Ethical Decision Making in Nursing Practice

TASK 1 TEMPLATE
References- 10 textbook or Journal
articles ( the references of the laws and
nursing standards are not counted in
this)
INTRODUCTION / OVERVIEW ( 100
WORDS APPROX)
While working in clinical settings, nurses
often come across situations where they
face dilemmas and unable to make
decisions. In such a case, a nurse must
follow the ethical standards and make
decisions based on the professional code
of standards in order to enhance the
quality of the nursing care and get an
improved health outcome of the
patients. The Nursing and Midwifery
Board of Australia sets out professional
code of conducts focusing on major
areas of practice which are mandatory
for the nurses to follow. The nurses must
work within the theoretical framework of
nursing standards and follow the

organization’s policy to achieve the
quality outcome and hence increase
patient’s satisfaction. The paper sets a
framework of nursing practice by
focusing on different areas of
professional conduct and outlines the
basic norms and protocols a nurse need
to follow to achieve a successful
outcome.
Case 1 You have just started placement in the operating theatre at
Sunshine Coast University Hospital (SCUH). You have been buddied with an
RN/RM. The list is covering gynaecology procedures. You have just
consented your firs
t patient with another RN/RM. This patient refused to consent to having a
student observe or assist for the procedure. Your RN/RM mentor asks you to
come into the theatre with her. You state that you are not allowed to go into
theatre as the patient does not want students to be present whilst they are
under anaesthetic. You are now feeling stressed.
(USE ETHICAL DECISION AND PRINCIPAL TO MAKE DISCUSSION)
DISCUSSION ON LEGISTATION (AROUND 325 WORDS)
Patient consent is an important factor in the healthcare context
aims to preserve autonomy of the patients by respecting their decisions.
Patient’s consent recognizes the patient’s right to autonomy and involve
in the decision making process provided they are supplied with the
required information (Wolf, Annas and Elias 2013). Healthcare
professionals must including physicians and Registered Nurses are
ought to respect the patient’s decisions and treat them with dignity
(Nursingmidwiferyboard.gov.au 2019). Patient consent should be always
taken for prior to making any kind of treatment decisions except for the

emergency cases where providing an urgent treatment is essential on
priority basis. It sets legal and ethical expressions of the basic rights of
the patients that is, self-determination and autonomy (Faden and Kass
2014).
Health professionals found breaching this law and treat patients
without valid consent are liable under criminal laws. Sometimes,
patients may not give consent to any medical treatment even if the
particular treatment will save their lives. Therefore, a constant ethical
debate is always raised in this area. Patients often refuses to give
consent for performing any medical tests, operations or medical
screening in the presence of any junior or unregistered nurse or health
staffs (Shaker et al. 2018).
The common law states that all competent adults have the right to
give consent or refuse any medical treatment or tests. The health
professionals may have face legal consequences in case consent is not
established. Under the law of trespass, patients have the right to not to
be subjected to any invasive procedure without their consent
(Alrc.gov.au 2019). The law is expressed as a right to respect a patient’s
physical as well as mental integrity equally like others. In the case study
provided, the nurse should work within the framework of supported
decision making to encompass the requirement of clinicians, health
professionals and other health workers to help and assist a person in
making decisions. Therefore, the healthcare professionals should
develop skills and knowledge necessary to talk about their health in
such a way so as to encourage people to make their own decisions
(Alrc.gov.au 2019).
The State and territory guardianship and mental health legislation
provides detailed rules for decision making regarding medical treatment
of adults who are not competent and are incapable of providing consent.
Guardian leadership outlines the criteria to appoint substitute decision
makers depending on the age of the patient and the type of the
treatment proposed (Alrc.gov.au 2019).
DISCUSSION ON REFLECTION ( AROUND 325 WORDS)
The case study depicts a scenario involving a student nurse who
has not got consent to enter the operation room for assisting or helping
the RN with the procedures. Although, the RN suggests the student

nurse to enter without the patient’s consent, on doing this, patient’s
autonomy will be violated and it could lead to the violation of nursing
standards and cause legal actions to be executed (Kaye et al. 2015).
If I was at the RN’s place I would never suggest the student nurse
to enter the theatre without the patient’s consent. Here, the student
nurse was facing a dilemma in choosing what she should do, whether to
listen to the RN or to the patient.
While working in clinical settings, nurses must follow the
principles and guidelines as set by the Nursing code of Standards and
make decisions based on ethical judgments. Nurses often come across
difficult situation during their practice and are unable to make clinical
decisions. Nurses need to make decisions based on ethics and work by
aligning with the professional code of conduct.
I have learnt from the above scenario that patient’s right must be
protected and respected and one should no way involved in any actions
that will prevent the patient’s from availing their basic right concerning
their health.
Patients often refuse to be accompanied by student nurses or any
junior nurses while having complicated procedures especially in the
operation theatres. Their concern must be respected and one should no
way involve in any activity that hampers the patient’s confidentiality and
disrespect their autonomy.
If I ever come across such a situation, I will make decisions based
on ethical standards and practice by adhering to the Ethical standards
of nursing which clearly states that nurses must respect the patient’s
vulnerability and must not express their personal views in such a way so
as to exploit the patient’s liability of making any decision and negatively
influence their autonomy in decision making
(Nursingmidwiferyboard.gov.au, 2019).
CONCLUSION (comprehensive analysis) around 150-180 words
Nurses often face dilemmas in difficult situation while dealing with
some patients who are unwilling to take medications or involved on any
medical treatment that are important. Nurses face a conflict between the