Exploring Ethical Dilemmas and ANA Code Application in ER Nursing

This essay delves into an ethical dilemma encountered by an emergency room nurse regarding a patient needing ventilation and vasopressors, but the ER doctor refused to provide it. The essay identifies breaches of ethical principles such as non-maleficence and withholding treatment, and relates them to the American Nurses Association (ANA) Code of Ethics, specifically provisions concerning patient advocacy, responsibility, and collaborative practices. Furthermore, it discusses ethical considerations when serving vulnerable populations, particularly individuals with intellectual or developmental disabilities at 'Opportunity House,' emphasizing the importance of acting in the patient's best interest, advocacy, and justice. The essay concludes by highlighting the applicability of ANA Code provisions to ensure effective nursing care for such patients.

Running Head: NURSING
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Nursing
12/7/2018

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1. From the given scenario in the assignment it has been analysed that being an ER
nurse, one of the major ethical dilemmas I faced is the ambiguity of inability to do things
which I considered right. The case represented about a patient suffering from the problem of
short of breath, and needed to be place on the ventilator.
However, the doctors were irresponsible towards providing treatment to the patient.
The patient did not suffer as he was able to answer the questions asked, and the house
supervisor was made aware of this situation. However, the ethical dilemma in this case was
the situation of moral distress, which could further led to a major harm to the patient in the
case.
2. Being in the role of an ER nurse, in context to the given case there was a breach of
certain ethics or ethical principles in the medical profession in the healthcare. Doctors or
health professionals refused to place the patient on vent, as being a nurse the central line and
the vesopressor were required because of the decreased blood pressure of the patient. These
ethical principles included first, “Principle of non-maleficence” and the second was the
“Principle of withdrawing or withholding treatment”( Johnstone, 2015).
3. American Nurses association code of Ethics for Nurses 2016 has stated some of the
ethical obligations which the nurses need to follow or comply within their medical profession
and practices. As per the ANA Code of ethics there are three provisions which relate to the
ethical issue in context to this case.
Provision 1: The nurse promotes and advocates for the patient’s right, health and
safety.
Provision 2: The nurse has the authority, responsibility and accountability for the
nursing practices, making decisions, and taking action which is consistent as they are obliged
to promote and provide effective care services to the patients.
Provision 3: One of the vital provisions in context to the case includes the
collaborative practices of the nurses, and maintaining the nursing values through their
profession. In addition, integrating the social justice into nursing and health policies is also
stated in the ANA Code (Walker & Breitsameter, 2015).
4. Here, as mentioned for the term called as ‘opportunity house’ the vulnerable
population refers to those people who are mentally disabled. And over the period of 50 years,

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the non-profit organisation is providing services to the people found with intellectual or
developmental disabilities.
The main principles or ethics which are important in providing services in relation to
this patient may include acting in the best interest of the patient and role of advocacy for the
patient. Ethical principle of justice on the other hand is utmost to ensure optimal care of the
patient suffering from the problem of short of breath. It may also include providing 24 hour
residential care (Opportunity house, 2018).
5. Discussing and reviewing the ethical principle which has been stated in the ANA
code of ethics, it has been understood that there are some of the principles which can be
applied to the services to be provided to the patient. These include Provision 1, Provision 6
and Provision 9, as they state about the effective role of nurses for such patients (Lachman,
Swanson & Winland-Brown, 2015).

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References
Johnstone, M. J. (2015). Bioethics: a nursing perspective. United States: Elsevier Health
Sciences.
Lachman, V. D., Swanson, E. O. C. & Winland-Brown, J. (2015). The New' Code of Ethics
for Nurses with Interpretative Statements'(2015): Practical Clinical
Application, Part II. Medsurg Nursing, 24(5), 363.
Opportunity house. (2018). Welcome to opportunity house. Retrieved from:
http://www.ohinc.org/
Walker, A. & Breitsameter, C. (2015). Ethical decision-making in hospice care. Nursing
ethics, 22(3), 321-330.