Reflective Practice Essay: Ethical Issues in Nursing Practice

This reflective essay, written by a nursing student, analyzes an ethical dilemma encountered during a clinical placement using Gibbs' reflective cycle. The incident involves a 75-year-old patient, Mrs. Annie, who was often neglected by nurses despite her need for assistance due to mobility issues. The essay explores the student's feelings, evaluates the situation, and applies deontological ethical principles to analyze the nurses' actions. The student identifies the ethical issue of nurses failing to provide adequate care and respect for the patient's needs, violating NMC standards. The essay concludes with an action plan focusing on improving communication, understanding patient needs, and adhering to ethical and legal obligations in future practice. The essay references relevant literature to support its arguments and provides a comprehensive reflection on the ethical challenges faced in nursing practice.

Reflective practice
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Introduction
The fundamental aim of the paper to use Gibbs reflective model to reflect upon an incident
related to nursing practice based on an ethical issue. Usually, nurses are faced with an ethical or
legal dilemma, where nurse must incorporate knowledge of legal and ethical aspects. As per
Nursing and Midwifery Code of Conduct (NMC), the nurses must gain knowledge regarding
ethical and legal aspects. The paper will explore the critical incident that raises ethical issue and
understanding of how to become effective nurse.
Gibbs reflective cycle
Description
My placement was in a busy public healthcare setting that treats different older patients those
who were coming for rehabilitation and rest. Mrs. Annie was a 75-year-old patient in the ward
who was dealing with orthopedic problems. She had broken her leg badly by falling from the
staircase in her home and also had bone deterioration. Due to this, the physiotherapist assisted
her to use a special strap and stick so that she can walk properly. Most of the time, she was
feeling afraid of falling, and so she used to call the nurses by pressing the calling bell to come
and help her. The nurses who were busy at times often overlooked Mrs. Annie and told her to
stop pressing the bell (Trollor et al., 2016). Most of the time, I witnessed that the nurses moved
the calling bell out of her reach so that she will be unable to call the nurses in any emergencies.
Feelings
When I first met Mrs. Annie, I introduced myself to build a strong and respectful relationship
with her. I wanted to make her feel relaxed as I observed that she felt quite nervous. It is the
responsibility of the nurse to understand the needs of the patient by developing a therapeutic
relationship with them (Mammen, Hills & Lam, 2018). Most often, the nurses complained about
Mrs. Annie's behavior that she is arrogant and does not understand that nurses are busy and tired.
I could understand the concerns of the nurses, but still, believe that their attitude towards her was
not fair. After observing the overall situation, I asked my mentor what is to be done to overcome

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this situation. I felt that in this case, it is ethically not permissible for the nurses to avoid Mrs.
Annie by not paying attention towards her.
Evaluation
During my placement, I got to know that exhaustion is a common issue faced by nurses as they
have to work for long hours without any break. Around 20% of the working population reported
symptoms that come under the issue of exhaustion (Lomas, Roache, Rashid & Jarden, 2019). I
was highly interested to know what are the ethical dilemmas faced by the nurses during their
nursing practice. Based on this incident, I was unhappy by observing the critical situation of Mrs
Annie as she was an old lady, and most of the time avoided by the nursing staff. As per NMC
standards, the nurses must enhance culturally safe workplace environment for providing quality
and safe care to the patients (MacLaren, 2018). However, as per my understanding, although
nurses face problems related to fatigue, it was not a major factor in this case. I realized the fact
that rather than tiredness, the nurses were lazier to look after Mrs. Annie.
Analysis
I analyzed that based on this incidence, the principles of deontological ethical principles are
applied as it helps in examining what actions could be taken to provide quality care to Mrs.
Annie. The deontology model states that nurses possess the responsibility to promote and
safeguard the well-being and interest of the patients. Thus, I acknowledged that nurse within the
healthcare setting must take efficient actions to safeguard and promote the wellbeing and health
of Mrs. Annie. As per the theory, there possess a duty of care where the nurses have the
responsibility to give attention to Mrs. Annie's concern (Snelling, 2016). As per NMC standards,
the incidents must be reported to the nursing unit manager (NUM). Thus, I have reported the
incident to the NUM regarding the situation faced by Mrs. Annie that reveals that the nurse
conduct was criminal. I learnt that nurses must respect and identify the dignity and uniqueness of
patients ethically and as per legal framework.
Conclusion
I am well aware of the fact that all the nurses do not avoid patient's call bells when they get
annoyed or tired when the patient is calling continuously. But I observed that generally few of

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the nurses do not give attention to patients call bell as they fail to understand the critical situation
faced by the patients. According to NMC standards, the nurses must adhere to ethical and legal
obligations along with national laws to provide safe care (Wilson & Cooper, 2016). Moreover, in
the future, I will strive hard to overcome the challenges that restrict me from doing the right
things as per NMC standards. I will practice safely by understanding the need of the patients and
assist them in emergencies which is required by the nurses while handling Mrs. Annie.
Action Plan
By developing an action plan, my significant aim is to execute further research on how to deal
and help the patients who require constant support by adhering to NMC standards. It is essential
to act appropriately to safeguard and promote the wellbeing and interest of patients (Gill,
Kendrick, Davies & Greenwood, 2017). Furthermore, I will implement an effective
communication strategy to understand patients need and contributing factors to assist them in
difficult situations. The effective communication strategy will help in contributing new solutions
and suggestions to comply with legal and ethical standards (Levshankova, Hirons, Kirton,
Knighting & Jinks, 2018).
Conclusion
The paper concluded by reflecting on an incident in a healthcare setting that raises ethical issue
using the Gibbs Reflective Model. Utilizing this model helped me in structuring my feelings and
thoughts adequately. It enhanced my level of awareness regarding the patient's feelings and
needs. It also helped in enhancing my knowledge regarding ethics and law that can be used in
practice in the future.

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References
Gill, F. J., Kendrick, T., Davies, H., & Greenwood, M. (2017). A two phase study to revise the
Australian Practice Standards for Specialist Critical Care Nurses. Australian Critical
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Levshankova, C., Hirons, D., Kirton, J. A., Knighting, K., & Jinks, A. M. (2018). Student nurse
non-attendance in relation to academic performance and progression. Nurse education
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Lomas, T., Roache, A., Rashid, T., & Jarden, A. (2019). Developing ethical guidelines for
positive psychology practice: An on-going, iterative, collaborative endeavour. The
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MacLaren, J. A. (2018). Supporting nurse mentor development: An exploration of
developmental constellations in nursing mentorship practice. Nurse education in
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Mammen, B., Hills, D. J., & Lam, L. (2018). Newly qualified graduate nurses’ experiences of
workplace incivility in Australian hospital settings. Collegian, 25(6), 591-599.
Snelling, P. C. (2016). The metaethics of nursing codes of ethics and conduct. Nursing
Philosophy, 17(4), 229-249.
Trollor, J. N., Eagleson, C., Turner, B., Salomon, C., Cashin, A., Iacono, T., ... & Lennox, N.
(2016). Intellectual disability health content within nursing curriculum: An audit of what
our future nurses are taught. Nurse Education Today, 45, 72-79.
Wilson, K., & Cooper, N. (2016). The professional role of the nurse. Clinical Skills for Nursing
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