Ethical Review of a Nurse

Ethical problems are some of the most difficult to handle appropriately because of their naturally sensitive nature.  Ethics require sound judgment, and adherence to rules that are not always as clear cut as laws.  Despite these difficulties, the issues are solved through the same dedication and resolve that other problems require.  Ethical issues often arise in the nursing practice due to the delicacy of patient caregiver interactions. Much like physicians ethics, it is the nurse’s duty to assist the patient to the best of their abilities, and to ensure that the workplace is beneficial for all patients.  Ethics can come into question in an individual’s own practice as well as observed issues in the practices of fellow nurses and doctors.  It is vital that these issues be considered from an objective standpoint and reported in situations where ethical codes are clearly broken.

I observed some questionable behavior from a fellow nurse that brought to mind various ethical implications.  The nurse displayed a lack of focus when dealing with patients and student nurses during her shift.  Although a lack of focus can be brought on by a multitude of different factors, in this case it almost hurt the patient the nurse was supposed to be helping.  A student nurse informed the nurse in question that the student nurse would be taking care of one of the nurse’s patients during her shift.  The student nurse was thus responsible for administering the patient’s medications.  Despite the student nurse’s disclaimer, the nurse in question proceeded with her administration of the patient’s medication.  The patient almost received a second dosage of medication from the student nurse, as the nurse in question forgot about the student nurse taking over the shift.  Lapses in concentration happen in the nursing profession, and ethical questions are brought to the forefront when possible drug use is involved.

The nurse may have forgotten the information the student nurse gave her due to drug abuse issues.  Administering the patient’s medicine inappropriately was not the only observed issue for the nurse.  She frequently took breaks of up to 20 minutes during her shifts, at which times she was unreachable.  The nurse was sometimes agitated with her patients and spoke inappropriately about them to the other staff members saying the patients were dramatic and entitled.  At one point a patient reported pain to me, which I relayed to the nurse.  The nurse downplayed the patients issue stating that the patient was simply lonely and was searching for attention.  Although patients can be difficult at times it is the nurse’s duty to respond appropriately to patients’ issues.  The nurse’s questionable actions indicate drug abuse.  American Nurse Today lists signs of substance abuse including “brief unexplained absences from the nursing unit” and “medication errors” (Thomas, 2011).  Possible drug abuse poses ethical issues, especially when patients are not receiving proper treatment.

Academic analysis yields multiple ethical problems with the actions of the nurse in question.  The major issue is that the quality of nurse’s patient treatment is suffering from possible substance abuse.  Provision one of Nursing World’s Code of Ethics speaks to a nurse’s duty to respect the patient’s lifestyle and choices ("Nursing world," 2010).  It is unethical to deny patient requests or dismiss them as trivial because the patient is seen as dramatic, even if such accusations are true.  The nurse dismissed claims of pain because the patient was lonely and needy, and by denying the patients’ needs the nurse further violated provision one of the code.

Provision four gives additional ethical grounding against the nurse’s treatment and diligence with the patients in question.  The primary line of the provision states that “the nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse's obligation to provide optimum patient care” ("Nursing world," 2010).  A failure to responsibly assign tasks to student nurses is in conflict with the provision.  The nurse must take responsibility for her actions, and responsibility for the causes of such actions, which in this case related to substance abuse.  The nurse cannot provide optimum patient care while impaired from substance usage and was not able to properly assign tasks either.  A failure to treat patients with the respect detailed in provision one is again the nurse’s responsibility and breaks ethical codes that are vital for nurses to follow.

From a personal standpoint, the nurse’s actions are unethical, especially when considering possible substance abuse as a primary cause.  A person under the influence of drugs is not able to provide optimal care for their patients.  The results can arise in a multitude of forms.  Failing to remember student nurse assignments and ignoring patient requests are harmful to a patient’s wellbeing.  A nurse who is jeopardizing patient health because of substance abuse is in full violation of my personal code of ethics.  Substance abuse is a health concern in and of itself, and it seems foolish for a nurse to be committing fully to helping others when they are in need of help themselves.  The nurse in question clearly is not giving her full attention to patients during her shifts.  She is unresponsive and takes breaks during times when she is supposed to be committed to her specific group of patients.  

In the situation where the patient reported pain, the nurse failed to intervene before pain increased ("Pain management policy," 1999).  I was able to assist the patient through no meditative means, making the nurses failed appearance additional disconcerting ("Pain management policy," 1999).  Again, the end result is that patient care suffers.  Substance abuse simply cannot be a working part of a nurse’s profession.  An impaired person affects the entirety of the staff, not just themselves.  The failure to properly delegate tasks can cause issues for the other nurses and students, magnifying the problems of substance abuse in the workplace.  I cannot ethically condone the nurse’s treatment of patients, especially if such actions were affected by substance use.  In the described examples the nurse is not giving proper consideration and attention to the patient, and that alone breaks ethical codes.

Although ethical problems arise often in the nursing environment, the analysis of these problems must be thorough and as objective as is humanly possible.  It appears that the nurse in question is a substance abuser, and that patient care is suffering because of said abuse.  In this case the nurse is breaking a variety of ethical codes both from an academic and personal standpoint.  She must improve upon her patient treatment, in addition to stopping the substance usage.  Nonetheless, it is vital to remember that humans make mistakes, and to not jump to conclusions on any particular case.  Harshly reporting a set of events could end an individual’s career, and any spinning of a story creates ethical problems on both sides.  It is important to report cases of substance abuse and unethical patient treatment in order to ensure that patients receive optimal care.  The reports must simply be done in as objective a manner as possible, in order to prevent the jading of any perceptions that are garnered from such reports.

References

Nursing world. (2010, Nov 15). Retrieved from http://nursingworld.org/FunctionalMenuCategories/AboutANA/Leadership-Governance/Nursing-Code-of-Ethics.pdf

Pain management policy. (1999, March). Retrieved from http://www.docstoc.com/docs/document-preview.aspx?doc_id=24187160 

Thomas, C.M. (2011, August). American nurse today. Retrieved from http://www.americannursetoday.com/article.aspx?id=8114&fid=8078