NURS3004: Ethical Considerations in Professional Nursing Practice

This NURS3004 case study examines the ethical and practical considerations in the care of Mr. Lamb, a patient receiving end-of-life care for metastatic bone cancer. The analysis focuses on the application of the ICN code of ethics, evaluating the decisions made by the nursing staff, and exploring alternative treatment options. It identifies legal and ethical issues, such as patient autonomy and the use of opioids for pain management. The report further discusses strategies for improving patient care through enhanced communication, collaboration with other healthcare professionals, and the development of essential nursing skills like problem-solving and leadership. The conclusion emphasizes the importance of ethical practice and holistic patient well-being in nursing.

NURS3004
Transition to professional
practice

Table of Contents
Case Study A....................................................................................................................................3
INTRODUCTION...........................................................................................................................3
Question 1........................................................................................................................................3
Question 2........................................................................................................................................4
Question 3........................................................................................................................................5
Conclusion.......................................................................................................................................6
REFERENCES................................................................................................................................7

Case Study A
INTRODUCTION
The ICN code of ethics is a statement regarding the responsibilities and liabilities of
nursing professionals, ethical values, behavioural and professional judgements and relationship
with the patients (Fowler (2019)). The ICN code of ethics provide framework for Nurses and
patients, Nurses and practices, Nurses and the profession and last the nurses and the global
health. This report will focus on deteriorating health condition of Mr. Lamb. The Report will first
analyse the already happened situation and then Knowledge gained through Mr. Lamb condition
management according to the ICN code of ethics. Furthermore, this report will guide in handling
the exact situation from the future prospectives and the knowledge and skills which must be
present in nursing staff who is providing the patient care.
Question 1
From the case study I have identified that Mr. Lam is under End of life care and the
assigned nurses are doing their work accurately. The nurses are doing their role considering the
ethical Values, responsibilities and the professional accountabilities. After going through the
medical history of Mr. Lam, the nurses have recognised that he is suffering from Metastatic Bone
cancer and have frequently visited the oncology department in past six month for his
chemotherapy. Mr. Lam was going to die soon the nursing staff decided to give him end of life
care. Nursing staff could provide this care at his home but as his condition was deteriorating by
the each passing days, the severe pain in spine is making him restless and he needs to be
comfortable as much as possible. The infusion pump containing the morphine is prescribed in
order to make him comfortable. Other alternatives can also be possible like IV therapy but the
best suited method in this condition was Infusion pump as infusion rate can be monitored and can
be changed accordingly. The taken decision was very well communicated among all the staff
member and well coordinated planned because they are continuously monitoring the infused
morphine rate and analysed that excess dose can leads to respiratory depression. The involved
stakeholder in treatment are Patient, Nurses, Nurses Leaders and the Nurse Managers. I have
identified some legal and ethical issue in the treatment like the nursing staff can go for some
advance treatment like surgery or targeted drug therapy instead of infusing opioids (McGinn &
Vana (2022)). The nursing staff have compromised the patient autonomy and manage the

problem poorly and not considered the physical comfort and mental and emotional needs of
patients. However the nurses have followed some ethical issues like they maintain the privacy
and confidentiality of the patient, they communicate with appropriate superiors for any kind of
risk or patients safety as it can be seen in morphine dose discussion. They are providing the
treatment without prejudice or any discrimination. The outcome of treatment are logical as the
dose of morphine reduces the respiratory rate by 8% and increase in dose can lead to respiratory
depression.
I will consider in detail about the various ethical and legislative issues first and try to
avoid during the practice. According to me other available treatment or therapy should also be
considered and discussed before finalising the treatment plan of action. I will maintain the ICN
guidelines and support the patient mentally, physically as well as emotionally.
Question 2
When I have been encountered with this scenario, I will first make sure that the patient is
somehow in comfortable environment and his privacy or confidentiality is maintained. Then I
will go through the medical history of the patients and go through the various treatment options
for the conditions. Before starting and during the patient I will ensure that the patient is getting
proper end of life care treatment and specially mental and physical support along with the
emotional support also. I will discuss with the higher authorities for surgical options or radiation
therapy and after that some medication for the removal of the spinal tumours so that patient can
get rid from the pain. I will make sure that the decision taken under the discussion must be
according to the Bioethical principles. I will make sure that their will be proper communication
between the serving staffs so that any kind of negligence or issue will not occur and also effective
communication between the patients and the healthcare provider so that the patient can easily
share his discomfort or problem with them without any hesitation. I will collaborate with the
different healthcare professionals to give the patient better comfort like physiotherapist to give
some relive from the pain improve the quality of life, psychologist to give patient emotional and
mental support and help in coping from anxiety, distress and depression, A counsellor who deal
with patient physical, mental and emotional issue (Keraite(2020)) I will make sure that the
patient will be comfortable with the treatment and cooperate while treating. I will provide
empathy by understanding and sharing other point of view as well as sympathy as a response to

the patient. I will incorporate all my clinical Experiences, knowledge and the chosen preferences
by the patient to provide the best care to the patient.
Question 3
For enhancing the skill and knowledge I will focus on :-
 Communication skills :- Effective communication skill will help the healthcare provider
to make bond with their patient, ask for necessary information regarding healthcare,
improve the satisfaction level of the patient, decline the readmission or patients complain
and improve the team work and collaboration with the others. It protect the patient from
several issue and also increases the working efficacy (Mabry & et.al. (2020)).
 Problem solving skills :- This skill improve the quality of care which are provided to the
patient as it improve the identification and analysation of the issues. By thinking
creatively and asking the right question to the patient with consideration of multiple
available options, nurses will able to solve the issue more effectively (Verkuyl & Hughes
(2019)). The nursing problem solving skill includes -
Assessment :- It involve the critical thinking skills and collection of data both subjective and
objective. Subjective data includes verbal statement given by the patient or the care giver and the
objective data are the measurable data of the patients.
Diagnosis :- A nursing diagnosis helps to prioritize the plan based on outcome of patient care. It
will help in planning and implementation of patient care.
Planning :- This stage involves formulation of goals and outcomes that directly impact the patient
care. The goal should be specific, action oriented, meaningful, time oriented and result oriented.
Implementation :- It involves the action that carry out the nursing intervention according to the
care plan such as direct or indirect care, standard treatment protocols, cardiac monitor or oxygen,
medication administration.
Evaluation :- This is a final and vital process of nursing intervention for positive outcomes. After
implementation of care nurses should reassess or re-evaluated the outcome which are desired.
 Collaborative ability:- Collaboration among the nurses and staff make the patient care
more efficient and effective. This also develop supportive environment to enhance and
develop the practices. It also prevent the medication errors.
 Leadership quality:- Nursing leader organize the training for the staffs, enhance
professional development and also prepare the budget. They make sure that the nursing

protocols are properly followed, collaborate with other healthcare professionals and
ensure the high quality care (Glassman, & Withall (2018)).
 Cognitive skills:- Cognitive skilled nurses have impressive characteristics like fair-
mindedness, innovation, motivation, creativity, flexibility, careful and deliberate attention
to thinking (Wilbanks & McMullan (2018)).
Conclusion
From the above report, It can be concluded that the nursing practice should be performed
under codes of ethics under the under the Internation Council of Nurses. Mr.Lam should be
treated in environmentally friendly treatment. The physical mental and emotional well being of
Mr. Lamb should be considered necessarily. The nursing staff should collaborate with the other
healthcare professionals like psychiatrists, physiotherapists, counsellor to control his mental and
emotional instability. For enhancing the knowledge and skills the nurses should develop
leadership quality, collaborative qualities, cognition quality, problem solving skills and
communication skills.

REFERENCES
Books and Journals
Fowler, M. D. (2019). In the Beginning... There Was Nursing Ethics. Journal of Christian
Nursing, 36(1), 14.
Glassman, K. S., & Withall, J. (2018). Nurse manager learning agility and observed leadership
ability: A case study. Nursing Economics, 36(2), 74-82.
Keraite, I. (2020). Strategies for the enrichment of circulating tumour DNA in clinical samples
(Doctoral dissertation, Heriot-Watt University).
Mabry, J & et.al. (2020). Virtual simulation to increase self-efficacy through deliberate practice.
Nurse Educator, 45(4), 202-205.
McGinn, T. M., & Vana, P. K. (2022). Legal and Ethical Aspects of Nursing Quality and Safety.
Quality and Safety Education for Nurses: Core Competencies for Nursing Leadership and
Care Management, 113.
Verkuyl, M., & Hughes, M. (2019). Virtual gaming simulation in nursing education: A mixed-
methods study. Clinical Simulation in Nursing, 29, 9-14.
Wilbanks, B. A., & McMullan, S. P. (2018). A review of measuring the cognitive workload of
electronic health records. CIN: Computers, Informatics, Nursing, 36(12), 579-588.