Ethical dilemma is a decision-making problem between two possible moral imperatives,neither of which is unambiguously acceptable or preferable .One action must be chosen, thereby generating a quandary for the person or group who is burdened with the choice. Example,the ethical dilemma which was encountered is in line of patient autonomy.The patient relatives were refusing to have blood transfusion for their child post operatively, despite the possible consequences ,but blood transfusion was necessary for saving the life of the child.With their refusal almost they created the end of life issue situation.
In the above scenario the other nurse was trying to leave the case by mentioning that patient and relatives are not willing and are not consenting for blood transfusion.
I was not against the patient autonomy,but my intention was to save the life of the child by explaining the consequences of refusal of blood transfusion.At last, they understood the importance of it ,they have been convinced for the blood transfusion and the child was out of danger.
Nurses face variety of ethical issues while dealing with patients, colleagues, or other health care personnel. Nurses, as a human being, differ from one another and possess their own intellectual and moral values. The ethical dilemmas vary in different situations depending upon the way we address it. Some nurses deal with the situation easily while it would create a dilemma for others. One of the examples of an ethical dilemma that can occur in our nursing practice is when nurses themselves are not properly equipped to complete their duties like nurses who notice their coworker’s lack of knowledge face an ethical dilemma of whether they should bring the issue to their nurse manager (Duquesne University, n.d.).
For some nurses, it would not be a problem and whistle blow right away, whereas, for other, it would be dilemma between patient care and the loyalty to colleagues and employer. One of my colleagues had a patient who had Ventricular Tachycardia then CODED at the beginning of the shift soon after taking the report. It was found that patient’s potassium and magnesium level been low for the last 12hrs and EKG showing frequent PVCs which was not addressed. The patient was on Lasix injection and the potassium level was not monitored. In my opinion, it happened because of a delay in patent management due to incompetency. My colleague had a dilemma about whether to report it or not because the nurse who gave a report to her was her best friend.
Personally, when I notice the incompetency among peers, I critically analyze the situation and if it is a threat to patient safety, I would report because as per the code of ethics as a patient advocator we are obliged to take action when a patient’s right or safety is endangered (Mansbach.,Kushnir., Ziedenberg., & Bachner, 2014). If it is something, we can help our colleague improve incompetency, I privately talk and advice the best way so that the nurse’s license as well as patient’s safety would not be affected. In that case, I talked to and assessed the knowledge of the nurse who gave the report. She said that she was not so confident to analyze the EKG rhythms and not aware of the protocols of managing patients on Lasix. So, I brought this issue and requested the management for the Inservice education which keeps us up to date in knowledge and skill helping to manage promptly and prevent from reoccurrence of the situation.
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An ethical dilemma refers to a decision-making problem where two possible moral imperatives are present, and neither is considered unambiguously acceptable or preferable. This creates a predicament for the individual or group tasked with making the choice. One example of an ethical dilemma that can arise in a medical setting is the issue of patient autonomy.
In one particular scenario, a patient’s relatives refused to consent to a necessary blood transfusion for their child despite the potential consequences. This refusal placed the child’s life at risk, and it created an end-of-life issue. Another nurse in the situation attempted to withdraw from the case, citing the patient and family’s unwillingness to proceed with the blood transfusion.
While recognizing and respecting patient autonomy, the medical professional in this scenario sought to save the child’s life by explaining the potential outcomes of refusing the blood transfusion. After thorough discussion and counseling, the relatives were convinced of the importance of the blood transfusion, and the child’s life was ultimately saved.
In another case, nurses may encounter ethical dilemmas related to their colleagues. For instance, when a nurse notices a coworker’s lack of knowledge or incompetence, a dilemma arises regarding whether they should report the issue to their nurse manager. Loyalty to one’s colleagues and employer may conflict with the responsibility to provide optimal patient care.
When faced with such a situation, it is important to critically analyze the circumstances. If the incompetence poses a threat to patient safety, it is necessary to report the issue, as nurses have an ethical obligation to advocate for patient rights and safety. However, if the deficiency can be addressed through education and improvement, it may be more appropriate to privately approach the nurse and offer guidance and support.
In the case of a colleague who failed to address a patient’s low potassium and magnesium levels, resulting in a critical medical event, the nurse faced a dilemma as the nurse who provided the report was her best friend. In this specific situation, the nurse decided to report the incident due to the potential harm caused by the delay in patient management.
Additionally, the nurse assessed the knowledge and skills of the nurse who gave the report and discovered a lack of confidence in analyzing EKG rhythms and managing patients on Lasix. To address the issue without compromising professional relationships, the nurse requested inservice education to enhance knowledge and skills, thus preventing similar situations from occurring in the future.
Overall, ethical dilemmas in a medical setting can arise in various situations, including patient autonomy and addressing colleagues’ competency concerns. It is crucial to consider the potential impact on patient safety and well-being, and to find a balance between advocating for patients and maintaining professional relationships.