This assignment discusses the concept and importance of bioethics and laws in healthcare, and reflects on important events where ethical dilemmas were faced and overcome with critical reasoning skills.
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Running head: REFLECTION ASSIGNMENT PART TWO REFLECTION ASSIGNMENT PART TWO Name of the student: Name of the university: Author note:
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1 REFLECTION ASSIGNMENT PART TWO Introduction: Nursing professionals have the duty in providing their clients with high quality and safe care that aligns with the preferences of the patients and makes them satisfied. Nurses are however confronted with different ethical challenges in their professional practice and therefore, it is expected of them to be familiar with different ethical codes of conduct as well as the different essentials of ethical decisions making. The International council of nurses for the nurses first adopted the first international code of ethics for the nursing professionals in the year 1953. The nursing midwifery board of Ireland had developed the Codes of ethics for nurses in Ireland outliningthecommitmentof thenursingprofessionin respecting,promotingaswellas protecting and upholding the fundamental rights of the people who are both the recipients and even the providers of nursing and healthcare (Vryonides et al., 2015). This assignment will discuss the concept and importance of bioethics and laws in healthcare in details. It will also reflect on important events where I faced ethical dilemma and how critical reasoning skills helped me overcome dilemma with application of correct principle and ethics. Bioethical principles: Studies have defined bioethics as “the field that remains concerned with basic human values like that of the rights to life and health as well as the rightness or wrongness of certain developments in healthcare institutions, medicine, life technology, health professionals and responsibility of the society for life and health of the members” (Holloway & Galvin, 2016).. Nurses need to develop an environment of mutual trust and respect between the patients and professionals. Studies opine that as patients entrust their dignity to that of the nurses, nurses also need to guard their privacy and thereby listen to their concern (Butts et al., 2019). The important
2 REFLECTION ASSIGNMENT PART TWO principles of ethics that every nurses need to be knowledgeable of are the autonomy and dignity, justice, beneficence and non-maleficence as well as privacy and confidentiality (Preshaw et al., 2016). The Codes of ethics act as guides mainly as the non-negotiable standards of ethics that nurses need to follow. It also acts a reminder of the commitment of the nurses towards the society. These codes help nurses in continuing their services with their learning and evidence- based practices. First case scenario: During the time of placement, I got the opportunity of caring for an old man named Jeremy Smith who was 85 years old. He was found to be non-compliant with the nursing healthcare professionals. His wife stated that he was treated unprofessionally by the nurses of another healthcare center. He had felt humiliated and insulted the last time he suffered from chest pain. This had made him dislike healthcare professionals and he was also not ready to be admitted to out hospital as well. I understood the situation and understood that the previous organization’s healthcare professionals had not maintained the bioethical principles of autonomy and dignity and this had affected the patient satisfaction. Studies are of the opinion that autonomy as well as patient self-determination is upheld when the nurses are seen to accept the clients as unique individuals who has the innate right for having their own opinions, values, beliefs and perspectives (Ellis, 2017). Nurses need to encourage patients for making their own decisions without any coercion as well as judgments from the nursing professionals.Every patient has the rights in rejecting as well as accepting any form of treatments. Dignity is found to be fundamental to the well-being of the patients as an important aspect of ethical nursing care. Nurses need to maintain the four aspects of dignity to
3 REFLECTION ASSIGNMENT PART TWO ensure high quality cares for which are respect, empowerment, communication, and autonomy. Ensuring autonomy and dignity of the patients make patients feel that the nursing professionals are genuinely interested in their care and that they respect the choices and identify the needs of the patients. Studies have found that when patients feel that their dignity and autonomy is respected, their adherence to treatment and compliance with the healthcare team increases (Soderhamn et al., 2015). Such patients are also seen to feel empowered and their ability to self- manage themselves increases. The nursing professionals of the previous organization did not properly respect Jeremy. The nurses there had not asked for informed consent from the patient regarding the treatment and therefore, the patient had no idea what treatment procedures were adopted for him. He was feeling stressed and when he enquired the professionals about the treatment, the nurses stated that they were undertaking the right care plan and that he would not understand even if the care plans are discussed. This affected his autonomy and dignity and he felt disrespected. Informed consent in medical treatment is found to be fundamental in both ethics as well as law. Studies opine that patients have the right in receiving information as well as asking questions about recommended treatments so that they can make well-considered decisions about care (Moyo et al., 2016). Successful communication in the different patient-nurse relationships helps by fostering trust and thereby supports shared decision making. This helps in reducing stress and anxiety among the patients as they know what are happening with their health. They also feel empowered and engage successfully in their own care. Nurses who were attending Jeremy had not followed the bioethical principles of autonomy and dignity and had not asked for informed consent. This had affected his self-esteem and self-respect as he felt that his choices and likings were not given importance. He felt insulted and humiliated when the nurse denied discussing his
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4 REFLECTION ASSIGNMENT PART TWO care plan in details stating that he would not be able to apprehend it. The nursing professionals had also breached the Human Rights act. Laws and regulations cover the rights of patients to be respected and included in their healthcare as a part of the human rights acts in the nation. Breaching of such laws and regulations might expose the professionals in legal obligations that can affect their practice and harmtheircareergrowth.Suchlegalobligationsaffectthereputationofthehealthcare organizations. Therefore, nurses need to ensure that they are maintaining the autonomy and dignity of the persons while they care caring for the persons (Doody et al., 2016). The code of ethics of Principle 1 has stated of the importance of respecting for the dignity of the person. Nursing professionals to ensure effective patient care delivery must follow all these. Second stage scenario: During the time of placement, I was delegated to handle a patient named Jack Jonas who was suffering from cancer and had undergone surgery for the removal of cancerous cell lump. However, after the surgery, reports revealed that there were still cancerous cells left in the body. On informing the patient about the same, the patient suggested to the healthcare teams not to reveal about it to his wife who is quite ill and suffering from depression and anxiety. However, one of the members of the team revealed the information when the wife of the patient constantly coaxed him to discuss about the surgery in details. To this, the patient’s wife felt restless and collapsed soon. The other family members then took her to the healthcare center for taking care of her. When the patient came to know about this, he felt disappointed and wanted to change the hospital.
5 REFLECTION ASSIGNMENT PART TWO On close analysis, it was found that another nurse of the healthcare team had breached the bioethical principle of confidentiality and privacy of the patient. Protection of privacy and confidentiality of the service users is extremely important for the healthcare professionals for maintaining a trusting relationship that helps in positive health outcomes on patients (Roux et al., 2017). Privacy in healthcare means that information that patients reveal to the professional as well as the different information exchanged between the patients and professionals including medications and other personal information need to be preserved and never revealed without the permission of the patient (Poikkeus et al., 2018). Confidentiality mainly prohibits healthcare professionals from disclosing information about the patient to others without permission. Studies are of the opinion that breaches in this bioethical principle can disrupt the development of trustworthy relationship among the patients and professionals. Their compliance would decrease with the development of disrupt on professionals. Besides, the patient may also get subjected to physical harm and unsecured life as perpetrators might use the information to harm the patient in many ways (Falkesntrom et al., 2016). Moreover, they may also suffer emotionally and mentally when private information is known socially. In case of Jack, it was seen that his wife was physically and mentally not well and revealing such information affected her health as well. This createdmentalpressureon Jackaffectinghishealthaswell.Thepatientwastherefore disappointed and wanted to change the healthcare sector feeling that he could trust no one in the organization. Privacy actlaw mainly requires the healthcare workers for protecting the confidential information of their service users (Kangasniemi et al., 2015) . Breaching of these bioethical principles would inevitably lead to legal obligations for not maintaining the laws and hence would expose nurses to punishments and penalties. This may even lead to cancelation of their
6 REFLECTION ASSIGNMENT PART TWO licensures that would affect their career. Besides, this would also affect the morale of nursing professionals making them feel less confident about their skills and knowledge. The nurse attending Jack might be also get involved in legal obligations and affect his career and patient health together. The code of ethics for nurses by NMBI principle 4 discusses the value of ethical management and information and hence maintaining this principle of trust and confidentiality. Conclusion: Bioethical principles govern the practice of nursing ensuring safety and quality care to all patients. The codes of ethics put forward by NMBI help nurses in guiding them through ethical decision-making and settling with solutions that respect autonomy, and dignity of patients. Nurses need to maintain other ethics like beneficence and non maleficence as well as privacy and confidentiality and justice. Nurses need to ensure that they follow the ethical principles to not get involved in legal obligation and increase the satisfaction of patients.
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7 REFLECTION ASSIGNMENT PART TWO References: Butts, J. B., & Rich, K. L. (2019).Nursing ethics. Jones & Bartlett Learning. Doody, O., & Noonan, M. (2016). Nursing research ethics,guidance and applicationin practice.British Journal of Nursing,25(14), 803-807. Ellis, P. (2017).Understanding ethics for nursing students. Learning Matters. Falkenström, E., Ohlsson, J., & Höglund, A. T. (2016). Developing ethical competence in healthcare management.Journal of Workplace Learning,28(1), 17-32. Holloway, I., & Galvin, K. (2016).Qualitative research in nursing and healthcare. John Wiley & Sons. Kangasniemi, M., Pakkanen, P., & Korhonen, A. (2015). Professional ethics in nursing: an integrative review.Journal of advanced nursing,71(8), 1744-1757. Moyo, M., Goodyear-Smith, F. A., Weller, J., Robb, G., & Shulruf, B. (2016). Healthcare practitioners’personalandprofessionalvalues.AdvancesinHealthSciences Education,21(2), 257-286.
8 REFLECTION ASSIGNMENT PART TWO Poikkeus, T., Suhonen, R., Katajisto, J., & Leino-Kilpi, H. (2018). Organisational and individual support for nurses’ ethical competence: A cross-sectional survey.Nursing ethics,25(3), 376-392. Preshaw, D. H., Brazil, K., McLaughlin, D., & Frolic, A. (2016). Ethical issues experienced by healthcare workers in nursing homes: literature review.Nursing ethics,23(5), 490-506. Roux, G., & Halstead, J. A. (2017).Issues and trends in nursing. Jones & Bartlett Learning. Söderhamn, U., Kjøstvedt, H. T., & Slettebø, Å. (2015). Evaluation of ethical reflections in community healthcare: A mixed-methods study.Nursing Ethics,22(2), 194-204. Vryonides, S., Papastavrou, E., Charalambous, A., Andreou, P., & Merkouris, A. (2015). The ethicaldimensionofnursingcarerationing:Athematicsynthesisofqualitative studies.Nursing ethics,22(8), 881-900.