Using the options below based on your specialization; create an ethical and legal decision-making dilemma involving an advanced practice nurse in the field of administration, education, or a nurse practitioner:
Administration Dilemma Healthcare Needs versus Resource Allocation
Education Dilemma Nursing Students Religious Beliefs versus Provision of Care
Practice Dilemma Honesty versus Withholding Information
Describe one ethical principle and one law that could be violated and whether the violation would constitute a civil or criminal act based on facts.
Construct a decision that demonstrates integrity and that would prevent violation of the ethical principle and prevent the law from being violated.
List three recommendations that will resolve advanced practice nurses moral distress in the dilemma you have presented.
Support your paper with a minimum of three scholarly references.
Full Answer Section
Ethical Principle Violation:
- Beneficence: This principle emphasizes the duty to act in the best interest of patients and to avoid causing harm. Reducing staffing in the telemetry unit could put patients at risk for complications and potentially violate the principle of beneficence.
Legal Violation:
- Nurse Practice Act (Specific to State): Most Nurse Practice Acts mandate that nurses maintain a safe patient environment and appropriate nurse-to-patient ratios. Reducing staffing below the safe ratio could be a violation of the Nurse Practice Act, which could be considered a civil offense.
Making an Ethical Decision:
Sarah demonstrates integrity by taking the following steps to prevent ethical and legal violations:
- Data Collection and Advocacy: Sarah gathers data on current staffing levels, patient acuity, and potential safety risks associated with staff reductions. She uses this data to advocate for alternative cost-cutting measures with a lower impact on patient care.
- Collaboration: She collaborates with other hospital leaders, including nurses and physicians, to brainstorm solutions for reducing costs while maintaining safe staffing levels.
- Transparency: She communicates openly and honestly with staff about the financial situation and the proposed cuts. This allows for open discussion and the exploration of alternative solutions.
Recommendations to Reduce Moral Distress:
- Open Communication: Hospital administration should foster open communication with staff, including nurse leaders like Sarah, to address concerns and explore solutions collaboratively.
- Support Systems: Providing access to employee assistance programs and mental health resources can help nurses cope with the moral distress associated with resource allocation challenges.
- Ethical Decision-Making Frameworks: Hospitals can implement ethical decision-making frameworks to guide resource allocation decisions and ensure patient safety remains a top priority.
References:
- American Nurses Association. (2017). Code of Ethics for Nurses with Interpretive Statements. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/
- Dos Santos, L. S., & Sousa, A. C. P. de. (2018). Moral distress in nursing: A concept analysis. International Journal of Nursing Studies, 83, 101-108. https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=09757619&AN=139165663&h=ILjFA4TUP2YS6y7aQaZCTvDec1lQ5GY7dbTxnVXdcl86XmH%2BtXgI1qeNNInCAXN4aBZfY8lCYX19oaoaqv%2Fp9A%3D%3D&crl=c
- National Council of State Boards of Nursing. (2023). Nurse Practice Acts by State. https://www.ncsbn.org/policy/npa.page
Sample Answer
Scenario:
Sarah, an Acute Care Nurse Practitioner (ACNP) and newly appointed Director of Nursing at City General Hospital, faces a challenging decision. The hospital is experiencing financial strain and needs to cut costs. The administration proposes reducing staffing in the telemetry unit, which cares for patients with heart rhythm problems. Sarah knows this reduction will decrease the nurse-to-patient ratio, potentially compromising patient safety and quality of care. Additionally, the telemetry unit is already understaffed, and further cuts could lead to increased burnout among nurses.