Nursing homework help
It has often been stated that once the APRN enters into the exercise of functions, it is committed to the willingness and responsibility to participate directly and get involved in the resolution of a conflict of an ethical nature instead of being one more observer, and passively being part of the group of “analysts” of some problem of an ethical dilemma.
The confusion between moral anguish and ethical dilemma is very frequent. Although they are used interchangeably, they are very different: ethics is related to the “rules of the game” provided by a third party (for example, religious principles or codes of conduct in the workplace). On the other hand, morality has more to do with the principles of each person concerning good and evil (Hamric, 2010).
Within the practice of care, the ethical dilemma is often present. In an ethical dilemma, there are at least two possible actions valid and approved from the ethical point of view, the conflict lies in which is the most convenient to provide and the most accurate care to the patient. On the other hand, when the provider knows which activity to be carried out, he feels powerless to carry it out due to circumstantial pressures, such as the norms of the Institution, supervision of another provider, among others; this constitutes moral distress, which colloquially we could express as frustration (Epstein, E.G., Delgado, S. (2010).
I would like to describe something that happened to me during my first work experience as an RN here in the United States, Florida. My first job as an RN was as a school nurse in a Middle School, where care work was not very demanding or very complicated, it consisted of evaluating and doing some simple cures of scrapes, simple blows, some ankle sprains, among others. The school nurse has to manage some cases of diabetic children for control and registration of their glycemia and insulin administration, if necessary, a couple of patients for gastrostomy feeding (G-Tube), and a couple of children with Attention Deficit and Hyperactivity Disorder (ADHD) to give them their daily dose of prescribed medication. Nursing homework help
One of these dilemmas came to me one early morning when a girl doing some pirouettes suffered from a dislocation of the patella in her right knee; when we were warned we immediately went to see the situation and I find the girl sitting on the floor of the gym halfway, lying on the head of the classroom staff, she had the knee affected in semi-flexion without being able to extend it, with much more fright than pain, so I could appreciate. However, She was very anxious and scared, and all the staff very tense.
I must point out that in my country Venezuela, I worked as an Orthopedic Surgeon for more than 30 years, and I am very accustomed to the management of fractures, dislocations, and a large number of musculoskeletal injuries during the time of exercise in Public and Private Institutions. As you know, my country is falling apart, and we decided to emigrate.
My ethical dilemma consisted at that time, that as a Specialist in Orthopedics of Adults and Children I felt fully qualified to solve a situation, which from the musculoskeletal point of view was not very demanding and the girl was sore and very anxious, but in the Institution where I was the scope of practice of School Nurse did not contemplate any type of manipulation. When I commented that I could solve it and that it was not complicated, all the Staff prevented me from doing it, since it did not “correspond” to me. I limited myself to applying physical measures, such as ice, and helping the staff provide a little more comfort to the student, while the 911 team was present, which had already been notified. “what a great frustration.” That is, the two alternatives I had were: solve the problem to alleviate the situation of the that I knew how to do it safely, or minimal intervention, such as physical measures and the patient comfort that was what I had to do.
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In the end, already with her mother present, who had participated, the student was transferred to the ER of the nearby hospital, by fire departments, with her knee locked …
To conclude, I would like to add that there is evidence to suggest when faced with ethical decisions, several mental processes that are not found in our conscious consciousness are activated (some mention intuition) and will be subject to the emotional state of the moment of the person involved (Guzak, 2015).
It has been proposed that the APRNs providing primary medical care must know the ethical foundations to face the conflicts of daily professional activity; however, studies show that not much is known in the practice of ethics and the factors that are related to quality care. Therefore, addressing practice environments with restrictions and investing in ethics education will improve the quality of care, teamwork, and more collaborative exercise.
References
Epstein, E.G., Delgado, S. (2010). Understanding and addressing moral distress. OJIN: The Online Journal of Issues in Nursing, 15(3).
Hamric, B. A., Hanson, M. C., & Tracy, F. M., & O’Grady, T. E. (2019). Advanced practice nursing: An integrative approach (6th ed.). Elsevier. ISBN: 978-0-323-44775-1
Neumann, J., Counts, V., & Jernigan, C. (2019). The Role of Oncology Nurses as Ethicists: Training, opportunities, and implications for practice. Clinical Journal of Oncology Nursing, 23(1), 103–107. https://doi.org/10.1188/19.CJON.103-107 (Links to an external site.)
Ulrich, C. M., Zhou, Q. (Pearl), Hanlon, A., Danis, M., & Grady, C. (2014). The impact of ethics and work-related factors on nurse practitioners and physician assistants’ views on quality of primary healthcare in the United States. Applied Nursing Research, 27(3), 152–156. https://doi.org/10.1016/j.apnr.2014.01.001 (Links to an external site.) Nursing homework help
