Ethical Conduct: The Lead Nurse at St. Johns Hospital Case Description (Essay Sample)

Ethical Dilemma
Student’s Name:
Institutional Affiliation:
Ethical Dilemma
Introduction
When one joins college, he or she will certainly have the ambitions of completing their course successfully and landing a good job. One expects to enjoy their work given that the profession they will be in fulfills their desires and interests. What most people fail to plan for are some of the challenges that come with work life especially in relation to ethical issues. Managing one’s expectations and learning how to maneuver through various ethical dilemmas is of the essence. After graduating, I managed to secure a nurse job at St’ Johns hospital. Hard work and commitment to delivering the best possible care saw me rise through the ranks to lead nurse in my department. Being a lead nurse is a role that came with its fair share of challenges. There were moments when I had to take responsibility for mistakes made by the colleagues working under me. The most notable incident for me while working as the lead nurse at St. Johns hospital that had ethical implications was a suicide attempt by one of the patients at the hospital.
Case Description
Mr. Brown was a chronic illness patient admitted at St. Johns hospital with a chronic illness. Apparently, his condition was not improving and suffering for him was immense. My department went out of its way to ensure brown received the best possible care and make him feel wanted and appreciated. However, for him, it turned out that he was not really interested in getting better and hoped that he would die sooner than later. His death wishes were unknown to any of the practitioners at the hospital or any of his family members. When death was not forthcoming, he began harboring suicidal thoughts. He was, however, unsure of how to go about it, an issue that disturbed him most of the time. After many days of deep thinking without any solution, he confided in Mrs. Stephens, the main nurse in charge of him. He pleaded with the nurse to keep this a secret between them. Mr. Brown wanted Stephens to relent on monitoring him at night so that he could accomplish his mission. Brown knew that there was a low risk of unexpected visitors to his wardroom. The nurse agreed to have it as a secret to gain the patient’s confidence in her and enable her release all the details.
The situation presented the nurse with an ethical dilemma. She was in a dilemma on whether to inform me and/or any of the other department members of the patient’s weird request. The best ethical decision in accordance with the institution’s code of conduct involved the nurse sharing such information with the department. After a careful analysis of the situation the nurse resolved to share with me and the rest of the team members the information relating to Mr. Browns intentions of committing suicide. As the head of the department and her supervisor, I had to step and offer leadership in the case. I invoked my knowledge on the hospital’s code of conduct including the guidelines that guide the conduct of nurses in general. I took advantage of the incident and sort to use it help everyone learn on how best to handle such a situation in case of need in the future or when offering counsel to someone in requiring guidance on such kind of matter.
I sat my team down and we went over the issue and discussed on how to go about it. I advised the members to strictly follow the institution’s self-harm protocol, requesting them to maintain efficient communication with Mr. Brown. Together with the team, I explored some of the reasons behind suicide attempts on part of the patient and availed the appropriate intervention in handling such risk factors. In collaboration with them, I came up with a schedule to assist in monitoring the client and further care accorded to him. The patient later on successfully moved to palliative care showing no signs of behaviors suggestive of self-harm. Four months later, he passed away peacefully in the company of his family, friends, relatives and men of the cloth.
Relevant Ethical Principles that Applied to the Case
There is a strong connection between ethical principles and ethical dilemmas. Any form of discordancy between two principles may result in ethical dilemmas. Such a situation is more so where the application of two varying ethics principles is sort but without involving a violation of any one of them. In the case of Mr. Brown, I noted that both the principle of autonomy and beneficence applied. It is the relevance of both principles in the case that caused the dilemma the nurse in charge of the patient had faced. The two principles could be applied in equal measure. The problem was that the application of either of them resulted in the violation of the other. There is a serious logical incompatibility between beneficence and autonomy, a fact to which the dilemma on whether the nurse should have shared the information with us against the patient’s wish arose. I also found the principle of non-maleficence relevant in the case.
Non-maleficence supports the beneficence principle. However, it infringes the principle of autonomy. The dilemma was significant as there arose a conflict involving beneficence, respect for autonomy and non-maleficence all of which were relevant in the scenario. Beneficence emphasizes doing good and implementing steps that benefit people. As a nurse and in accordance with beneficence principle, one ought to carry out actions that contribute to the wellbeing of the patients under their care. Such actions have to be positive, within the law and in line with expectations of the nursing ethics code. Mrs. Stephens had to consider the actions that were in the best interests of the patient. I had informed, Mrs. Stephens when she approaching me in relation to the issue that her reporting the matter to me was the right thing to do as it was what was expected and best fitted in with the beneficence principle. Her actions helped the department take a necessary intervention to ensure the patient’s attempts at inflicting self-harm on himself were unsuccessful.
Non-maleficence principle required nurses to ensure that their actions would not inflict harm on their patients. Ignoring the patient’s intentions of committing suicide would have in itself have been an action that caused the patient harm. Mrs. Stephens’ actions helped avert self-harm. With regard to autonomy principle, the nurse feared that she may have infringed on the patient’s right to his own decisions. As a team, we realized that despite the patient’s autonomy, as nurses, in line with autonomy principle, the patient’s confidentiality also needed to be respected and that we were supposed to seek the patient’s consent. The choice, of maintaining the secret would have considered informed consent but then lead to self-harm. Reference to the precedents and the common law helped me maneuver through the conflicting viewpoints. Letting the patient inflict self-harm would have equated to assisted suicide. Under the law, patients do not have the right to seek assistance to die at the time of their choice and as such, it does not recognize assisted suicide. Putting this postulation by the law into perspective, it would be against the law for me to allow the patient to go forth with his plans of committing suicide. Even though Brown’s independence is significant, it cannot override the law that prohibits assisted dying by healthcare practitioners.
Current Hospital Culture
The hospital’s culture `at the moment offers an elaborate and clear way of going about just any ethical dilemma or ethical issue. Sharing of information relating to the clients with fellow team members is now paramount in cases involving the wellbeing of a patient to ensure that the best possible care...