Nursing practice is associated with the need to make evidence-based ethical decisions that may have diverse effects on patients, nurses’ colleagues, and their healthcare facilities. One of the most recent situations related to ethical decision-making involved communication aspects. I administered the medications in accordance with the developed treatment plan for my patient. In several hours, I noticed a certain deterioration of her health and addressed the physician regarding the matter. He said that some negative effects were possible, so it was better to monitor vital signs. When I asked the physician to see the patient, he said he had more urgent cases to address and will come shortly. In several hours, the patient’s physical condition worsened significantly, so I came to the physician and asked him to come as soon as possible or rather immediately. I saw the physician’s reluctance, so I stressed that the situation was serious. When the physician checked the patient, he changed the treatment plan by replacing some medications with others. In less than two hours, the patient’s condition improved considerably.
Although no legal action was undertaken and no further issues regarding the patient’s health occurred, some legal ramifications could have taken place. For instance, the hospital (as well as the physician and me) could be sued for negligence. Failure to assess, monitor, and communicate could become the primary accusation in that case (McBride, Tietze, Robichaux, Stokes, & Weber, 2018). If I had not convinced the physician to assess the patient’s state and change the treatment plan, the patient’s health could have deteriorated dramatically. The patient could demand some compensation, which would result in quite substantial financial losses for the hospital.
In the mentioned situation, I did not address our ethical committee or other healthcare professionals. However, our Nurse Manager played quite a considerable role in my decision-making process. We have regular training aimed at improving communication and interdisciplinary collaboration. One of the major lessons I learned is that my responsibility is to ensure the provision of all the necessary details to involved stakeholders and make sure that the patient receives high-quality care.
Training is one of the methods to improve decision-making because nurses need to have the necessary skills and knowledge to make decisions in diverse situations (Davoodvand, Abbaszadeh, & Ahmadi, 2016). Irrespective of working experience and years in practice, nurses need to learn more about the latest ethical decision-making models. Excessive workload and fatigue can make nurses less attentive to numerous details that can lead to serious issues. Another method to improve the quality of decision-making is to develop effective protocols that will guide nurses’ in their daily practice. In order to introduce such protocols, it is necessary to conduct continuous research and engage healthcare professionals, administrators, and the ethics committee. Although all cases are unique, it is possible to create sound plans to respond to situations that are similar in some ways.
In conclusion, it is necessary to note that nurses have to make ethical decisions that can have various effects on the involved stakeholders. Adverse patient outcomes, legal ramifications, financial and reputational losses, emotional distress are only some problems that can arise due to unethical decisions. Therefore, hospitals should make sure that training and protocols are available for their nursing staff, which will be instrumental in improving the quality of ethical decisions made by nursing professionals.
References
Davoodvand, S., Abbaszadeh, A., & Ahmadi, F. (2016). Patient advocacy from the clinical nurses’ viewpoint: A qualitative study. Journal of Medical Ethics and History of Medicine, 9.
McBride, S., Tietze, M., Robichaux, C., Stokes, L., & Weber, E. (2018). Identifying and addressing ethical issues with the use of electronic health records. OJIN: The Online Journal of Issues in Nursing, 23(1).