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Importance of Ethics in Nursing

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There is no field of social activities that does not deal with ethics, and that is why the field of nursing is not an exception in any way. In fact, ethics in nursing practice play a crucial role in delivering the appropriate services and communicating with patients. In patient care, ethics help to regulate interpersonal relations and define the line between the right and wrong decisions. The knowledge and application of ethical code of nursing helps to avoid professional mistakes and satisfy high quality of services and interaction with patients for the sake of effective management and treatment.

Application of ethical norms in nursing and patient care, in particular, leads to many positive results and effects. To start with, it is beneficial for interpersonal relations between nurses and patients, meaning that it helps to build trustful cooperation, to resolve emerging conflicts, to create the atmosphere of mutual respect and involve patients in active treatment of diseases. It is important to remember that ethics strongly contributes to medical efficiency and fruitfulness (Shahriari et al., 2013). For instance, the preservation of ethical norms in patient care helps to gather sufficient evidence about patient’s health, needs and possibilities, prescribe the needed medicine and choose the optimal way of treatment (Lowe, 2015). The ethical behaviors of nurses also assist in a better understanding of patients’ psychology and interests, which contributes to amelioration of services provided.

Moreover, ethics contributes to the preservation of justice in nursing practices. Nurses should behave not only morally, but also objectively and fairly in all situations. Ethics, as a tool of reaching justice, means the opportune and sufficient revelation of facts, reliability, respect and responsibility to provide truthful information and services (Lowe, 2015). Besides, ethics is the key principle, which identifies the line between objective and subjective attitudes to the situation and ways of its solution (Mitchell, 2016). Therefore, the ethical principles help nurses to behave objectively and to stick to the general regulations and rules, rather than stick to sympathy and personal emotions.

In my experience, I encountered an ethical dilemma of honesty and truth telling, when it comes to communication with patients. One of my patients was diagnosed with a serious disease, which demanded elaborated treatment and could even have led to lethal consequences. The family of a patient asked the involved staff not to inform him about the threatening diagnosis, claiming that it would strongly upset him and could lead to emotional and psychological distress. The family decided to keep the diagnosis in secret, and, in such a way, to protect the patient from additional worries and from depressing mood. Apparently, the patient did not know about the request of his family and had frequently asked about the test results, which could have revealed his health condition. Besides, the patient always demonstrated increased attention to treatment measures and asked many questions regarding biological and physiological aspects of his health conditions and principles of the suggested treatment plan. In other words, he always wanted to know the actual information about the progress of the disease, as it helped him to better realize the situation and prepare himself for potential outcomes. However, I guess I could understand the positions of both – my patient and his family, and it was difficult to handle this ethical dilemma.

The emerged situation questioned a couple of important principles in nursing ethics. First, it directly questions the principle of honesty. Ethical code of interpersonal behavior and nursing, in particular, highly emphasizes the importance of honesty, as the preliminary condition of respectful and trustful cooperation (Robinson-Papp, & George, 2015). Honesty is not a mere trait of character, when it comes to nursing. Hiding the actual information or reporting only partial truth may lead to serious mistakes in treatment and to the deterioration of quality of healthcare. Apart from that, the revelation of lie will seriously worsen the trust relations between nurse and patient. Thus, honesty is one of the primary ethical principles, which has been doubted in this exact case.

Second, the case relates to the principle of confidentiality and privacy. According to the nursing code of ethics, it is of paramount importance to satisfy the need in confidentiality and non-revelation of personal information of patients. The exceptions can be made in special cases, depending on the context of treatment and mental conditions of patients (Baines, & Edwards, 2015). For example, the concept of “therapeutic privilege” states that healthcare staff should avoid telling diagnosis to the patient, if it can evoke strong negative reactions, such as chronic depression, suicidal behavior, and etc. (Hodkinson, 2013). However, in most cases, ethics claims the importance of confidentiality of information, meaning that nurses are obliged to report important information about health only to patients themselves.

Third, I suppose this case deals with the ethical principle of trust. In contrast to honesty, trust reflects on the kind of relations between patients and nurses, and, therefore, it demands mutual efforts and responsibilities (Din?, & Gastmans, 2013). The lack of trust in nursing may lead to inappropriate diagnosis, misunderstanding of patient’s health conditions and needs, and insufficient communication, essential for the relevant treatment plan (Cannaerts et al., 2014). In this case, telling the truth to the patient was the matter of trust, as it was the sign of respect and liability.

I have chosen to tell the truth to the patient, after having an explanatory conversation with the family and proving the importance of such a decision. In my opinion, behaving in another way would mean the violation of ethical code and norms of nursing. It is true that some exceptional cases require healthcare staff to avoid telling the truth to patients for the sake of their welfare and emotional stability (Murray, & McCrone, 2015). However, the background for such cases are thorough examinations of psychological health of patients, sufficient evidence about unstable emotional health, or legally authorized claims from caregivers (Grace, 2017). In that situation, there was no evidence to make conclusions about poor psychological heath of the patient and his inability to bear with the news. Therefore, there were no reasons to hide the truth and use relatives as mediators in that particular situation.

Moreover, the analysis of researches and studies of ethical aspects in nursing clearly shows the significance of honesty and trust in the patients-nurses relationships. For example, the majority of patients would like to know about cancer diagnoses, even if they are terminal or incurable (Matsuyama et al., 2013). More than 90% of surveyed nurses believe that it is logical, ethical and correct to inform patients about the actual diagnoses, rather than communicate indirectly through their family members (Tang et al., 2017). In these terms, I believe that telling the truth to patients is the core of trustful and ethical relations between nurses and patients, which can guarantee fruitful cooperation and communication.

To conclude, it is difficult to underestimate the role of ethics in nursing practices, as nearly every situation in healthcare deals with some kind of ethical implications and constraints. I have experienced the ethical dilemma of truth telling in the working relations with my patients. After the consideration of ethical principles and general ethical regulations in nursing, I have concluded about the necessity and importance of telling the truth. On the one hand, this decision perpetuates the idea of opportune and sufficient informing of patients on conditions of trust, honesty and responsibility. On the other hand, the refusal to tell the truth would result in the lack of respect and trust, which could have deteriorated the quality and efficiency of my services in regards to the patient.

References

Baines, S., & Edwards, J. (2015). Considering the ways in which anti-oppressive practice principles can inform health research. The Arts in Psychotherapy, 42, 28-34.

Cannaerts, N., Gastmans, C., & Casterl?, B. D. D. (2014). Contribution of ethics education to the ethical competence of nursing students: educators’ and students’ perceptions. Nursing ethics, 21(8), 861-878.

Din?, L., & Gastmans, C. (2013). Trust in nurse–patient relationships: A literature review. Nursing Ethics, 20(5), 501-516.

Grace, P. J. (2017). Nursing ethics and professional responsibility in advanced practice. Jones & Bartlett Learning.

Hodkinson, K. (2013). The need to know—therapeutic privilege: A way forward. Health Care Analysis, 21(2), 105-129.

Lowe, N. K. (2015). Nursing, Nurses, and Ethics. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 44(3), 339-340.

Matsuyama, R. K., Kuhn, L. A., Molisani, A., & Wilson-Genderson, M. C. (2013). Cancer patients’ information needs the first nine months after diagnosis. Patient education and counseling, 90(1), 96-102.

Mitchell, P. H. (2016). Nursing ethics and social justice. International nursing review, 63(1), 1- 2.

Murray, B., & McCrone, S. (2015). An integrative review of promoting trust in the patient– primary care provider relationship. Journal of advanced nursing, 71(1), 3-23.

Robinson-Papp, J., & George, M. C. (2015). Trust and the ethics of chronic pain management in HIV. The Journal of the Association of Nurses in AIDS Care: JANAC, 26(5), 509.

Shahriari, M., Mohammadi, E., Abbaszadeh, A., & Bahrami, M. (2013). Nursing ethical values and definitions: A literature review. Iranian journal of nursing and midwifery research, 18(1), 1-8.

Tang, W. R., Hong, J. H., Rau, K. M., Wang, C. H., Juang, Y. Y., Lai, C. H., … & Fang, C. K. (2017). Truth telling in Taiwanese cancer care: patients’ and families’ preferences and their experiences of doctors’ practices. Psycho?Oncology, 26(7), 999-1005.