The issues associated with patients’ life wishes provoke many controversies and confusion in health professionals. The do not resuscitate (DNR) orders oblige nurses to not perform the cardiopulmonary resuscitation (CPR) on a patient and let him or her die. The DNR is a statement of the patient’s informed decision about what he or she wants to do as his/her disease advances, and according to the ANA Code of Ethics for Nurses (2001), RNs should always regard the patient’s will as a priority and “actively participate in assessing and assuring the responsible and appropriate use of interventions in order to minimize unwarranted or unwanted treatment and patient suffering” (p. 7). Moreover, nurses should advocate for engaging in discussions about DNR with patients, their family members, and other nurses. It is possible to say that this task and role in nursing practice is important as it may help to mitigate potential ethical dilemmas due to differences in the patient’s and his/her attorney’s points of view regarding CPR and DNR.
Case Study Analysis
In the reviewed case study, the similar situation caused an ethical problem as the son of a dying patient with the DNR order disagreed with the nurse’s decision to stop the CPR and threatened to sue the hospital. Because of this conflict, the nurse felt uncertain whether her decision was right. Nevertheless, her action was consistent with the ANA statement. To prevent this ethical situation, the nurse might have discussed the DNR and the patient’s choice with his family members in a timely manner and probably might have encouraged them to dissolve the differences in opinions on this topic beforehand.
Ethical Situation in the Professional Practice
In my professional practice, there were no ethical dilemmas related to patients’ life and death choices. However, there was one linked to nurses misconduct and whistleblowing. It happened when an RN delegated the task to a nurse who did not have sufficient experience to perform it. The RN did so because the day was very intense and there were not enough practitioners on the shift, so task delegation seemed to be the only way to do everything appropriately.
However, delegating tasks to a less experienced and unlicensed nurse could be detrimental to patients’ health. Thus, it is possible to say that although the RN was under pressure, she conducted irresponsibly. When another RN noticed it, she did not talk to her colleague but addressed the charge nurse directly. As a result, the nurse who delegated the task was severely reprimanded. Due to this, the relationship of the RN who reported the incident with the majority of other team members was damaged as they criticized her conduct and tended to support the other one.
The given situation can be described as the case of internal whistleblowing. Whistleblowing as such is an act of revealing wrongdoing to the public or authorities (Provance, 2016). The case demonstrates that although whistle-blowers may have an internal motivation to act ethically and reveal some potentially unjust or harmful organizational or employee behaviors, their decisions to report may impact them negatively.
An act of whistleblowing is rather an unusual behavior. Most of the people prefer not to make any efforts to expose wrongdoers even when considering that their behavior may be extremely harmful because whistleblowing is associated with many threats including excess psychological pressure, damaged social life, and even job loss. Moreover, while whistle-blowers may see themselves as heroes, others (e.g., colleagues) may regard them as “treasonous” villains (Provance, 2016, p. 1). And it is possible to say that the situation in which people prefer to keep silence and fear of retribution for being honest is stimulated by the lack of legal support and underdeveloped culture of organizational ethics.
Adverse impacts of whistleblowing on individuals’ life indicate the need for change in the principles of professional and organizational conduct. Honesty and ethical behavior should not be regarded as something unusual but rather should be promoted by hospitals. In this way, it will be possible to minimize the damage to the well-being of whistle-blowers.
American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Nursesbooks.org.
Provance, S. (2015). Ethics of whistleblowing. OpEdNews.