Ethics means the principles that guide what a professional such as a registered nurse is expected to do in delivering services to patients in healthcare institutions. It describes what is correct or wrong regarding decisions that influence nursing behavior, subsequently affecting patients’ treatment outcomes (Pozgar, 2014). Bioethical decision-making involves addressing ethics in healthcare, medicine, and biotechnology, among other disciplines. In other words, bioethics issues are the correlation between drug administration, legal matters, religion, science, and policy-making (Butts & Rich, 2016). There are many legal actions taken against a nurse who neglected their duties due to poor ethical considerations in their line of responsibilities (Piryani et al., 2016). Bioethics contributes to important methodologies and insights to make changes and policies ethically linear with resources in the medical facilities.
Bioethical concerns trigger nurses to ask what they should do, how they should treat others, and what type of professionals they should be in healthcare provision facility. Bioethics is associated with a nurse-patient relationship, resource allocation, sexuality and gender, disability matters, mental health, clinical research, and assisted techniques in medical procedures such as reproduction in human beings (Taylor, 2016). This paper aims to apply the bioethical decision-making model to analyze the specific clinical situation chosen below.
The Patient-Care Situation in Which a Registered Nurse Intervened
Patient X was admitted to a healthcare institution where he complained about various symptoms. First, the patient told the doctor about fatigue and shortness of breath. Second, the patient admitted suffering from chest pain, irregular breath, and showed some pale or yellowish skin signs. When the laboratory tests were done, the doctor concluded that Patient X suffered from a lack of vitamin A. However, the nurse involved in the process took the keen analysis of the procedure and discovered that the possibility of Patient X having vitamin A deficiency was rather low in contrast to anemia. The nurse provided some insights to the doctor by critically analyzing the situation with the healthcare professional.
The process was conducted ethically, and the decision was made, revealing the first diagnosis was incorrect. Patient X’s results later indicated that he was suffering from a lack of iron. The doctor had to change the prescription of the drugs and therapeutic strategies that were supposed to be introduced to Patient X. From the scenario, the nurse played a vital role in advocating for Patient X’s right medication. This shows that the nurse was focused on the well-being of the patient to ensure quality healthcare provision.
Application of Bioethics Decision-Making Model
In the situation, when a patient receives a wrong diagnosis, a Bioethics Decision-making Model can be applied to factor in several issues in the decision. First, the medical indications involve autonomy and beneficence. The second factor is the quality-of-life which involves nonmaleficence and veracity (Taylor, 2016). The third is patient preferences by asking whether or not the patient has the capacity and personal wishes. Lastly, contextual features such as social, economic, legal, and institutional impacts may arise if the problem is not solved immediately. Bioethical decisions are a combination of ideas from many models, such as the Four Box Model. The description of Patient X’s situation is analyzed to show the extent of nursing advocacy that the nurse portrayed.
Definition of the Dilemma
In this case, it involves a clear description of the subject by expressing the torn-between situation. The issue here is the wrong diagnosis caused by erroneous test procedures or negligence of the doctor. In other words, the nurse weighs between concealing the discovery or safeguarding the health of the patient. The problem would be a nurse having a phobia of outshining the doctor who appears to be the boss because they seem to be showcasing (Butts & Rich, 2016). The issue is that it may be a matter to consider ethically to keep the due duties of a responsible nurse.
Identification of the Medical Facts
At this point, a nurse may apply ideas of the Four Box Model that includes the first step of medical indications by analyzing the possible medical diagnosis for the patient’s symptoms. In that case, the patient had anemia which is a lack of iron in the body. Some of the symptoms that the nurse compared are weakness, fatigue, irregular heartbeats, among others. However, the doctor’s diagnosis information indicated that patient X was suffering from vitamin A deficiency (Piryani et al., 2016). The nurse made decisions based on the facts and expertise concerning the two-malnutrition deficiency. Medical facts are guided by medical knowledge and the details concerning the disease.
Identification of Non-Medical Facts
Here the nurse checked the quality of life by determining other facts, such as if the family members have had such a problem. That was possible by interrogating the members present, including their lifestyle. It was important to note that the difference between the two diagnoses is negligible due to similar causes (Butts & Rich, 2016). Additionally, the patient was asked various questions regarding his past health conditions to ascertain the possible indications. Non-medical facts are useful to determine the feasibility of a disease occurring depending on the information given.
Review of Underlying Ethical Concerns
At this point, the nurse considered the contextual features that would result in the final justice to Patient X. Some of the factors that helped make a decision here are social, economic, legal, and other circumstances that would prevail if an alternative diagnosis was not factored (Pozgar, 2014). The nurse probably feared possible personal and institutional liabilities due to the omission of an important step when carrying tests for Patient X. Reviewing underlying health conditions is important since it gives a history of Patient X with malnutrition diseases.
Definition of an Alternative
According to the research and knowledge that the nurse had on malnutrition deficiencies, the actual disease was anemia as opposed to vitamin A deficiency that has been concluded earlier. After various considerations, the doctor revealed that Patient X’s test results indicated a diagnosis of iron deficiency (Piryani et al., 2016). Therefore, the doctor changed the prescriptions made earlier, which gave the nurse confidence that there was an assurance of recovery for Patient X without any other complications (Pozgar, 2014). The nurse played a critical role in the process and challenged the doctor on the accuracy of the test process involved in that particular diagnosis.
Discussion of Nurse’s Role as an Advocate for Patients
The concept of nursing advocacy in a clinical setting can be concluded on several attributes. They are safeguarding of patient’s autonomy, representing the patient to the medical facility, and championing for social justice (Pozgar, 2014). From the attributes, there is a reflection that advocacy enhances the patient’s safety and well-being under medical care (Taylor, 2016). Patient advocacy should be an ethical responsibility for registered nurses. When a doctor gives a wrong diagnosis due to ignorance or skips an essential step, a nurse’s insights can improve the quality of care to the patient. The reason is that a patient will be prevented from getting the wrong drug administration which could deteriorate their conditions.
The motivation of nurses reporting possible mistakes is to fulfill the professional allegiance that they get after training. Communication is a crucial factor in nursing advocacy because the parties have to be on clear and concise concurrence on the matter (Taylor, 2016). Research shows that successful ethical advocacy for a nurse dwells in the quality of the relationship between a nurse and a patient (Butts & Rich, 2016). Nursing advocacy can be elaborated as ‘whistle blowing’ by exposing negligence that can be encountered in a clinical setting.
Nurses’ role in patient advocacy is essential, and this means they are supposed to be in the frontline to give insights for any possible harmful action. A nurse must empower vulnerable clients and deliver them from uncomfortable scenarios that are encountered during clinical procedures and treatment process. The role of a nurse is important as it assures patients of necessary treatment and protects them from incompetency in medicinal administration. A nurse is always supposed to be in an exceptional position to advocate for the patient as it is a requirement by all medical institutions’ ethical practice. It is recommendable that nurses take courage and act according to their required performance levels under the guidance of bioethical conclusions to avoid negligence in hospitals.
Butts, J., & Rich, K. (2016). Nursing ethics (4th ed.). Jones and Bartlett Publishers.
Piryani, R., Piryani, S., Poudel, R., & Sharma, M. (2016). Needs assessment for teaching/learning nursing ethics for master of nursing students. Asian Bioethics Review, 8(2), 134-142.
Pozgar, G. (2014). Legal and ethical issues for health professionals (4th ed.). Jones & Bartlett Learning.
Taylor, M. (2016). Impact of advocacy initiatives on nurses’ motivation to sustain momentum in public policy advocacy. Journal of Professional Nursing, 32(3), 235-245.