NURS2016 Winter 2019: Ethics Case Study Presentation & Analysis

This presentation analyzes an ethical dilemma faced by a Registered Practical Nurse (RPN) named Corrine, who was terminated after refusing to assist in the dialysis of a palliative patient, Mr. X, due to moral and ethical objections. The presentation identifies the ethical principles at stake, including the nurse's responsibility to the public and accountability for their practice, as well as the right to refuse treatment that conflicts with their moral beliefs. It explores the roles of various stakeholders, including the nurse, physician, patient's family, and supervisor, in the decision-making process. The presentation outlines a plan of action to resolve the ethical dilemma, emphasizing the importance of clarifying the ethical considerations, weighing different perspectives, and ensuring that patient care aligns with both ethical principles and medical best practices. It also discusses the nursing process in ethical decision-making, including identifying the dilemma, exploring options, reviewing choices, and evaluating outcomes. The presentation concludes by emphasizing the significance of ethical awareness in nursing practice and its impact on future professional conduct.

NURS2016 / Winter 2019 1
ETHICS CASE
STUDY GROUP
PRESENTATION
Group Member Names:

NURS2016 / Winter 2019 2
ASSESS THE SITUATION
•Identify the problem in question, asses the genesis factors of
the problem, which in this case, is the ethical issues verses
the routine management of the patient.
•During assessment, ask the questions, is the problem only
arising once or repeatedly, is there any other people who have
been fired unfairly because of standing per their own
understanding of their roles, rules and limits of practice.
•Gather information on other extra areas to ascertain
occurrence of similar problem in other areas.

NURS2016 / Winter 2019 3
Mr. X case study
• This a case scenario involving Corrine who had been
employed as an RPN in a hospital for 11 years. She got
terminated from her employment on August 6,2016.
•This was after she alleges that in early July 2016 a supervisor
periodically assigned her to assist in dialysis of Mr. X who
Had double lower limb amputation and a number
comorbidities.
•Corrine however believed that she had moral, medical, ethical
and philosophical objections to performing dialysis on the
client because the client was palliative (Johnstone, 2015).She
also believed that the dialysis was causing the client additional
complications and adverse events.

NURS2016 / Winter 2019 4
Identify the Problem
What is the Ethical Dilemma?
•Corrine was wrongfully dismissed yet the code of ethics would
support someone In the nursing profession who refused to
participate in the course of treatment that against the nurse’s
moral and ethical believes and values
•Mr. X’s family wished him to be kept alive through dialysis and
they think he will not survive without it. Corrine however believed
that the dialysis was causing more harm to the patient than good.
In fact Corrine claims she and the team had to cease dialysis on
some occasions because the client had one episode of cardiac
arrest and another episode of severe internal hemorrhaging
during the treatment.
•It was unethical to dismiss Corrine for refusing to perform
treatment that’s against nurses moral and ethical believes and
values.

NURS2016 / Winter 2019 5
Identify the Ethical Principle
Each nurse is responsible to the public and accountable for
ensuring that his/her practice and conduct meets legislative
requirements and the standards of the profession.
They are responsible for the decisions and actions hat they
conduct including the consequences that follows the actions
and decisions should in all ways promote respect for the
profession.

NURS2016 / Winter 2019 6
The Roles/Who was Involved
Who is Responsible to Make
the Decision
• The Nurse, the Physician, Family
members
• The supervisor
Who is Affected by the
Decision
• Mr. X
• Corrine

NURS2016 / Winter 2019 7
FORMULATION COLLECTING THE
DATA
Asses the situation under study, state the objectives, then
formulate the hypothesis, conduct a reconnaissance of the
place of study then assemble the necessary tools for data
collection, do pre-testing of tools. Then carry out the actual data
collection in the area of study. Finally analyze the results in
order to come up with a proper conclusive judgement

NURS2016 / Winter 2019 8
Laws-Acts-Standards-Guidelines-
Ethical Principles
•The supervisor should put in place mechanisms that allow for
staffing decision that are in the best interest of the clients and
professional practice.
•The nurse demonstrates standards by advocating on behalf of
the patients and also performing actions in situations where
clients safety and well being are not compromised (Moorhead
et.al, 2018).
•they should identify ethical issues and communicating them to
the health care team.

NURS2016 / Winter 2019 9
Facts versus Values/Beliefs
•It is a fact that Corrine should be submissive to her supervisor
however the nursing values restrain her from performing what
the supervisor and family required for the client.
•Dr. Dibello has to respect the family members’ decision
concerning Mr. X but also he should consider the values and
believes guiding the treatment of the patient.

NURS2016 / Winter 2019 10
Medical Facts or Health Care
Information
•The patient should be given treatment that promotes the
quality of his/her health without compromising or putting his
life in danger. For example dialysis should not be initiated on
patients under palliative care.

NURS2016 / Winter 2019 11
Capacity of Decision Makers
•Decision makers holds a very vital position in the life of the
patient because the decisions that they make will determine
both the quality of treatment and care that the patient
encounters in the hospital setting.
•The quality of life of the patient is also dependent on the
decision makers.
•The workers and their working conditions also relies majorly
on the decision makers, for example, Corrine got dismissed as
a result of decision made by the decision makers.

NURS2016 / Winter 2019 12
IMPLEMENATION
PLAN OF ACTION TO RESOLVE THE
ETHICAL DILEMMA
•Make clarification of the dilemmatic state of ethics by using the
data collected from the hospital managers. Discuss with the
hospital managers on the issues between ethical spells and
the desires of the patient under care. Weigh the two sides to
come up with appropriate agreement to clear and solve the
perceived conflicts between ethical issues and the medical
care giving of the patient.