Reflective Essay: Ethical Issues and Nursing Practice

This reflective essay examines the ethical issues arising in patient care, particularly concerning the controversial use of opioids in migraine treatment. It addresses the potential ethical dilemmas faced by healthcare professionals, such as maintaining patient confidentiality, avoiding malpractice and negligence, and managing waiting lists. The essay explores the importance of building and sustaining healthcare workers for the future and addressing the shortage of family doctors. It also analyzes the impact of medical errors. The reflection section uses Gibbs' reflective cycle to analyze an experience with patient interaction, discussing feelings, evaluation, and action plans. The essay emphasizes the importance of accurate information, the adverse effects of opioids in migraine treatment, and the influence of ethical considerations on professional nursing practice. The essay concludes with insights gained from the experience and the importance of ethical decision-making in healthcare.

Reflective Essay

Contents
INTRODUCTION.....................................................................................................................................3
MAIN BODY.............................................................................................................................................3
Possible ethical issues in the context of patient care................................................................................3
Reflection................................................................................................................................................5
CONCLUSION..........................................................................................................................................7
REFERENCES..........................................................................................................................................9

INTRODUCTION
A migraine can be defined as a neurological condition which can be an origin of many
symptoms like intense headaches, nausea, difficulty in speaking, numbness etc. Patients with a
migraine problem feel throbbing in a particular area with variable intensity (Balsam, Brooks and
Reuter, 2017). They may experience pain in the eyes or face and be sensitive to light. It is
usually recommended that opioids should be avoided during treatment of a migraine as they do
not work well clinically. Also, they are known to generate bad outcomes that can lead to a
transformation in regular headaches. Thus, patients with migraine problems should be taken care
of effectively. This report explains the ethical issues relating to patient care and a reflection of
how can this influence professional nursing practice.
MAIN BODY
Possible ethical issues in the context of patient care
Opioids should not be used during the treatment of migraine as they do not work
properly. Also, there are no cases that show pain-free results with using opioids. They have
shown to have adverse effects on the patients and their health. An ethical issue can be defined as
a problem wherein an organization or individual is required to choose between alternatives that is
evaluated as right or wrong. There are various ethical issues that can be faced by health care
professionals in delivering patient care. Some of them are described below –
Patient Confidentiality – All health care centers are required to keep the information
about a patient’s medical history confidential. Violating this can lead to various legal and ethical
consequences for the respective health worker. There are various laws that govern the release of
the medical information of a patient that all health centers are required to adhere to. The laws
state what kind of information can be shared and which information has to be kept private
(Boland, Dikomitis and Gadoud, 2016). Patient Confidentiality is one of the most important
ethical issues during patient care and HIPAA or Health Insurance Portability and Accountability
Act defines exactly what kind of information can be released and who can see the information.
This ethical issue is important in retaining the necessary bond of trust and an effective
communication between the doctor as well as the patient. Therefore, any kind of information
pertaining to the patient should not be withheld as it can harm the patient in some or the other

way (5 Ethical Issues in Healthcare Management, 2020). And in order to do this, the security
policies within the healthcare center should be strengthened.
Malpractice and Negligence – Professional who work in a health care setting are always
at the risk of being charged with negligence and malpractice (Godwin, 2019). A patient can sue
the health workers in a case of being harmed by medical equipment that is defective, any kind of
medical errors etc. Also, if the medical care workers fail to provide effective treatment of to the
patient, they are still under the risk of being charged with negligence. Therefore, it is necessary
that all health care professionals should carefully follow all the practices while providing
treatment to the patients in order to avoid any kind of problems. Negligence is a way when
someone acts in such a way that can harm the other person, in this case, the patients. Therefore,
health workers should not violate or be careless while treating the patients because doing so can
impact their overall career and can also lead to cancellation of their practice.
Building and sustaining healthcare workers of the future – With the number of people
being diagnosed with diseases increasing very year, the number of people needed to take care
and manage the patients will also increase. Many studies have forecasted a shortage in the
number of healthcare professionals around the world. Therefore, there is a need to train as many
health care professionals as required keeping the future conditions in mind. Young people who
opt to study and build a future in the health care industry should be provided extensive support.
Tis can be done in the form of providing effective education facilities as well as training during
their internships so that they come out with a deep knowledge and understanding of the different
methods of treating the patients effectively. Building and sustaining healthcare workers for the
future is also one of the important ethical issues within the health care industry (Guerra, 2016).
As a result, the patient will receive extensive care and will also be treated in the most efficient
manner. Also, the health care industry will become more proficient in treating the patients.
Waiting Lists – This is another important ethical issue in patient care and many
healthcare centers have been facing challenges regarding the same. The demand for healthcare
services is increasing because the number of cases relating to public health are going up year
after year. Tis has put a pressure on the healthcare centers including hospitals, clinics etc.
Waiting lists in some cases can lead to compromising in the patient’s health. It may also lead to a
wrong usage of the limited resources available in the hospital. Patients who are in the waiting

lists have to wait for a long time and as a result are disadvantaged. Therefore, instead to making
people wait for long durations of time, the health care professionals should inform them if the
number of beds available for the patients are not enough or if there is a shortage. The health care
staff should be such that they can be trusted upon by the patients as well as their family
members.
Shortage of family doctors – This is another ethical issue of patient care that has
become a challenge in recent times (Hosein and Rao, 2017). The number of medical graduates
has gone down sharply and is being considered one of the most recent issues in the sector. Many
people around the world, who live in rural areas do not have an access to family doctors or
physicians. This has led to an increased pressure on the existing healthcare facilities as people
have to wait in long waiting lists to get an appointment with the doctor. Therefore, this problem
is of great concern for a nation whose overall healthcare system is centered on necessary medical
services.
Issue of Medical Error – Last but not the least, medical error can also pose a challenge
to the care of patient within a health care system. The public should be made aware of the
common medical errors that can affect a patient receiving the wrong prescription, cases wherein
the hospital failing to sterilize the medical equipment etc. Medical errors come along with some
ethical implications and effective measure should be taken to minimize or eliminate the various
medical errors.
Therefore, these are some of the possible ethical issues that should be followed in the
health care industry while treating the patients to ensure that they are treated effectively.
Reflection
In a reflective essay, an individual is required to write about, examine their experiences
and also write about their thoughts and feelings that are related to a particular experience. It
helps in linking different ideas and thoughts together thereby identifying ideas between them
(Marvell and Simm, 2018). Gibb’s reflective cycle is a model that was developed by Graham
Gibbs in the year 1988. The model is a framework that examines experiences by which an
individual can plan and learn different things about a particular experience. It comprises of six
stages that are described below –

Description - During my professional learning practice, I got a chance to work a chance
in a medical setting as an intern wherein I learnt that opiates and opioid medications are
generally not used during the treatment of a migraine. This is because they have not proved to
work well and there are no studies that have shown that these medications show pain-free results
(Ochs, 2019). I got an opportunity to understand the concept of migraine, its causes, system and
treatment. I also got a chance to interact with some patients who were dealing with the problem
of a migraine. The interaction helped me understanding what problems they’ve been facing due
to the same. The senior under whose guidance I was working was also present during the
situation. Therefore, this particular element of the model contains a factual description of an
incident.
Feelings – When I asked my mentor if I could speak to other patients on my own without
any assistance, he did not agree which made me a little frustrated. I knew that I could talk and
interact with the patients effectively. Surprisingly, my mentor agreed on my interacting with one
of the patients. While doing so, I felt a sense of responsibility and noted down all the problem
that particular patients was facing. But while doing so, I felt that I should prove my work to my
mentor and perform all the tasks that were assigned to me effectively. I also made sure that all
the tasks were completed well within time. When I look back, I feel completely satisfied that I
decided to complete the assigned tasks on time. Also, I was appreciated for this by all members
of the team.
Evaluation – In this stage, the situation is evaluated and judged by the individual. There
were two other interns who had been performing well and this is what motivated me to put in my
best efforts. So, I worked hard and aimed at generating best output which turned out to be pretty
good. But there were some things that did not go as planned and proved out to be challenging. I
feel pleased that all my team members including my mentor that she responded in a positive
manner towards my work. Also, I learnt the importance of working as part of a team as well as
safeguarding the well being of patients within a hospital. In the evaluation stage, both positive as
well as negative aspects should be discussed by the individual (Gibbs' reflective cycle, 2020).
Analysis – By searching and analyzing some literature about working in a healthcare
setting, I found that when individuals join in as interns, they should be provided an orientation
about the particular department in which they are going to work effectively. Also, providing

training can be helpful for them when they interact with the patients and carry out different tasks
that are assigned to them effectively (Samanian and Roohani, 2018). Through analyzing the
situation, I also found that all of it worked out well because I took initiative to understand the
problem of the patient and also, helped him out with the same. Apart from this, I also carried out
all out the tasks assigned to me in a proper and structure manner. I also got to learn that patients
should be educated about the small medical errors that can take place in the health care center.
Conclusion – This stage is about what all did the individual learn from the experience
(Sharif and Zainuddin, 2017). Talking about this particular incident, I learnt that when a person
wants to prove that he/she is an effective learner, they should step forward and take
responsibility. And this is not only limited to healthcare sector but any other sector as well. I also
learnt that although there are ties that can pose challenge or be rough, but one should make
effective decisions and formulate strategies that can help them stand out. In this particular case,
interacting with patients having migraine problems enhanced my overall knowledge about the
subject. An I think that it will be truly helpful in my future jobs. Also, in order to handle such
patients, it is important to develop patients and one should always talk to them nicely.
Action Plan – This is the last stage and it involves what would one do differently in a
similar or related situation. This is important as it helps the person in thinking about how will
they handle that particular situation (Wilhelm, 2016). I am going to learn about opioids, their
impact on patients and also revise all my notes relating to migraine and its effects so that in the
future, when a similar situation comes up, I am ready to face the same. This will also be helpful
in my clinical placements and enable me to get a high-quality placement. Also, I will make sure
that I am well versed with the medical history of my patients and also interact with them in order
to get to know them. This will help me in treating the better.
Therefore, Gibb’s reflective cycle is an important framework that helps in understanding
and analyzing different situations an individual may across. This not only helps them in
understanding where did they perform well, but also what can they do in similar or related
situations in the future (Yerrabati, 2017). Also, it can be used in various situations and is not
limited to just one. It requires a person to look beyond mere experiences and attain a deeper
understanding of the same. The model can also be used to help members of a team think about
how they deal with various situations.

CONCLUSION
From the above report, it can be concluded that the number of patients with chronic
diseases like migraines is increasing. Therefore, there are several ethical issues that are related to
patients in a health care setting. A greater number of healthcare professionals will be required in
the future and in order to have them, students that are studying medical science should be offered
various opportunities and also provided the best education facilities. Once they graduate,
effective training should be provided which is a necessary part of their career. Also, Gibb’s
reflective cycle can be used to analyze and understand a particular experience effectively.

REFERENCES
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