CNA153: Ethico-Legal Reflection on Nursing Practice

This report presents a reflection by a nursing student on an ethical dilemma encountered during a clinical placement in a busy urban hospital. The student was instructed by a registered nurse to recap a needle after administering an injection, which contradicted the student's training on safe sharps disposal. This led to an ethical conflict, resulting in a needle stick injury. The reflection utilizes Driscoll's reflective model to analyze the situation, exploring the ethical and legal complexities involved, including the nurse's lack of professionalism and the potential risks to the patient. The student examines their emotional response, the impact on their values, and the need for a firm professional stance in future situations. The reflection also considers the importance of upholding ethical standards, maintaining composure, and promoting ethical practice within the nursing profession. The report concludes with insights on how the experience has shaped the student's perspective on patient welfare and professional conduct, emphasizing the need for adherence to ethical guidelines and cautious interactions with colleagues and seniors. The student also references relevant literature to support their analysis.

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WHAT
The scenario that is presented here is one in which I as a nursing student had gone for my
placement in a busy urban hospital.in the course of my duties, I found myself in a situation in
which I was asked by the registered nurse in charge to recap a needle right after administering
the injection. This is totally against what I had learnt in my course work which advises that the
needle should be placed in a kidney dish and disposed immediately ( Blais 2015). I was therefore
torn between respecting the command of the superior nurse or sticking to the ethical values that I
was taught by my professors. ( Cahnmann-Taylor, and Siegesmund, 2017). I was hesitant in
recapping the needle as instructed and this led to the registered nurse shouting at me after several
occasions of trying to tell me to recap it. I got tensed up and in a flash of a moment, I tried to
recap the needle but in the process I ended up pricking my left thumb. This action is dangerous
as it may lead to contracting of a disease from the person that was being given the injection. The
registered nurse in the end blamed me for what had happened and asks to remove the blood of
the patient in order to establish if there is any form of disease that I may have contracted.
SO WHAT
I was in shock and dismay to the fact that the registered nurse could ask me to recap the
needle which was against the normal procedures. This is due to the fact that I did not expect that
a qualified person such as the registered nurse could decide to conduct himself in a non-
professional manner and in total disregard of the ethical procedures when it comes to the
administration and disposal of injection needles. The ethical complexity in this case is the fact
that the nurse lacked integrity and professionalism in the disposal of the needle. The nurse is
bound by the ethical values of the profession to ensure that she observes integrity in the cause of

her work. The nurse encouraged the use of unethical practice which goes against the ethical
values of nursing. The action was also against the legal requirements which dictate that she
should conduct herself in a professional manner in the discharge of her duties. The failure to
comply with this may result in the nurse being suspended from her duties. The action also put the
patient at risk due to the unethical practice and the lack of respect to the patient .the patient is the
most important person who should be respected and thus the practices that are done in relation to
him should observe the ethical values required. The situation therefore created a legal and ethical
complexity as the necessary values and legal expectations were completely disregarded ( Avery,
2016).This was either a pure case of ignorance of the required ethical standards or just a case of
wanting to hurriedly do away with the needle without following the right procedure. My
response to this action was brought about by the fact that the registered nurse is someone that I
respect and look up to in order for him to guide me in the nursing professional and therefore I
expected that he will be the one to ensure that I follow the right procedure in the disposing of the
needle. Therefore, it came as a shock to me that the person who is in charge of ensuring that I
conduct myself in the best professional way and in observing the relevant ethical standards is the
same one that is asking me not to adhere to them. This situation made me really think about my
values in relation to the nursing profession and challenged me to a great extent to ensure that I
observe all the required professional procedures in my future life as a nursing professional. The
situation also made me feel sad about the nursing profession and some of the people, such as the
registered nurse who would bend the required standards in disregard of the patients that they are
serving. I felt that there needs to be a change in the way the relevant people in the nursing
profession act whether they are being seen or not. The nurse have to adhere to the ethical

standards that are spelt out in the profession and be able to observe them at all time whether you
are a senior or junior in the chain of command ( Horton-Deutsch, and Sherwood, 2017).
The scenario made me interpret that there could be a number of nurses who are deemed
qualified and who would advocate for such a situation in which I found, myself in (LoBiondo-
Wood, and Haber, 2017).The nurse sees that as a student, you are still ignorant and therefore
they could inform you to do whatever they would wish as you lack the proper knowledge to
question their actions. The instruction to recap the needle made me connect with what the
professors had taught me on the safe disposal of the needles and this proved a challenge in
carrying out the directive. The actions surprised me totally and this was the cause of my
hesitance for some period. It is important that I be mindful of several ethical considerations even
when dealing with my seniors. I should be able to be a person of integrity in ensuring that I carry
out my duties in a professional manner whether I am being observed or not. Also, honesty and
credibility are critical ethical issues that I should be mindful in order to ensure that I discharge
my duties in the best way possible ( Masters, 2018).
NOW WHAT
There are several conclusions that I was able to derive from the situation that I was in.
The first conclusion was the fact that in future, I need to have a firm professional stand when I
am being faced with a situation that will make me act in unprofessional way and in disregard of
the ethical values that I have been taught in the nursing profession (Bernhardt, 2015) This will
assist me in being able to fully discharge my duties with the highest form of standard and reject
any form of manipulation of the ethical values that may come my way either through my
colleagues or my seniors ( Mill, Allen, and Morrow, 2016). Also, I have leant that it is important

to remain calm whenever faced with a situation and try to analyze the way forward. This is
something that I could have done and prevented myself from pricking my left thumb thus
exposing myself to the risk of contracting diseases. This means that it will be important for me in
the future to maintain high ethical values and also to diffuse any form of tension that I may have
due to the occurrence of a situation. Furthermore, there is need to ensure that all the nurses are
reminded of the need to uphold ethical values in their work (Grace,2017). This is important as it
will ensure that they are able to carry themselves in a professional manner and thus both the
nurses and the patients will be able to interact well and thus the healthcare will be improved
(Murdaugh, Parsons, and Pender, 2018).
The reflections have in a way shaped my opinion on the need to uphold the ethical and
professional values that are demanded of us in the nursing profession. They have gone to further
strengthen the personal values that I had in relation to the nursing values and also keeping in
mind the welfare of the patients that I will be serving. My opinions have changed in the sense
that I now see the need to ensure that we do not put the patients that we are serving at risk just
because of not following the recommended procedures. As a student, I have been taught various
ethical practices and professional manners that I am expected to observe in the nursing
profession. It is my intention to practice the same as I undertake my placement and also to do the
same in the future as I pursue my career goals. The new perspectives that may come along the
way will not in any way change the beliefs and values that I hold but rather I will analyze each
and every one of them in order to ensure that I still maintain the standards that are required of
me. In analyzing the whole situation, I have realized that it will serve as an important learning
experience that will greatly assist me in my professional duties. The situation is going to help me
ensure that I follow all the necessary procedures that will be there in the undertaking of my

duties and not at any one time try not to follow them. This will ensure that I serve my patients in
the best possible way. Also, the experience will make me be extra cautious of my colleagues and
seniors in the cause of undertaking our duties. This is in the sense that I will be able to monitor
closely the activities that surround me in order to ensure that none of the other nurses engage
themselves in malpractices which are unethical and which do not meet the professional standards
that are required in the nursing profession (Rudy, and Gordon, 2018).

References
Avery, G., 2016. Law and ethics in nursing and healthcare: an introduction. Sage.
Blais, K., 2015. Professional nursing practice: Concepts and perspectives. Pearson.
Bernhardt, P.E., 2015. 21st century learning: Professional development in practice. The
Qualitative Report, 20(1), pp.1-19.
Cahnmann-Taylor, M. and Siegesmund, R. eds., 2017. Arts-based research in education:
Foundations for practice. Routledge.
Grace, P.J. ed., 2017. Nursing ethics and professional responsibility in advanced practice. Jones
& Bartlett Learning.
Horton-Deutsch, S. and Sherwood, G.D., 2017. Reflective practice: Transforming education and
improving outcomes(Vol. 2). Sigma Theta Tau.
LoBiondo-Wood, G. and Haber, J., 2017. Nursing research-E-book: methods and critical
appraisal for evidence-based practice. Elsevier Health Sciences.
Masters, K., 2018. Role development in professional nursing practice. Jones & Bartlett Learning.
Mill, J.E., Allen, M.N. and Morrow, R.A., 2016. Critical theory: Critical methodology to
disciplinary foundations in nursing. Canadian Journal of Nursing Research Archive, 33(2).
Murdaugh, C.L., Parsons, M.A. and Pender, N.J., 2018. Health promotion in nursing practice.
Pearson Education Canada.

Rudy, S. and Gordon, B.A., 2018. GLOBAL HEALTH PROFESSIONAL SKILLS AND
CAREERS. Foundations for Global Health Practice, p.351.