Research Paper on Ethical Issues and Challenges Patients and Staff Face in Long-Term Care Facilities

Introduction

The paper is a result of research that was conducted concerning some ethical issues and challenges that patients and staff in nursing homes otherwise referred to as long-term care facilities. In normal circumstances, some firms involved in providing care for people may it be street children, people with disability, orphans as well as the sick; tend to be associated with some ethical behaviors. These behaviors are evidenced in many perspectives. The paper has analyzed experiences from the employers and employees about moral issues as well as the challenges they face while within the facility.

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The paper starts by analyzing the basic ethical principles which include Autonomy, Non-maleficence, Beneficence and justice. These principles are set to be followed by nursing facilities, circumstances under which ethical challenges are experienced and how they are avoided, the manner in which the facility handle a patient with family issues as well as other private issues, actions which are taken regarding commonly occurring ethical issues as well as the importance of communication in healthcare professionalism. It also involves many articles relating to the same which will give support to significant points on the issues. Finally, it will end up with an overall conclusion regarding the overall idea of the issue.

Research Objectives

There have been many ethical problems and challenges which exists in nursing homes. Some of the common ones include lack of enough resources, making decisions when it comes to end-of-life-care as well as the use of restraints (Joan &Gastmans, 2015). The main aim of this study was to investigate and determine the ethical issues and common challenges that are being experienced in nursing homes following the opinions of all the staffs and patients in the facility. It also focused to find out the common types of challenges faced in long-term care facilities.

Methodology

The study made use of a questionnaire as primary collection tools while other information was recorded from articles that happened to have focused on such challenges before. The use of the questionnaire was based on patients and nurses but also included other professionals who had the opportunity to participate in it.

Findings

After the questionnaires were filled, some challenges were noted including lack of resources covered about 80%, improper communication among the residents and their families involved about 20%, and dignity issues covered 57% while the quality of care accorded to them while in the facility seemed more challenged covering 76%.

Literature Review

According to the Health Care Financing Administration (HCFA), nursing homes have been deemed as crisis zones especially when it comes to the provision of health care within the facility (Joan &Gastmans, 2015). It was noticed that a more significant percentage of residents living within the facility has dramatically declined while those who remain in the facilities happen to be old aged. This implies that there are issues and challenges in the long-term care facilities that happen to be burdened and therefore call for demand for nursing through home care.

Through a conference referred to as "Challenges in long-term nursing facilities" which was held in March 2002, at Florida state university, many concerns were raised concerning cost, quality of care provision, decision making, and consumer preferences as well as workplace issues (Joan &Gastmans, 2015). The conference raised some concerns that made individuals shift their preferences from long-term nursing care facilities to nursing home cares that happened to as well be faced by other challenges which mostly included financial cost of the service, access to the service as well as lack of principles based on nursing home care.

Discussion and Data Analysis

This part will tend to bring out the challenges and ethical issues that were brought about through the opinion of the staffs and patients within the nursing care facility as evidenced by the filled questionnaires. To start with, it points out some of the principles that guide the operations of the specific facility. Just like any other facility or organization, principles are fundamental. These principles define the way people should behave within as well as outside the facility. Their main concern is to ensure that those working within the facility are bound to the values otherwise there is always a penalty in case of a breach. The main principles which are based on nursing care facilities include the principle of autonomy, Non-maleficence, Beneficence, and justice.

Autonomy

Autonomy can be defined as a personal rule associated with oneself which is responsible for essential choices that result from personal limitations as well as control of interference by others. Those people who are autonomous happen to act intentionally with much understanding of the matter. People or external forces never influence them. This is a fundamental principle concerning medical ethics (Chadwick, 2016). The principle allows or gives patients an opportunity to make personal decisions regarding his/her health care which they will either get or not. It is an essential component of any decision made in any medical facility. The patient is the one responsible for the final decision since the body or mind under concerns his/her own. The principle, therefore, is fundamental and efforts should be enforced to ensure that it is not taken lightly. The main idea behind putting emphasis is believing of free will and personal importance. The principle ensures that the decisions of the patients are in their own hands and not in the hands of nurses or even family members.

Non-maleficence

This principle states that people should act in a manner that they don't cause harm to others or inflict evil to them. This principle particularly emphasizes avoiding causative or intentions made to harm which even includes the risk of causing harm. This implies that whether knowingly or unknowingly subjecting a patient to harm or risk will be regarded as a violation of the principle (Gallagher, 2016). This risk ranges from emotional or physical harms. In cases of a health care setup, harms involve causing disability, pain or even death to a patient or even staff within the facility. In some cases, especially in health care, it is noticed that there are situations in which at some point the patient might be experiencing harm. The situation calls for another harm from the surgeon or nurse which at this point happens to avoid prevalence of greater harm thereafter. The principle at such situation expounds more by saying that such harm is brought into consideration as long as the act is not guided by needless harm.

Principle of Beneficence

This principle is based on addressing the actions of the nurses towards the promotion of good. This can be seen as attending well to the patients. This principle closely relates to the principle of non-maleficence in the sense that it is based on not doing any harm to the patients. The principle in other terms happens to work along values such as kindness, mercy, and charity (Nelson, 2014). Beneficence is a very fundamental principle or aspect for this matter about health care. Through this, the patients-nursing relationship is enhanced. Violation of the principle is based on having bad intentions towards others or patients in the case of health care facilities.

Justice

It is the fourth ethical principle in nursing care facilities. It is based on the fact that justice involves giving someone what he/she deserves. Justice can be measured or viewed regarding equality and fairness concerning a justice (Ashwill, 2014). In a healthcare setup, justice involves equal treatment of all stakeholders concerning the provision of services as well as the allocation of resources. Unfair and unequal treatment implies a violation of the principle of justice.

Common Ethical Issues and Challenges Experienced in Nursing Care Facilities

Issues around healthcare happen to be associated with many different situations. Such issues rotate around confidentiality, the relationship between patients and staff as well as informed consent. Though in some situations, a different approach is applied although the action may be considered unethical, at some point, they are guided by the principle of autonomy (Yip, 2018). Such situations include the need for euthanasia based on the patient's opinion and situation. In case the patient calls for euthanasia, we realize that ethics at that point will be acting contrary to the principle of autonomy. In this study, it was realized that some nurses happened to have been involved or find them in some dilemma. Some of the most common ethical issues and challenges that staff and patients face in the nursing include:

Confidentiality

The concept of confidentiality lies within the privacy standards which apply mostly to patient's information. Nurses are not required to reveal any information with regards to the customer's medical situation. Violating patients confidentiality can expose one to legal and ethical related consequence despite just hurting the patient (Wong, 2018). This was evidenced by the result drawn from the study implied that patients who were affected by sensitive diseases such as HIV/AIDS patients. A number of these patients seemed to be undergoing a lot of stigma from other patients. This can be evaluated as a result of lacking confidentiality. Some of the nurses must be involved in sharing such patient's information which is very wrong, unethical and illegal. This can be avoided by educating and encouraging the nurses on the importance of keeping the patient's information private to avoid stigma. The challenge nurses also face based on the fact that some of the family members might inquire about the patient's situation. This again leaves the nurses in a state of a dilemma which at times seems critical. To avoid this, it's always important to consult the patient.

Relationships Between Patients and Health Care Providers

Patients and health care providers' relationships are highly prohibited especially personal relationships. This implies a sexual relationship between the patient and the health care provider which has been evidenced in many nursing homes. It is very unethical therefore at any instance and under any circumstance to engage in such relationships.

The relationship can also be by blood or by marriage or can be friends with the health care provider. In such instances, we realize that there happen to be favors given to such patients especially during admission. This is unethical in the manner that it is simply another form of corruption. Acting in such a manner will mean that you're against the common policy in most of the health care facilities which normally is a policy that is associated with the equal provision of services to all (Cheung, 2018). Violation of this policy has serious legal consequences. Among these consequences is losing a practice license.

Malpractice

This is a universal ethical issue in most of the health care facilities. It is associated with the poor handling of equipment as well as the use of wrong or defective medical products on the patient (McLaughlin, & Frolic, 2016). It is seen as the inability of the nurse or health practitioner to perform the medical duties completely and ending up causing harm to the patient. It may also include failure to report some of the incidences concerning their duties to the doctor in the institution or facility. Such errors are very consequential, and a patient can sue the practitioner in case of such.

Negligence

Negligence is another prevalent ethical issue in most of the nursing care. It simply involves the failure of the nurse or healthca...