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Summarize in 500 – 600 words a nursing experience when you faced an ethical dilemma and discuss any emotions or moral distress you experienced. Describe the setting and individuals involved as well as how the individuals or groups perceived the problem. Identify conflicting values and beliefs at the individual, organizational, and societal levels that influenced perceptions of the people involved in the experience. Provide assessment data or information about the situation that might have been helpful. Describe how additional information could be obtained and the resources available. Cite references if used. Do not submit as an attachment and do not exceed 600 words.
Using the Model of Culturally Competent Ethical Decision Making, redefine and make recommendations in 250 to 300 words to correct the dilemma using the concepts of cultural context and cultural competence as well as compassion, social justice, human rights and partnership, collaboration and advocacy. This model can be found in Chapter 14 of the Andrews & Boyle text. This chapter is accessible through thePoint, please refer to the inside cover of the Andrews & Boyle text to register the textbook and have access to this information. At least one reference must be cited, and do not to exceed 300 words.
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Introduction
Ethical dilemmas in nursing are common experiences, however, these situations can be overwhelming sometimes. The ethical principles intended to guide decision-making in healthcare include autonomy, justice, beneficence, and non-maleficence (Pozgar, 2019). All these areas are closely related when making decisions regarding patient care. The purpose of this paper is to summarize a nursing experience as well as recommendations to solve the dilemma based on the Model of Culturally Competent Ethical Decision Making.
Summary of the Nursing Experience
The ethical dilemma discussed or experienced here occurred in an acute care hospital that offers various health care services to various groups of patients. In that scenario, a patient diagnosed with severe malaria was admitted to the hospital. The physician developed a standard plan for treating severe malaria and instructed the attending nurse to administer the drug (CDC, 2022). The physician recommended IV artesunate, which is the first-line drug for the treatment of severe malaria in the US. Artesunate is approved by the FDA for the purpose and is readily available in the market.
The 36-year-old female patient refused IV antimalarial treatment stating that she only knows of oral antimalarial drugs. The patient began crying and shouting at the nurse when she tried to explain the benefit of the IV drugs. The nurse was in a dilemma whether to give the medicine or accept the irrational decision of the patient. The patient accuses the nurse of being rude to her and not giving proper reasons for rejecting her preferences.
The people involved include the physician, the nurse, and the patient. The patient has conflicting values and beliefs that are against those of the facility, the care providers, and the entire medical practice. The care providers follow standard medical practices, values, and beliefs (Pozgar, 2019). The nurse assumes that the patient understands her plan of care, hence, does not provide a clear explanation for the treatment regimen. The patient on the other hand rejects the treatment because she believes she needs to accept only treatments she knows more about.
It might have been helpful if the nurse was ready to take her time and explain the reason for IV antimalarial treatment to the patient in a respectable, compassionate, and polite manner. The patient believes in oral medication due to a lack of knowledge about IV artesunate. Patient education here was important. The nurse could have sought help from other care providers if she could not handle the situation (Pozgar, 2019). The patient felt diminished, despised, and disrespected. She felt that her preferences were not being considered. The nurse was supposed to practice autonomy and informed consent and politely explain to the patient the need to use IV treatment instead of oral drugs.
Additional information that could have been of help can be retrieved from the internet, on the websites of professional organizations, and in nursing journals. Professional organizations such as American Nurses Association (ANA) offer educational and learning materials to nurses regarding ethics and how to deal with ethical dilemmas (Pozgar, 2019). Furthermore, using databases such as PubMed, Google scholar, CINAL, and others, one can retrieve useful information about the main ethnical pimples in nursing to help professionals overcome ethical dilemmas (Pozgar, 2019). Another place to get useful information includes the national library. It has all kinds of textbooks regarding ethics in health care.
Recommendation to Correct the Dilemma using the Model of Culturally Competent Ethical Decision Making
Culturally competent ethical decision-making is a core element of providing quality healthcare (Andrews et al., 2020). The Model of Culturally Competent Ethical Decision Making emphasizes compassion, human rights, social justice, advocacy collaboration, and partnership. These are the primary principles that can be applied to resolve the issue. In that regard, the nurse needs to show compassion to patients in whatever way or level of interaction (Andrews et al., 2020). The nurse needs to practice respect for human rights, which protects the inherent dignity of everyone. The right to health is one of the most respected human rights. The right to information and informed consent also needs to be emphasized in health care. For instance, the patient has the right to receive information and consent before implementing the treatment regimen (Pozgar, 2019). Patients need to be accorded social justice by treating them equally, fairly, and appropriately, in terms of treatment, resource distribution, and conversation.
Collaboration and partnership with other care providers and the patient and family members are crucial in health care. In cases of ethical dilemmas, nurses should work in collaboration with other care providers and experts, such as the ethics committee, and patients or family members to solve such issues (Andrews et al., 2020). Advocacy should form the basis of decision-making to ensure patients’ rights are not violated. When making decisions, it is essential to maintain the individual’s core values and beliefs while negotiating those cultural differences that can hinder quality healthcare services (Andrews et al., 2020). Cultural re-patterning may be considered where applicable.
Conclusion
Ethical dilemmas are common in nursing practice, hence, nurses are required to have the ability and skills needed to overcome the problems. For instance, nurses must adhere to the provided ethical principles in nursing. Justice and patient autonomy with informed consent are important ethical principles. The model of Culturally Competent Ethical Decision Making provides some essential concepts needed to address ethical dilemmas.
References
Andrews, M. M., In Boyle, J. S., & In Collins, J. (2020). Transcultural concepts in nursing care (8th Edition). Wolters Kluwer.
CDC. (2022). Intravenous Artesunate for Treatment of Severe Malaria in the United States. https://www.cdc.gov/malaria/diagnosis_treatment/artesunate.html#:~:text=Per%20WHO%20guidelines%2C%203%20doses,of%207%20days%2C%20if%20needed
Pozgar, G. (2019). Legal & ethical issues for health professionals. Jones & Bartlett Learning.