Nursing Report: Ethical Dilemmas in Nursing and Healthcare Practices

This report provides a comprehensive overview of ethical considerations in nursing practice, focusing on the impact of technology, social media, and quality assurance. It addresses the ethical implications of smartphone use among healthcare providers, emphasizing the need for education on patient safety and privacy. The report also explores the ethical and legal ramifications of social media use by nurses, including discussions on patient privacy, HIPAA regulations, and employer monitoring. Furthermore, it examines the relationship between hospital accreditation, reimbursement, and healthcare quality, highlighting the importance of evidence-based practices and patient-centered care. The report concludes by discussing the role of health informatics in facilitating patient-centered care while acknowledging potential challenges such as increased bureaucracy and dehumanization. Overall, the report emphasizes the importance of ethical decision-making, adherence to professional standards, and the integration of technology to enhance patient outcomes and improve the overall quality of healthcare delivery. The report references multiple studies and articles to support its claims.

Running head: NURSING
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Name of the Student
Name of the university
Author’s note

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1. i) Use of smartphone can cause distraction among the health care providers and can increase
the risk of the patient errors. Health care providers should be educated about the risk of
distracted doctoring. Only specific functions of the smartphone will be allowed to use, for
example the calendar device, alarms, the notes app for reducing the loads of the cognitive “to
–do- lists. Smartphone photography is an advantageous learning and is a communication
device, however, respect for the patient and the privacy of the patient has to be paramount.
Any photograph obtained will be taken in a way disclosing none or the minimum amount of
health information to of the patient (Jeon & Lee 2015). Smartphones should be set to silent,
air phone or do not disturb mode, at the time of patient encounters. Patient permission should
be obtained before using them in front of the patient. Personal or professional
communications should be kept separate at all the times (Vearrier, Rosenberger & Weber,
2018). Controversial issues should be avoided in social networking sites. Anything related to
the clinical experience should not be disclosed in personal sites. No information related to the
patients, staffs, supervisors, or the employers related to practice should be discussed in the
social networking site (McBride, LeVasseur & Li, 2015). The nurses will access to their
social networks only during their break time.
ii) Verbal abuse or body shaming of patients are equally wrong as that of malpractice against
clients. As per the ANA codes of ethics, nurses are ethically obligated to practice with
compassion and respect for inherent dignity, worth, and the unique characteristics of each
and every person. They are bound by duty to help the needy and saves lives, hence such a
comment is not only offensive, but questions their personal values and upbringings. Legal

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and ethical allegations against both the alleged health care workers and the organization can
be raised by the child’s family. Additionally, sharing the baby’s picture without the
permission of his/her parents, in social media is straight away against the privacy policies of
most of the hospitals as well as the HIPAA rules. There are HIPAA laws and standards
applicable to social media use. All the health care groups should implement HIPAA social
media policy for reducing the risk of the privacy violations. Such a case directly breaches the
HIPAA policy. Violations can cause penalty or a person might end up in jail. However, the
level of the punishment is determined by the extent of severity of the violation. In case there
was no willful neglect of the rules and violations are corrected within 30 days, knowing that
the HIPAA rules have been violated, in that civil penalties might not be applied.
2. i) Interfering on personal life of students is not acceptable, but if it refers to obscene posts or
racist comments in social plat forms, then it is good for the Universities or the employees to
take certain measures before employing them. This approach is quite popular as employers or
colleges want to make sure that the candidate is a good fit for the company. It has been found
in studies that employers conduct social screenings for information supporting the
qualification of the candidates (Root & McKay, 2014). Many of the companies want that the
candidate has a professional online persona. Some of the things on the social media that has
to be avoided on social media are –provocative or inappropriate posts and information about
them drinking or using drugs. These kinds of the information are especially useful in hiring
teachers or social workers. These information can be useful to obtain information whether the
candidate has poor communication skills, or if their attitude is linked to any criminal
behavior, or if the candidate or student has made any discriminatory comment related to

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gender, religion and race (Kluemper, 2013). Hence, it can be said that seeking of such
information can be justifiable, as long as too personal information are not getting breached.
ii)
Currently, there are no federal laws which restricts an employers from monitoring the employees
conduct on the social networking sites. But there are various software that can be used for
monitoring the online activities of the employees. But, in order to maintain trust among the
employees, it is necessary to develop a social media policy that will clearly define the acceptable
behavior of the employees (Root & McKay, 2014). Although, it is ethical and justifiable to select
candidate on the basis of experience, but social network screening is really a rich source of
applicant information, but includes several legal and ethical issues and the potential risks and the
benefits varies widely as per the approaches used for the screening. There are a wide range of
HR issues that needs to be considered like discrimination, privacy, hiring, and generalizability,
management of the impression, reaction of the applicants, validity and utility. Since, we cannot
stop the employers in social network screening (Kluemper, 2013). People should be careful
about the anything that is posted on social media. Further, the employers should also assess the
validity of the post and should equally analyze the education credibility of the candidate (Root &
McKay, 2014).
3. Quality is an important but a critical component in providing a high performing health
system. Receiving the health care is never enough for the users and the patients who access
the health care system, be it a clinic or a hospital has to be confident about the type of care

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received – whether the care is effective or safe and is entirely in compliance with the latest
medical evidence (Jha, 2018). These are specifically necessary for the hospitals, with
severely ill patients, but it has been suggested by the data, that the care quality does not
match optimum amount of care. Accreditation ensures high quality as the accredited
hospitals pass the state inspection for receiving any kind of Medicare reimbursement. Data
have suggested that the hospitals that are accredited are more likely to stick to evidence
based process measures, although the difference is often limited. A study consisting of 3891
hospitals have reported that the hospitals that are non-accredited, perform worst on a series of
process-of –care measures and are less likely to improve their performance. There are few
data supporting the relationship between reimbursement and the quality. It has been found
that hospitals having low rates of Medicare based reimbursement have lesser performance on
medical care, may be because of the difficulty in vesting in advanced equipment of maintain
appropriate patient staffing. Current survey has established congruence between better
provider care, reimbursement and patient satisfaction. Hospitals with better patient oriented
practice and reimbursement policy have displayed high levels of patient satisfaction. Health
informatics, particularly, any advances in the technologies has the potential to facilitate a
health care, that is patient centered (Snyder et al., 2011) . Informatics facilitate the
availability of important information, although it has been also found to be increasing
bureaucracy, dehumanization and often interfere with patient-doctor relationships. Clinicians
can use informatics for integrating information, they learn from the patients for providing a
patient centered care. It facilitates multiple members of a multidisciplinary team with team
updates and help then to share critical information.

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References
Brown, V. R., & Vaughn, E. D. (2011). The writing on the (Facebook) wall: The use of social
networking sites in hiring decisions. Journal of Business and psychology, 26(2), 219.
Jeong, H., & Lee, Y. J. A. S. (2015). Smartphone addiction and empathy among nursing
students. Advanced Science and Technology Le
Jha, A. K. (2018). Accreditation, quality, and making hospital care better. Jama, 320(23), 2410-
2411.
Kluemper, D. H. (2013). Social network screening: Pitfalls, possibilities, and parallels in
employment selection. In Social media in human resources management (pp. 1-21).
Emerald Group Publishing Limited.
McBride, D. L., LeVasseur, S. A., & Li, D. (2015). Non-work-related use of personal mobile
phones by hospital registered nurses. JMIR mHealth and uHealth, 3(1), e3.
Moore, S., & Jayewardene, D. (2014). The use of smartphones in clinical practice. Nursing
Management, 21(4).
Root, T., & McKay, S. (2014). Student awareness of the use of social media screening by
prospective employers. Journal of Education for Business, 89(4), 202-206.
Slovensky, R., & Ross, W. H. (2012). Should human resource managers use social media to
screen job applicants? Managerial and legal issues in the USA. info, 14(1), 55-69.

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Snyder, C. F., Wu, A. W., Miller, R. S., Jensen, R. E., Bantug, E. T., & Wolff, A. C. (2011). The
role of informatics in promoting patient-centered care. Cancer journal (Sudbury, Mass.),
17(4), 211–218. doi:10.1097/PPO.0b013e318225ff89