THE MOST CHALLENGING ETHICAL GUIDLINE FOR HEALTH CARE PROFESSIONALS
Nursing as a profession has its code of ethics that guides nursing practicing as a profession. Almost all the ethical guidelines are challenging but in my own point of view, the most challenging one for me is nurses and patients- the autonomy of self- determination of the patients.
The nurse is supposed to respect the autonomy of self- determination of the patients and, also helps to enable the patients to take independent decisions by providing suitable information. Here comes the situation whereby the patient’s decision may not be the best for his health condition, but according to the ethical guidelines, the nurse is to respect the patient’s decision, without the nurse imposing its own decisions on the patients. During such situations, health care providers find themselves in difficult situations by having conflicting ideas and ethical dilemma, thus respecting patient autonomy verses protecting the patients’ health condition.
A typical case study is the situation where a patient who is suffering from a chronic lung disease and is under monitory, yet the patient demands smoking. Meanwhile, the patient is fully informed of the consequences of smoking on his health and the patient is not willing to let the nurses disclose the issue to any of his relatives.
The health care provider knows that, smoking could worsen the patients’ health conditions, but the case is that, the health care provider is to respect the patient’s autonomy. This situation for instance becomes very challenging as the nurse is also supposed to promote and maintain the good health of the patients.
In conclusion, the most challenging aspect of this ethical guideline “Nurse and patient-the autonomy and self-determination of patient” is when the patient’s decision is conflicting with the health care providers plan, and decision has to be made either by the patients significant other or by the nurse. This may prolong the implementation of the health care plan due to delay in reaching consensus.
WHAT CAN HAPPEN TO A NURSE WHO IS GUILTY OF ERROR OR NEGLECT
Medical negligence occurs when a doctor /nurse performs their job in a way that deviates from the accepted medical standard of care (Goguen n.d.).
If a nurse provides a care that is sub- standard in terms of accepted medical norms/ethical under the circumstances, then the nurse has failed to perform his/her duty and this is also said to be negligence (Goguen n.d.).
The National Authority of Medicolegal Affairs are responsible for the national guidance and supervision of health care professionals. That is, they are responsible for monitoring, providing the rules and guidelines governing the profession. They also pass judgement/sanctions to those that are found guilty of their offense in medical profession such as suspicion of medical malpractice.
When a nurse is found of guilty of his or her error or neglect during practice, the National Authority for Medicolegal Affairs have the right to issue appropriate measures to penalize the nurse. The National Authority for Medicolegal Affairs is a body responsible for nursing professional guidance and supervision that is they provide the guideline, code of ethics and rules which governs the practice of the nursing profession. They also grant the right to practice as a licensed professional. Therefore, if a nurse is guilty of error or neglect, the nurse will be sanctioned according to the acts of this body.
According to National Authority for Medicolegal Affairs, act of health care professionals section 26(1030/2000) sanctions for misconduct (Act on Health Care Professionals, 1994), the National Authority for Medicolegal Affairs may issue specific regulations and instructions to the nurse as to how the nurse should go about his/her professional activities. Depending on the type of neglect, the National Authority for Medicolegal Affairs may impose restrictions on the right to practice professional activity for a fixed period or until further notice. Thus, the nurse may not be able to exercise his/her full right to practice as a nurse, and there may be some limitations.
In other words, the right to practice as a licensed professional may also be withdrawn for a fixed period or until further notice. In this case, the nurse loses his/her right as a licensed professional during or within that stipulated time. In some cases, the National Authority for Medicolegal Affairs may interdict a professional with a protected title to use the occupational title of a health care profession as prescribed by Decree for a fixed period or until further notice. In this sense, the nurse may be prohibited from using the professional title. For instance, if the neglect was committed by a senior nurse, she may lose the title as a senior nurse.
Which depends on the gravity of the offence committed, the nurse’s sole right of a professional to practice may be cancelled out rightly. Unlike the other sanctions whereby the nurse can be called back to profession or a sanction may be uplifted, here in this case, the nurse may not have the chance to practice the profession again.
WHAT TO DO AFTER MEDICATION ERROR
If a medication error has been committed and the nurse as noticed it for instance, he/she has giving antibiotics to a wrong patient: Firstly, the nurse should discontinue the drug administration after which the patient should be assessed for any adverse reactions and treated accordingly. (Scrubs 2012).
Furthermore, the nurse should contact the physician as soon as possible and explain clearly the situation/error to the physician to assess if the patient requires an antidote to reverse the potential harmful effects of the dosage/medications. Also, the nurse should notify the rest of the care team which may result in considerable changes that would predetermine the patience’s care plan.
As soon as the situation has been resolved, the nurse is expected to document and make an incident report in full, detailing the circumstances of the error to examine the problem and implement better practice so that similar mistakes may not occur in future.