Nursing practice involves dealing with complex situations that are hazardous to ethical practice.

# 1

Nursing practice involves dealing with complex situations that are hazardous to ethical practice. An ethical dilemma is when a nurse has to choose between two or more competing values, each with consequences (Haahr et al., 2019). A further analysis of an ethical dilemma encountered during practice reveals the experience and its resolution.

The dilemma faced during practice involved a 27-year-old single mother of one who was brought to the healthcare facility by her mother. L.K. came to the hospital with symptoms that raised concern from the time she started explaining them and on further assessment. First, she had a high temperature, which made her feel hot while shivering simultaneously. The patient indicated feeling tired and had no energy for a while. A loss of appetite was also reported, in addition to a weight loss she could not explain. The patient indicated that she had lost at least four kilograms in the past two weeks, which worried her. Her major complaint was the itchy skin accompanied by darker pee and yellowing of the white of her eyes. The physician on duty conducted assessments on her and insisted she undergo an assessment focusing on her pancreas. Her results revealed that she had pancreatic cancer. However, her mother insisted we should not reveal the truth to the patient. She insisted the patient had gone through a lot of challenges in her past and had been suicidal. The mother insisted that revealing her condition to her would have a detrimental impact on her. As nurses, the challenges faced were between telling the truth to the patient or being deceptive. Interaction with other healthcare professionals further revealed the difficulty of dealing with this ethical dilemma.

The resolution of the above dilemma follows the patients’ and nurses’ fundamental rights as the guiding principles in addressing the complex situation. According to Inkeroinen et al. (2022), the fundamental rights of the patients include their right to know the truth. The fundamental right, therefore, dictates that the nurses reveal their condition to the patients. Also, part of the fundamental rights includes the right for the healthcare personnel, including nurses, to remain true to their profession, which dictates the practice of fidelity and non-maleficence. The principle of non-maleficence emphasizes the need to prevent patients from harm with moral rules such as not killing and inflicting pain or suffering, not causing offense, incapacitating, and depriving patients of a good life arising under it (Varkey, 2020). Denying the patient information on their health condition may result in negative consequences, including denying them the right to better plan to improve the quality of their lives. Also, the patients and their family members deserve to know the facts surrounding their illnesses, whether bad or good. Nurses and other healthcare professionals have an ethical obligation to reveal the truth to patients so that they can make informed decisions. Examining the above and ethical practice components for nursing practice resulted in telling the patient the truth.

The ethical dilemma faced in healthcare practice presents two sides, each having consequences. Telling the patient the truth about their health condition had consequences and was unethical conduct. However, not telling the patient the truth about their health condition further exposed them to additional deprivations that would have amounted to unethical conduct. The two sides had consequences. Nonetheless, revealing to the patient the true nature of their health condition was ethically sound.

# 2

In healthcare, nurses, like other healthcare providers, face situations where they have to refer to nursing ethical principles in difficult situations (Gebreheat & Teame, 2021). This often calls for the nurse to recognize their values and their professional obligations. An ethical dilemma can therefore be described as a situation whereby a person has to choose between two conflicting options, neither of which results in a manner considered ethical or favorable. The nurse should be aware that no matter what choice they make, there will be consequences. Because the American Nurses Association (ANA) recognized that ethical dilemmas are part of nurses’ everyday practice, they developed the nurse’s code of ethics to act as a framework for helping nurses during situations of ethical dilemma (Lee & Kim, 2020). As a result, every nurse must become familiar with the code of ethics for nurses.

According to experts, for an ethical dilemma to occur, there must be three conditions (Ricciardelli et al., 2022). The first situation is where a person is required to decide what the best action is to take. The second condition requires that there should be two or more choices that a person is required to choose from (Taşkıran & Turk, 2023). The third requires that the outcome of any of the choices made should not be favorable and result in negative consequences. Ethical dilemmas present themselves in different forms and due to different reasons, which require the nurse to be able to effectively differentiate between personal and professional.

During my clinical practice, there have been situations of ethical dilemma that I have experienced. However, one situation that stands out was while providing care to a fifteen-year-old boy who, after collecting his personal history and having diagnostic tests conducted, was identified to have chlamydia, a sexually transmitted infection. From the beginning, the patient requested that he be examined and diagnosed privately, as he did not want his parents to know he was sexually active. His mother agreed to wait in the waiting room but was eagerly waiting to know what the condition was with her son. However, after learning of his diagnosis, the patient requested that the attending physician and nurse not inform anyone about his condition, including his mother. The dilemma in this situation developed when, as a nurse, I was required to determine whether it was appropriate to inform the mother of the patient’s STI status. On one hand, it is important to uphold confidentiality, including for adolescents, as the law requires that adolescents be provided confidentiality in healthcare. However, for the patient to receive the appropriate treatment and support, the mother needed to be notified of his condition. Because the adolescent was old enough and capable of giving consent regarding his healthcare, I was obligated to adhere to patient-provider confidentiality. I had to provide this information about confidentiality to the mother as well as encourage the mother to have open communication free of judgment with the adolescent if she wanted to learn about her son’s condition and provide the necessary support.

You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
All replies must be constructive and use literature where possible.

Grading Rubric

Your assignment will be graded according to the grading rubric.

Discussion Rubric
Criteria Ratings Points
Identification of Main Issues, Problems, and Concepts

Distinguished – 5 points
Identify and demonstrate a sophisticated understanding of the issues, problems, and concepts.

Excellent – 4 points
Identifies and demonstrate an accomplished understanding of most of issues, problems, and concepts.

Fair – 2 points
Identifies and demonstrate an acceptable understanding of most of issues, problems, and concepts.

Poor – 1 point
Identifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts.

5 points
Use of Citations, Writing Mechanics and APA Formatting Guidelines

Distinguished – 3 points
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.

Excellent – 2 points
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.

Fair – 1 point
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.

Poor – 0 points
Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention.

3 points
Response to Posts of Peers
Distinguished – 2 points
Student constructively responded to two other posts and either extended, expanded or provided a rebuttal to each.

Fair – 1 point
Student constructively responded to one other post and either extended, expanded or provided a rebuttal.

Poor – 0 points
Student provided no response to a peer’s post.

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