Ethical Considerations in Nursing Practice: A Case Study Analysis

This essay examines the code of ethics in nursing practice, focusing on a case study of a terminally ill patient, Mr. Washington, and the ethical dilemmas faced by the nursing staff. The analysis highlights key ethical principles such as beneficence and fidelity, as well as the issue of workplace violence. The essay discusses the conflict arising from the patient's wife's demands to reduce pain medication, which contradicts the nurses' responsibility to provide optimal care. It explores the nurses' obligations in upholding ethical standards, addressing workplace violence from the patient and his wife, and ensuring patient safety and well-being. The conclusion emphasizes the importance of ethical behavior and mutual respect in healthcare settings, referencing relevant literature to support the arguments presented. The essay provides insights into how nurses can navigate complex ethical situations, ensuring quality patient care and maintaining professional integrity.

Code of ethics in nursing practice
Introduction
Nurses are bound to legal and ethical principles. Ethical principles are the structured
guidelines that help the nurse in decision making. Ethical principles ensure safe and quality
nursing care for the patients. According to ANA bioethics is an essential part of nursing
practice. This assessment helps to analyze the ethical issues in the case scenario of Mr.
Washington. He is a terminally ill patient who is receiving care as per the decision of his
wife. This assessment improves the understanding of the code of ethics and helps to
implement the ethical principles in nursing practice.
Ethical issues
Analysis of the ethical issues in the case scenario helps in decision making. In the case
scenario, Mr. Washington is harming and hitting the nurses who are caring for him. Mildred
is Washington’s wife who holds the power of attorney of decision making for the patient. She
is insisting the nurses to reduce the dosage of analgesics so that Mr. Washington would
respond to her when she arrives (Preshaw et al. 2016). Mrs. Mildred is using abusive words
on the nursing staffs which is an unethical issue and considered as workplace violence. The
nurses refuse to get assigned to Mr. Washington as the patient’s wife is demanding
aggressive care for the patient. Critical analysis of the ethical issues erodes the ethical
dilemma and helps to focus on the promotion of the health of the patient.
In the case scenario, the patient is trying to harm the nurses who are aggressively providing
care for him. The patient’s behavior is unacceptable as it may cause physical injury or loss of

interest in the profession for nurses. Mrs. Mildred wife of Washington is using abusive words
against the nurses (Borhani et al. 2014). The behavior of the patient and his wife against the
nurses are considered to be unethical action against nurses. Nurses can restrain the patient’s
upper arm to prevent harm or injury to the nurses. Critical analysis of the case scenario,
confirms that there are various ethical issues that may affect the patient and also the nurses
involved.
Beneficence
Beneficence is doing the action that is good for the patient. In the case scenario, Mr.
Washington is suffering from severe pain due to metastasis of cancer. But Mrs. Mildred is
insisting the staff reduce the dosage of the analgesics so that the patient would not be sedated
when she arrives to visit him (Pasero et al. 2016). The Nurses are not supposed to abide by
the instructions of Mildred as she has no authority to recommend or refuse the medication.
Pain is a high priority problem in patients with end-stage cancer. The nurses have to consider
the need of the patient and implement the medication orders as prescribed. According to the
ethical principle – Beneficence the nurses are expected to do good for the patient.
Fidelity
Fidelity is the ethical principle that is related to the standards of nursing. It states that the
nurse has to keep her promise and needs to be faithful to her professional promises. The
pledge taken by the nurses is to ensure safe and quality health care for all the patients.
According to Fidelity, the nurses are not expected to refuse the nursing care for Mr.
Washington. Instead, the nurses can implement other options like legal principles and ethical

principles to handle Mrs. Mildred to avoid being hostage (Al-Ghareeb, & Cooper, 2016). The
nurses can also explain the patient's condition and required care for Mrs. Mildred.
Workplace violence
In this case scenario, Mrs. Mildred is using abusive words towards the nurses which is
unacceptable action. Her action is determined as workplace violence and also unethical
behaviour which confirms that Mildred has no respect for the nurses and the nursing
profession (Phillips, 2016). Admitting such behaviour in the clinical environment will make
the other patients and their relatives behave in the same manner. According to the survey of
the Washington State Nurses Association, 86% of nurses suffer workplace violence in the
country. The nurses need to report the behaviour and usage of abusive words to the
immediate supervisor as per the law. Unethical behaviour and workplace violence of Mildred
need to be controlled to maintain the integrity of nurses and the nursing profession.
Conclusion
Unethical action or behaviour against the patient or nurses is objectionable in the clinical
environment. Both health care professionals and patients are bound to ethical and legal
principles. The nurses are expected to provide safe and quality health care for the patients.
Patients and his/her family is expected to respect the health care professionals and profession.
Mutual understanding of the importance of ethical principles in patient care improves the
therapeutic relationship in health care.

References
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