University Nursing Case Study: Ethical Dilemmas and Patient Care

This case study analyzes a nursing scenario where a registered nurse makes assumptions about a patient and his partner, leading to an ethical dilemma. The nurse, upon admitting a patient named Alan who arrived with his husband Mark, incorrectly assumed Mark was the caregiver and discussed medical history with him, ignoring Alan's direct involvement in his own care. This behavior violated patient-centered care principles and ethical codes, potentially causing emotional distress to Alan. The case highlights the importance of non-judgmental assessment, open communication, and respecting patients' relationships and choices, including sexual orientation. The author reflects on how they would handle the situation, emphasizing the need for direct patient engagement, ethical considerations, and the importance of communication skills to foster a therapeutic relationship. The assignment emphasizes the significance of ethical awareness, patient-centered approaches, and effective communication in the nursing profession, underscoring their impact on patient outcomes and professional development.

Running Head: NURSING
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Name of the Student
Name of the University
Author Note

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What?
During my clinical placement when I was working in a hospital I met Alan who had
encountered an accident and was admitted to the hospital. After Alan’s admission it was
found out that he had a similar kind of accident many years ago as a result of which he needs
a wheelchair to walk. He was also suffering from a wound in the leg and also needed
treatment for that. Alan came to the hospital with his husband Mark. However, the registered
nurse made certain assumptions regarding the entire scenario. As Alan and Mark were both
same sex partners, the registered nurse considered that Mark is Alan’s care taker. The
registered nurse also completely ignored Alan and considering Mark as the care giver
discussed the medical history with him (Rainer, Schneider & Lorenz, 2018).
The behavior shown by the nurse might make Alan feel very ignored as the nurse fails
in her attempt to give Alan patient centered approach for the treatment. As it is the duty of the
nurse to make sure that the patient is engaged with the entire treatment plan however, the
nurse fails to provide such an approach (Krautscheid, 2017; Hopia, Lottes & Kanne, 2016).
The nurse ignored the actual relationship between Alan and Mark and can also affect their
sentiments. The nurse should always consider the emotions of the patients as they play a key
role in determining the positive patient outcome (Preshaw et al., 2016).
So what?
It is very clear that the reaction of the nurse was not very effective around Alan and
the nurse was also very anxious to know about their personal relationships. This hampers the
patient centered approach that should be practiced by the nurse and is also against the code of
ethics for the nurses (Aitamaa et al., 2016). If I would have been at the place of the nurse my
responses would be very different from that of the registered nurse. This is because without
making any assumptions about the relation between Mark and Alan I would have asked them

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about it and then have acted accordingly. This approach is better as it would have not hurt
their emotions. I would also have preferred a patient centered approach by discussion the
medical condition to both of them. From this scenario it is very clear that there are certain
cases in nursing that are against the ethical concerns that have to be followed by the nurses in
order to treat their patients. Thus, ethical issues are a big concern in the nursing profession
(Hopia, Lottes & Kanne, 2016).
These expressions have a very adverse effect on the patients because they tend to
hamper the mental balance as well as the emotional state of mind in the patient. Thus they are
very important to determine positive patient outcome (Aitamaa et al., 2016; Preshaw et al.,
2016). This can in turn impact the treatment of the patient and thee way in which the patient
responds to the treatment. Thus, it also lowers the management ability of the clinic or
hospital. As the registered nurse discussed the entire case with that of Mark and ignored Alan
he might feel left out as he was the patient but the nurse did not consider the fact ( McCarthy
& Gastmans, 2015).
The scenario can be related to my personal and professional development as being a
nurse I got the chance to know the importance of patient centered approach in a clinical
setting along with the use of effective communication skills while talking or addressing the
patients. It taught m as how to deal with patients who come from a diverse background while
respecting their cultural beliefs. The case study also taught me how to deal with people who
have different choices in terms of sexual orientation, sexual preference, culture or religion
(Krautscheid, 2017).
Now what?
This experience taught me about the ethical dilemmas that are present in the
profession. The nurses should face these dilemmas while they meet the patient, otherwise the

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treatment of the patient cannot be done effectively (Hopia, Lottes & Kanne, 2016). Another
approach that I will take is to have a patient centered treatment that will emphasize the
treatment to revolve around the patient and not around the disease. In order to make these
approaches successful the treatment process should be transparent to both the family care
givers and the patients. Along with this training in effective communication skills should also
be a part of the profession as it will help the nurses to understand patient situation and act
accordingly (Aitamaa et al., 2016; Preshaw et al., 2016 ). Effective communication can act as
a tool that can help in strengthening the bond between the patient and the nurse or with the
other healthcare staff that helps in the better treatment of the patient.

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References
Aitamaa, E., Leino-Kilpi, H., Iltanen, S., &Suhonen, R. (2016). Ethical problems in nursing
management: the views of nurse managers. Nursing ethics, 23(6), 646-658.
Hopia, H., Lottes, I., &Kanne, M. (2016). Ethical concerns and dilemmas of Finnish and
Dutch health professionals. Nursing ethics, 23(6), 659-673.
Krautscheid, L. C. (2017). Embedding microethical dilemmas in high-fidelity simulation
scenarios: Preparing nursing students for ethical practice. Journal of Nursing
Education, 56(1), 55-58.
McCarthy, J., &Gastmans, C. (2015). Moral distress: a review of the argument-based nursing
ethics literature. Nursing ethics, 22(1), 131-152.
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.
Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An
integrative review. Journal of clinical nursing, 27(19-20), 3446-3461.