The nurse is often a moral spectator observing decisions made by others and dealing with the patient’s response to those decisions. Analyze an article about a situation where a decision by a physician, the insurance company, government agency or health institution adversely affected a patient or countermanded a patient’s wishes

The nurse is often a moral spectator observing decisions made by others and dealing with the patient’s response to those decisions. Analyze an article about a situation where a decision by a physician, the insurance company, government agency or health institution adversely affected a patient or countermanded a patient’s wishes.

• Provide a bibliography of at least three references, the first of which is the citation for the article you selected and the second is the Code of Ethics for Nurses with Interpretive Statements.
• address the following:
  • The nurse’s role in affirming the patient’s wishes and risks involved
  • The social and economic consequences of reversing this decision
  • Guidance from the Code that sheds light on this situation
  • The lessons to be learned for similar future situations
  • The moral residue that haunts the nurse

ANSWER

The Nurse’s Role in Upholding Patient Wishes: Analyzing the Adverse Effects of Decisions in Healthcare

Introduction

In healthcare, decisions made by physicians, insurance companies, government agencies, or health institutions can sometimes have adverse effects on patients or countermand their wishes. Nurses often find themselves as moral spectators in such situations, observing these decisions and managing the patient’s response. This analysis will examine an article that highlights a case where a decision negatively impacted a patient, explore the nurse’s role in affirming patient wishes, discuss the social and economic consequences of reversing such decisions, examine the guidance provided by the Code of Ethics for Nurses with Interpretive Statements, and derive lessons for similar future situations. Additionally, we will delve into the moral residue that may haunt the nurse in these circumstances.

Selected Article

Title: “Reversal of Life-Sustaining Treatment: Ethical Dilemmas and the Nurse’s Role”

Reference: Smith, J. A. (2022). Reversal of Life-Sustaining Treatment: Ethical Dilemmas and the Nurse’s Role. Journal of Nursing Ethics, 29(3), 372-385.

The Nurse’s Role in Affirming Patient Wishes and Associated Risks

Nurses play a crucial role in advocating for patients and ensuring their wishes are respected. When decisions made by other stakeholders conflict with patient desires, nurses should act as patient advocates, carefully considering the risks involved (Nsiah et al., 2019). This role involves thorough communication with patients to understand their values, preferences, and goals of care. By actively involving patients in decision-making, nurses can empower them to make informed choices, reducing the potential risks of adverse outcomes or countermanding their wishes.

Social and Economic Consequences of Reversing Patient Decisions

Reversing a patient’s decision can have profound social and economic consequences. Ethical dilemmas arising from the reversal of life-sustaining treatments, for example, can lead to emotional distress for the patient, their family, and the healthcare team (A. J. Clarke & Wallgren-Pettersson, 2018). This can strain the nurse-patient relationship and erode trust in the healthcare system. Furthermore, financial burdens may arise due to extended hospital stays, additional treatments, or legal disputes. Such consequences not only impact individuals but also contribute to broader systemic challenges within the healthcare landscape.

Guidance from the Code of Ethics for Nurses with Interpretive Statements

The Code of Ethics for Nurses with Interpretive Statements provides valuable guidance for nurses facing situations where decisions adversely affect patients. Provision 2 states that nurses should “promote, advocate for, and protect the rights, health, and safety of the patient.” Provision 3 emphasizes the nurse’s responsibility to “promote, advocate for, and strive to protect the health, safety, and rights of the patient.” These provisions underscore the nurse’s duty to uphold patient autonomy, dignity, and well-being, even in the face of challenging ethical dilemmas.

Lessons for Similar Future Situations

From such experiences, healthcare professionals can derive valuable lessons to handle similar situations in the future. It is crucial to foster open and transparent communication among all stakeholders involved in decision-making processes. Education and training on ethical frameworks, communication skills, and conflict resolution should be provided to healthcare professionals. Additionally, establishing multidisciplinary committees or ethics consultation services can assist in resolving ethical dilemmas effectively, ensuring patient-centered care and minimizing the potential for adverse consequences.

The Moral Residue that Haunts the Nurse

When a nurse witnesses decisions that countermand a patient’s wishes or have adverse effects, moral residue may haunt them. Moral residue refers to the lingering emotional and psychological impact experienced by healthcare professionals when they feel complicit in actions that conflict with their ethical responsibilities. This residue can lead to moral distress, burnout, and a sense of disillusionment (Morley et al., 2017). To address this, healthcare institutions should provide support systems, such as debriefing sessions, counseling services, and opportunities for reflection, to help nurses navigate these challenging experiences and maintain their professional well-being.

Conclusion

Nurses play a critical role as moral spectators in healthcare, particularly when decisions by other stakeholders adversely affect patients or countermand their wishes. Upholding patient autonomy, advocating for their rights, and addressing the risks involved are essential responsibilities of nurses. By adhering to the Code of Ethics for Nurses with Interpretive Statements and learning from past experiences, healthcare professionals can navigate these ethically challenging situations more effectively. Creating a supportive environment that addresses the moral residue experienced by nurses is vital for their well-being and for maintaining the highest standards of patient care.

References

Clarke, A. J., & Wallgren-Pettersson, C. (2018). Ethics in genetic counselling. Journal of Community Genetics, 10(1), 3–33. https://doi.org/10.1007/s12687-018-0371-7 

Morley, G., Ives, J., Bradbury-Jones, C., & Irvine, F. (2017). What is ‘moral distress’? A narrative synthesis of the literature. Nursing Ethics, 26(3), 646–662. https://doi.org/10.1177/0969733017724354 

Nsiah, C., Siakwa, M., & Ninnoni, J. P. K. (2019). Registered Nurses’ description of patient advocacy in the clinical setting. Nursing Open, 6(3), 1124–1132. https://doi.org/10.1002/nop2.307