Ethical Dilemmas in Nursing Practice

This assignment delves into the complex ethical considerations nurses encounter in their practice. The provided list of scholarly articles covers a range of topics, from recruitment and consent for vulnerable populations to the ethical implications of artificial nutrition and hydration. The materials also explore the emotional burden of keeping information from parents, caregiver experiences with dementia patients, and factors influencing nursing student incivility. Furthermore, the readings examine ethical frameworks for decision-making, the impact of compassion on nurse well-being, and the moral challenges posed by economic pressures in healthcare.

INTRODUCTION TO PROFESSIONAL NURSING

The Code of Ethics for Nurses in Australia are useful in terms of managing the profession
of nursing. This is relevant to all the levels of nursing and different area of practice that
encourages the value of clinical practice and service delivery procedure (Sinclair, Papps &
Marshall, 2016). The framework has included several guidelines that are essential to be
considered by the nurses especially at the time of treating different patients. However, at the
same time, it is also crucial for the nurses to refer to professional code of conduct wherein the
associated persons are required to act in professional capacity. It is generally accepted that while
performing any role and duties, professional standards needs to be maintained in the domain of
nursing (Rockingham, 2016). This states that the nurses are required support and assist the
patients so that all the issues faced by patients can be resolved suitably.
According to the present case, nurse working in health care organisation of Australia has
observed that one of the colleagues is looking after an elderly patient who is highly confused and
who finds more risks of fall (Weiss, Malone, Merighi & Benner, 2016). Further, it is also
observed that in order to manage this situation, colleague ties the patient to a chair so that to
avoid the risk of falls. Thus, on the basis of observation, it can be said that such sort of practice
should not be practiced in the profession of nursing as this lies under unethical aspects. Thus, for
the witness nurse, it is essential to follow all the codes of ethical practice so that value of nursing
profession can be enhanced. Therefore, professional standards define the practice and behaviour
of nurses and midwives which comprises of code of conduct, code of ethics, guidelines to
professional boundaries and standards for competency services (Moule, Aveyard & Goodman,
2016).
Thus, according to Section 6, registered nurse is required to focus on providing safe,
appropriate and responsive quality nursing practice so that interest of patient can be protected. In
this context, registered nurse should provide and delegate best quality services so that health
aspects of patients can be managed (Coyle and Ferrell, 2016). At the same time, nurse should
also focus on ethical goal- directed actions where in suitable care should be delivered to the
elderly patient. Regulation placed in Section 6 is based on comprehensive and systematic
assessment and this is also useful in getting appropriate outcomes as per the service provision
(Hammar, Swall & Meranius, 2016). Under Nursing and Midwifery Board of Australia, the
registered nurse is entitled to provide comprehensive, safe and quality services to attain the
agreed goals and outcomes which are associated to the nursing requirements of people.

According to the legal framework, nurses must conduct all the activities within the scope
of practice as this is also vital in terms of maintaining the interest of patients. Similarly, nurses
must also provide effective and timely direction and supervision to the elderly patient (who is at
risk of falls) for the purpose of ensuring that suitable services are being delivered in safe and
correct manner (Andersson, Petersén, Graff & Edberg, 2016). Similarly, in this context
registered nurse must also use the appropriate processes for the purpose of identifying and
reporting potential and actual risk related system issues. Thus, carrying out the same thing can
assist the registered nurses to analyse if the colleague is still adhering to unethical practices.
There, looking towards the present case, it can be said The Code of Ethics for Nurses in
Australia must be adhered because it is designed for managing the profession of nursing. As per
the framework, registered nurse must value quality nursing care for all people so that
(Barkhordari-Sharifabad, Ashktorab, & Atashzadeh-Shoorideh, 2017). At the same time, nurse
must also focus on maintaining kindness and respect for self and others. For instance- if any of
the colleague is following unethical practice, then nurse must report that to the senior authority.
Proper action can be taken in the same area so that the value of nursing profession can be
enhanced. Besides this, nurses should also focus on professional boundaries which separate the
therapeutic behaviour of the nurse from any behaviour. These boundaries are essential since that
gives a sense of legitimate control in a relationship (Buka, Davis & Pereira, 2016). Professional
boundaries are chiefly adopted because that aids the nurse to set several limits in relationship
formation.
Regarding this, it can also be said that there must be proper therapeutic connection
between the nurse and the patient (who is at risk of falls). It also states that care is improved
when nurses and the patients do not engage in dual relationships (Carey & Griffiths, 2017). Thus,
up to greater extent, it is crucial for nurses and patients to avoid dual relationships. Nonetheless,
in this domain nurse must also comprehend the complexities which may develop if professional
relationship exist among nurse and patients. In this case, the colleague has performed an
unethical act; therefore according to monitoring aspects, nurses must examine any boundary
crossing which have other implications on service provision (Coyle & Ferrell, 2016). Nurses can
also seek support and guidance from professional leaders when they have consideration about the
boundaries in therapeutic relationship.

For instance- the elderly patient is at risk of falls; hence considering this aspect it is
crucial for the nurses to involve the patient in decision making process so that appropriate
actions can be taken accordingly. In this respect, legal framework of The Code of Professional
Conduct for Nurses in Australia can be adhered (Druml and et.al., 2016). Such code is essential
to be applied because that has determined standards for professional practice and that is also
expected to uphold while maintaining the provision of good practice. In this legal aspect, nurses
are requisite to support the health and wellbeing and informed decision making of people that is
expected to get care. Therefore, as per the framework, nurses must promote and preserve the
trust and privilege that is inherent in the relationship among nurses and the patients (Hammar,
Swall & Meranius, 2016).
On the basis of above discussion, it can be said that professional guidelines are required
to be followed in the practice of nursing so that value of heath care services can be enhanced.
Moreover, this is also essential in terms of enhancing the effectiveness of ethical values and
norms. On the basis of theoretical perspective, The Code of Ethics focuses on four major
guidelines which are different in all the value statements (Holloway & Galvin, 2016). As per the
case, Value Statement 6, can be applied which states that nurse must develop safe culture which
focuses on shared knowledge and understanding of health and safety aspects. In this respect,
focus should be laid on four major dimensions such as self, person, colleagues and community.
The dimension of self-states that nurses must value safe practices and safe working
environment and they should also share knowledge and skills with others. This is essential in
terms of developing learning aspects among other people working in health and social care area.
At the same time, nurses also possess moral and legal right to develop safe environment for self
and patients (Ibrahim & Qalawa, 2016). They need to conduct this without developing any sort
of fear for their own safety. Therefore, this is the way through which nurses can value the
management of competence in contributing to a safe care and practice environment. Further,
nurses also hold several responsibilities towards the patient (elderly patient who is at risk of
falls). Thus, looking this concern, nurse should recognise that people are vulnerable to injuries
and illness; thus they must be prevented from all sorts of harms and hazards. Nurses play
imperative role in identifying the impact of adverse events in health care settings which support
and participate in systems where people are at risk of harm (Mallari, Grace & Joseph, 2016).

Nurses also seems to contribute in the confidential reporting of adverse events; hence
according to the present case, it is essential for the registered nurse to report about the acts of the
colleague especially while observing unethical practices. In this respect, it can be said tying a
patient from chair merely to prevent risk of fall brings more issues in care services for the elderly
patient (Moule, Aveyard & Goodman, 2016). Significantly, since the case is focusing on the
wrongdoing of colleague; therefore the nurse must ensure that they are also following safe
practice. In this way, nurse can support the development of a safer health care system through
non-punitive human error.
At the same time, nurse should also identify their own errors and risks so that
improvement can be facilitated accordingly (Rantanen and et.al., 2016). In this way, it is evident
that adhering to such things could assist the nurses to reach towards the determined aim and
objective. Last dimension is community which denotes that nurses must act through industrial
and professional organization’s authorities. At the same time, they should also participate in
developing and improving safety and security for patients. Alongside, this also includes actively
promoting the provision of equitable and culturally responsive services (Rockingham, 2016).
Nurses must also value ethical management of information which includes management of
professionalism in the practices of nursing.
Nursing is associated with a variety of legal and ethical implications that duly
necessitates the care workers to strictly follow the same. It is where ethics is duly referred to be
an integral part of nursing with a special context of the recent scenario where the Australian
nurses are continually dealing with a wide range of ethical dilemmas while practising their daily
activities. Where in the present case, the nurse is dealing with a patient is dealing with a
significant issue of risk falling (Johnstone, 2015). Due to which, a nurse is certainly required to
assist this patient in attempting all routine activities. However, this in turn has become an
annoyed task for the nurse for which, the patient is now tied to the chair whenever an assistance
is required to be given. It is however a clear indication of an unethical practice by the nurse that
duly violates the foremost ethical principles among the six fundamental ones. It is where the
nursing ethics rotates around the concept of a collaborative care by the nurses where the patients
have a prior right of being physically independent whenever and wherever possible.
It is in inclusion of human rights component that is in turn needs to permit them to be
informed with a prompt and withholding consent. It is where this law of being informed lies

within the ethical belief of autonomy by outlining a minimal criterion of behaviour that must be
accepted by the assemblage. It is in support of yet another substantial fact where abidance to the
legislative law is a mandatory outlook in nursing practices (Green and et. al., 2015). However,
conformity with the ethical belief's of liberty should be applied at individual level within nursing
practices. It is with yet another general compliance where the nurses in concord to their
Australian nursing practices are required to abide by the request made by the patients even if
they are not getting agreed to it on personal level. It is with a fundamental sense of ensuring
justice with the service users who must be evenly treated by them care providers.
On the basis of above study, I can say that the study has improved my personal and
professional capability and it has also changed my critical thinking. If I would be at the position
of a nurse, then I would have considered the requirements of ethical and professional codes as
that highly strengthens the practices of nursing (Sinclair, Papps & Marshall, 2016). I can say that
all the relevant sections are required to be applied so that patient in the present case can be
provided suitable services. In this realm, it can also be said that being a registered nurse, focus
should be laid on delivering quality services. Nurses must also maintain respect, dignity and
value for the patients under all the value statements. For instance- instead of tie, nurses could
have used several tools to get indication about the risk of fall. Thus, accordingly there are various
solutions to this problem which I would have used. Moreover, in this area it is also crucial to
ensure that focus is laid there on quality services for meeting all the requirements of the patient
(Weiss, Malone, Merighi, & Benner, 2016). Henceforth, in this way I would be managing all my
roles and duties in the above discussed ways.

REFERENCES
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