Navigating Ethical Challenges in Nursing Practice: Case Scenarios and Moral Decision Making

QUESTION

Case One

You have been working at Sonivale Gardens Residental Aged Care for seven months of a year long graduate program. You enjoy the facility and have established rapport with the staff and residents. Sonivale Gardens has 38 single rooms. Clinton is an RN who moved to Sonivale from the city for a tree change and has worked in residental aged care for 15 years. Clinton has worked at Sonivale Gardens for two years. While you have become friendly with a few of the RNs, Clinton is quiet and tends to keep to himself. You have heard Clinton complain of back pain several times since you have worked at Sonivale and seen him taking tablets at the end of his night shift as you are coming on, but you had not thought anything of it. You have been added to a WhatsApp group with a few of the staff and you notice that there are several negative comments about Clinton and his ‘dodgy’ medication practices. On your next shift you are completing the medication count with Gwen (RN), when you notice the Panadiene Forte of a recently deceased resident are missing. Tanya (EN) is in the room and explains that Clinton took them out of the cupboard as they were no longer required. There is a line through the page and Clinton has written ‘deceased’.

Case Two You have been working at the Sonivale Super GP Clinic for five months as a new graduate nurse. You love the clinic environment and the variety of patients that access the service. You are working an afternoon shift and the clinic closes at 2100 hours. Today has been very busy but the last patient was seen at 2015 hours, so you are enjoying a quiet moment to file some documentaion. Your colleague Angela (Registered Nurse) has been at the GP clinic for 20 years through its evoluaton from regular GP practice to super clinic, is on one of the computers. Angela is respected for her extensive knowledge base and is highly regarded by the medical staff. As you walk behind Angela, you notice that she has a patient’s blood results open. Angela says to you, ‘I saw my ex’s new partner at pathology last week, and I want to know what’s wrong with her’.

There have been a number of high-profile cases in the media recently, which have highlighted the need for nurses to have a comprehensive understanding of their moral, ethical, legal and professional obligations in relation to their practice. We acknowledge that these cases have been extremely complex and distressing for those involved.

Throughout your career you will encounter situations which will call on your moral courage and decision making. This assessment task requires you to explore these as a beginning practitioner – and asks the question – what would you do and why?

ANSWER

Navigating Ethical Challenges in Nursing Practice: Case Scenarios and Moral Decision Making

Introduction

As a new graduate nurse working at Sonivale Gardens Residential Aged Care and Sonivale Super GP Clinic, I am faced with challenging ethical dilemmas that demand moral courage and decision-making skills. This essay will address two case scenarios that have ethical implications and explore the actions I would take and the reasons behind my decisions.

Case One: Medication Mismanagement at Sonivale Gardens

The situation at Sonivale Gardens involves concerns about Clinton’s medication practices and the missing Panadiene Forte of a deceased resident. Upon noticing negative comments in a WhatsApp group and witnessing Clinton taking tablets for back pain, I find myself in a dilemma.

Action and Rationale

Gather Information: As a first step, I would gather more information by speaking with Gwen and Tanya about the missing medication and Clinton’s behavior. It is crucial to obtain a clear picture of the situation before jumping to conclusions.

Report to Supervisor: If my investigation reveals any suspicion of medication mismanagement, I would immediately report my findings to my supervisor or the facility’s management. This is essential to ensure the safety and well-being of the residents.

Encourage Open Communication: I would encourage a culture of open communication among staff members to address concerns and report any irregularities without fear of repercussions. Encouraging transparency can prevent similar incidents in the future.

Case Two: Privacy Breach at Sonivale Super GP Clinic

The situation at Sonivale Super GP Clinic involves Angela, a respected nurse with access to patient’s private health information, inappropriately viewing a patient’s blood results due to personal reasons.

Action and Rationale

Address the Issue: I would approach Angela in a non-confrontational manner and express my concern about her accessing a patient’s confidential information for personal reasons. I would emphasize the importance of patient privacy and confidentiality in healthcare.

Remind of Ethical Obligations: I would remind Angela of our ethical obligations as healthcare professionals to protect patient information and maintain confidentiality. This includes adhering to the principles of privacy outlined in the Health Insurance Portability and Accountability Act (HIPAA).

Report to Supervisor: If Angela does not acknowledge her breach of privacy or continues such behavior, I would report the incident to our supervisor or clinic management to ensure appropriate actions are taken to prevent future privacy breaches.

Conclusion

Ethical dilemmas are a reality in nursing practice, and moral courage is essential to navigate these challenges. In both scenarios, my actions prioritize patient safety, privacy, and well-being. By promoting open communication, ethical decision-making, and adherence to professional standards, I aim to maintain the highest level of integrity in my nursing practice. As a beginning practitioner, I recognize the significance of ethical considerations in shaping my nursing journey and providing optimal care to patients.