ethics-and-Human-Rights.pdf Words: 363