Research Paper on Ethical and Legal Issues in Nursing

Introduction

Ethical and legal dilemmas are common in nursing because of the nature of the work they do. For example, some of the activities they undertake could be legal but against the wishes of the patients while others may be unethical but necessary. Nurses have to balance between all of these requirements and they have to meet their requirements. A common case is when the patients are not willing to take the medicine they need and they are unwilling to compromise their beliefs, whether religious or cultural. Sometimes nurses have to use legal methods to force patients to undertake their medicines. As anew Registered Nurse (RN), the dilemmas can be challenging ad it is hard to make the right decisions without facing opposition, confusion and avoiding mistakes. Exposure to the working environment improves the ability of the RN to pursue their careers without errors. Professional nursing standards act as guidelines to the nurses and can be followed to arrive at the final decisions when dispensing different duties. The purpose of this study is to analyze a possible scenario that occurs in many hospitals and that requires nurses' intervention and an analysis of how nurses can handle it. It also aims at analyzing the recommendations that can be used to solve the challenges faced by nurses in this dilemma. The scope of the study is limited by the resources and objectives. It covers only the case of a new RN in a similar scenario.

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Overview of Jade's Dilemma

Jade, a new RN, arrived late for her night shift and overheard some nurses in the lift speak of a patient who should be compelled to comply with the medical processes offered in the hospital for the sake of another. She found a taped handover report from the outgoing nurses and had to work with the shift controller, Lisa because the hospital was understaffed. She later met Bethany's mother, who had strict religious beliefs against the use of medications. Bethany was only aged 11 and needed urgent medical attention for her chest infection. Her mother refused any medical process offered and rather opted to stand by her religious views. Lisa had arranged on giving medication to Bethany secretly when her mother went to the toilet but it did not work. She had also pursued a legal procedure to compel Bethany's mother to obey the medical process and Jade disclosed the plan to her. She left the hospital and Jade was blamed for "helping kill the child' by disclosing this information against Lisa's wishes.

Specific Events of the Scenario

Ethical and Medico-Legal Issues

In the case of Jade and Bethany above, the first ethical issue was that it was wrong to dupe the mother and give medication to Bethany secretly through ice-cream. The paracetamol that Lisa had suggested to have administered using ice cream could have helped Bethany's condition. However, it was unethical to do it against the mother's will. Jade found it unethical and refused. Ethical dilemmas are common in the nursing environment and they affect the quality of the services offered, the efficacy of the nurses and the trust that patients have on the nurses (Aitamaa, Suhonen, Iltanen, Puukka, & Leino-Kilpi, 2019). The views of the mother are valid and she has the rights to practice her religious beliefs. She also has a right to make decisions on behalf of the minor. However, it is also illegal to deny Bethany her medical right. The use of ice cream to administer paracetamol against the mother's knowledge is unethical and reduces the trust that the mother had in the nursing procedures.

The trust that patients have in the nurses makes it easy for the RNs to administer medications. According to Dawson-Rose et al. (2016), trust between the patients and the care providers in a critical factor in the management of the diseases and it determines the way the medical processes are done. Therefore, Jade's views that the paracetamol should not be administered disguised as ice cream were valid and she wanted to prevent the trust that Bethany's mother had in the system. The dilemma arises from the fact that the child does not get the medication she needs and she is at risk of getting worse. Jade had to choose whether to protect the trust and ethical standards of the nursing profession or help the child get medication, regardless of the methods used. The medico-legal issues associated with the case are that Lisa had sought for legal compliance to ensure that Bethany received medical attention against her mother's will and that she would have to forego her religious rights and freedom. It was necessary to compel her to agree on the medical procedure and the legal process had to be followed.

Clinical Decision Making

Making the right decisions is critical in the nursing practice and can have major impacts on the nursing practice. Nurses are expected to make clinical and non-clinical decisions that have the best outcomes at all times (Johansen & O'Brien, 2016). Making decisions about the patient's' needs is necessary because it helps the nurses choose the right medication required. If the wrong medication is applied, it is possible to create worse challenges for the patient than the one they are suffering from. The clinical decision-making process is associated with the level of knowledge that the burses have and it can be affected by the experience and exposure they have. In this case, Lisa's decisions could be informed by their exposure and experience in similar cases. However, for Jade, the decisions made by Lisa are against her expectations and she feels the need to protect Bethany. Nurses are expected to make medical decisions on behalf of the patients who are not in a position to do so (Standing, 2017). For example, due to lack of knowledge, most of the patients cannot choose the right medicine to apply in their sicknesses. Nurses are believed to be in the best position to make these decisions and administer the medications on time to save the lives of the victims.

In the scenario, Jade is expected to make decisions on behalf of Bethany and her mother. However, it is a dilemma because the mother is against the conventional medications that should be applied to Bethany. Jade has to choose between following the code of ethics given by the nursing body or to do the morally right thing. In such a case, the decision made could have long-lasting impacts on the patient and this requires a lot of caution. Some of the concerns raised by the other nurses in the lift are relevant to the decision-making process and they show that there is a divide between the way nurses make decisions and what is right (MelinJohansson, Palmqvist, & Ronnberg, 2017). Some nurses make decisions that are legal but morally wrong or against the human rights of the patients.

Scope of Practice and Professional Nursing Standards

The behavior of the nurse is an important consideration for any hospital and it is necessary to have a consistent and verifiable set of rules and principles that can guide the nurses. The scope of the practice is based on the action set in each state and it determines the duties and responsibilities of the nurses. The professional nursing standards are generalized rules that are used to guide the nurses on the way they should handle different duties with care. The general aim of each is to ensure excellent and competent care at each stage of the nursing practices. It is essential for a nurse to understand the scope of the roles they are allowed to perform. A nurse is not allowed to perform some of the duties that are meant for their leaders and doctors. For example, Jade cannot perform surgery on a patient because her scope limitation does not allow her to do so. The decision to inform Bethany's mother about the legal process to compel her to allow Bethany's treatment was beyond her scope and she should have left Lisa to handle it. The way data is released to a person determines their reaction. Out of experience, Lisa could have convinced Bethany's mother to allow the medical process to continue. The terms of service of the nurses have to be guided by the principles under the scope of their practices. The cope should be communicated effectively to the relevant stakeholders (Halcomb, Stephens, Bryce, Foley, & Ashley, 2016). The nursing profession is dynamic and it is important for Lisa and Jade to update their knowledge about it to avoid making mistakes with patients like Bethany in the future.

Teamwork and Interdisciplinary Practice Issues

Teamwork is an integral pillar in any profession and increases the synergy from the employees. Nurses work in teams to achieve the goals of their shifts. For example, when Jade was reporting for her shift, she needed information about the patients from the outgoing nurses. The nurses recorded the reports and she listened to get updated about the needs of the patients she was to handle for the night. Teamwork is applied in all professions and not just in nursing and it helps improve the accuracy and efficiency of the work (Souza, Peduzzi, Silva, & Carvalho, 2016). Lisa expected Jade to be a team player and not to disclose her plans to Bethany's mother. However, Jade failed in this role and disclosed the plans. She was blamed for having made the mother leave the hospital without the medication for Bethany. In infusion nursing, teamwork is cited as one of the most effective solutions to the efficacy of the nurses (Judge, 2017). Most of the nurses rely on the information from their peers when starting their shifts. In this scenario, teamwork was poorly utilized.

Key Roles and Responsibilities

The scenario presents Jade with a chance to practice several roles and responsibilities that are taught in the nursing course. Nursing requires strong leadership to assist in making decisions that have positive outcomes for the patients and the hospitals (Porter-O'Grady & Malloch, K., 2015). The scenario proves that there is poor leadership because the transition from one shift to the other is not done effectively. The nurses do not take it seriously and there are low restrictions on the privacy of the patients. There is a need for transformational leadership to improve the situation (Fischer, 2016). The healthcare center should have an effective way of dealing with cases similar to that of Bethany without violating any of their rights and any laws. Nursing is a dynamic profession and requires effective leaders. One of the major challenges is choosing the leaders (Scully, 2015). The nurses that left the hospital before Jade arrived discussed the patients in the lift which is a violation of the privacy of the patients. Good leadership should change such a trend and improve the future of the nursing profession (Grossman & Valiga, 2016). For a newly graduated RN, one of the first responsibilities is to offer a solution to the leadership gap.

The existing workforce has a leadership gap that requires the attention of Jade to fill. She should approach Lisa and explain to her whatever is wrong with the plans she had for Bethany against her consent. The other role is to update the management on the latest leadership requirements in nursing. The other role is to help other nurses understand the legal and ethical issues related to such scenarios.

Conclusion

The scenario is an example of a case whereby nurses are faced with ethical and professional dilemmas and have to make the right choices to ensure they offer the most efficient solutions. Jade's first mistake was that she arrived late for her shift and it was difficult to connect with the information about the patients. She should have arrived on time to get all the information she needed for the shift. The case of Bethany and her mother is not unique and it can occur ion any health center. It is important for nurses to have the necessary skills to deal with such p...