Navigating Ethical Dilemmas in Nursing
Legal and ethical issues in nursing can be quite complex, and nurses do not always have clear and specific guidance as to the best actions to take. Instead, nurses rely heavily on the Nursing Code of Ethics, their healthcare leadership team and their own moral guidelines to navigate these challenging situations.
Understanding Ethical Dilemmas in Nursing
At its core, the nursing profession requires nurses to provide patients with personalized care that protects their safety, health and well-being. It sounds simple, but in reality, most nurses face ethical dilemmas on a daily basis. In an ever-evolving healthcare industry, it can be difficult to navigate ethical decision-making in nursing, making it important for nurses to develop a strong foundation on which they can build their career upon.
What Are Ethical Dilemmas?
Ethical dilemmas are defined by Science Direct as a challenging circumstance in which an individual has to consider their own moral foundation as well as the ethical impact of their choice. In nursing, most ethical dilemmas do not have clear and concise solutions, requiring nurses to rely on ethical decision-making models to make the best possible choice given the circumstances.
The Role of Ethics in Nursing
Ethics plays a critical role in nursing practice, especially considering the personal and clinical care that nurses provide their patients with on a daily basis. According to the American Nurses Association, nurses are frequently faced with ethical dilemmas, some of which require quick decisions during crisis moments, and others that require consultation with a larger healthcare team. Knowing the ethical principles in nursing and being familiar with nursing ethical decision-making models can help nurses navigate these dilemmas in a way that prioritizes the needs and preferences of the individual patient.
Common Ethical Dilemmas Faced by Nurses
While the Nursing Code of Ethics serves as a guide for nurses navigating ethical dilemmas on a daily basis, knowing how to manage the most common ethical issues in nursing can give you the confidence you need to work with your patients each day. These are the most common ethical dilemmas faced by nurses:
Patient Autonomy vs. Medical Recommendations
This common ethical dilemma requires nurses to consider the top two ethical principles in nursing and navigate through the Nursing Code of Ethics.
The first component of the Nursing Code of Ethics is patient autonomy, which refers to a patient's ability to make their own decisions about their health and well-being. Autonomy in nursing is critically important, particularly when it comes to allowing patients to make decisions that align with their cultural traditions and religious beliefs.
However, in some cases, a patient's decision may directly contradict medical recommendations. As the second component of the Nursing Code of Ethics, beneficence in healthcare requires nurses to do what is best for the good of the patient. When a patient's decision directly affects your ability to do your best for your patient, it can be morally distressing.
You can best navigate this common dilemma by actively working to listen to the patient and understanding their perspective and collaborating with the healthcare team. In the event that the patient stands by their decision, be sure to document the process to verify that you did your best to provide them with the medical care they needed.
Confidentiality and Privacy Concerns
Patient privacy is protected by law, requiring nurses to prioritize patient confidentiality at all times. If a patient confides in their healthcare provider, they have an obligation to keep that information secure and private. However, in some cases, the information that a patient provides may directly compromise the health and safety of themselves or others. In that case, you may have to work with your leadership team to determine the next best step.
End-of-Life Care and Advance Directives
Nurses working with terminal patients will frequently rely on end-of-life care ethics to navigate challenging situations and difficult decisions with their patients as well as their caregivers. If a patient's end-of-life wishes conflict with the family's preferences, nurses must emphasize patient autonomy and educate the family to help them understand the patient's perspective.
Resource Allocation and Fairness
Resource allocation in healthcare ethics can be particularly challenging, particularly in an era in which there are staffing shortages in hospitals and increasing patient volumes. If you are faced with a situation in which you must allocate resources according to priority patients, it is important to make sure that all patients are being considered equally, regardless of background. You should collaborate with members of the healthcare team to determine which patients require resources immediately while still balancing the needs of all patients in the facility.
Nurse Advocacy and Institutional Pressure
Nurses are more than just caregivers for their patients—they are advocates and they must be willing to stand up to institutional pressure that may compromise the health, well-being, or safety of the patients. Informed consent in nursing can be particularly challenging, especially when there is institutional pressure to obtain informed consent to streamline procedures and increase efficiency within the hospital system. You must actively work to ensure that your patients fully understand the treatment that they are receiving before they give informed consent, as this is the only way to protect their health and advocate for their preferences.
Strategies for Navigating Ethical Dilemmas
Navigating ethics in nursing practice can be complex, because there is not usually a black-and-white answer to any of these ethical dilemmas. By understanding the best strategies for ethical decision-making in nursing, you can become more confident in your skills as a nurse.
Applying the Nursing Code of Ethics
The Nursing Code of Ethics was first developed in the 1950s by the American Nurses Association, and while the code has been revised over the years to reflect technological advancements and cultural changes, it still serves as the primary guide for nurses navigating ethical dilemmas. The four key ethical principles of it are autonomy, beneficence, justice, and nonmaleficence.
Ethical Decision-Making Models
Ethical decision-making models provide nurses with a framework for making decisions that protect the preferences of the patient while prioritizing their healthcare needs. Most ethical decision-making models involve:
- Identifying the issue.
- Applying the Nursing Code of Ethics.
- Determining options for navigating the issue.
- Considering the consequences.
- Implementing the decision.
Collaborating With the Healthcare Team
As a nurse, you are often responsible for working directly with patients, but it's important to keep in mind that you are a member of a larger healthcare team. When faced with ethical dilemmas, it's essential to collaborate with other members of the care team to consider all facets of the dilemma and come up with a conclusive decision.
Seeking Guidance from Ethics Committees
For those truly exceptional ethical dilemmas, you can consult with the ethics committees at your healthcare facility. These committees can help you weigh the decisions available and determine the best course of action.
Resources for Nurses Facing Ethical Challenges
Nursing can be a harrowing profession, but it's important to remember that you are not alone. By relying on support and guidance as you navigate these ethical decisions, you can feel better about the path that you choose to take.
Professional Organizations and Support Networks
Professional organizations in nursing often offer support networks that allow nurses to connect with other healthcare professionals around the country. By joining these organizations, you have the ability to access a higher level of support, allowing you to receive the guidance you need.
Continuing Education and Training
By prioritizing continuing education and training, you can become aware of the cultural and societal changes shaping the healthcare landscape today. In addition, you can learn how to leverage advanced technology in nursing. Through continuing education and training, you can improve your skills so that you can make the best possible decisions for your patients and for yourself as a nurse.
Legal and Policy Resources
As you navigate ethical challenges in nursing, you will want to rely on legal and policy resources to verify that you are remaining in compliance with healthcare laws and workplace policies.
The Importance of Self-Care When Facing Ethical Dilemmas
Burnout is on the rise in the nursing profession, largely because nurses are faced with so many complex and distressing decisions on a daily basis. Self-care is playing an increasingly important role in nursing, and by taking care of yourself, you will be able to better care for your patients.
Managing Stress and Moral Distress
Establishing professional boundaries in nursing is key to managing your work-related stress and any moral distress that results from navigating ethical dilemmas in nursing. By compartmentalizing and allowing yourself to disconnect during your non-working hours, you will feel ready to take on these challenges.
Building a Supportive Work Environment
Cultivating a positive work environment requires collaboration on the part of nurses and healthcare leaders. When you work in a supportive environment, you will feel less intimidated by these ethical issues, because you will know that you have the support and guidance of your leadership team.
Learn How to Navigate Ethical Challenges in Nursing Practice at Indiana Wesleyan University
At Indiana Wesleyan University, we recognize that the ethical challenges in healthcare are growing more complex with each passing day, which is why we provide our nursing students with a faith-based foundation that will help them navigate moral distress in nursing with ease. Our nursing degree programs feature a modernized curriculum that effectively prepares nursing students for the current healthcare landscape, and our instructional model focuses heavily on the distinction of Christian nursing, which has long set the stage for effective patient care and improved outcomes.
Request more information about our degree programs and find your path forward today.
Sources
https://www.indwes.edu/find-your-program
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10353582/
https://www.shiftmed.com/blog/a-nurses-guide-to-ethical-dilemmas/
https://www.eruditenursing.education/navigating-ethical-dilemmas-in-nursing-practice/
https://nurse.org/education/ethical-dilemmas-nursing/
https://www.sciencedirect.com/topics/social-sciences/ethical-dilemmas
https://www.nursingworld.org/content-hub/resources/workplace/why-ethics-in-nursing-matters/
https://www.apna.org/news/a-systematic-approach-to-ethical-decision-making-for-nurses/
