Ethical Dilemma Case Study

1 January 2017

Nurses are faced with ethical dilemmas every day. There are a lot of different beliefs surrounding ethics and the code of ethics. Ethics and ethical issues have always existed, that is why they have put in place the code of ethics. The American Nursing Association (ANA) Code of Ethics isa guideline to help nurses determine which course of action to pursue. Every minute many ethical decisions are made, some may not comply with guidelines and others the patient’s will never understand. In this case study the nurse is put in an uncomfortable position and has two find a way to comply with the family, the patient, and the doctor’s orders.

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How can she report to the doctor the information the daughter has told her? How she approached handling the situation and not let the patient know his daughter does not want to care for him? How does she break the news to the patient that he will not be going home with his daughter? These are just several of the questions the nurse will have to answer to provide the best possible care for her patient. All ethical decisions should comply with the code of ethics and always be for the patient’s health. Ethics should be recognized from the patient, the family, nurse, and doctor’s point of view or scope of practice.

The purpose of this paper is to find ethical issues within the case study. The paper will highlight the definition of ethics, the dilemma the nurse faces in the case study, and the possible solution. The case study involves a 65-year-old Hispanic male admitted in hospitalwith hyperglycemia. The ethical issues beganwhen the nurse is told by the daughter of the patient she cannot care for him. The nurse is put in a position of finding a place for her noncompliant patient. The nurse is also informed the patient has sought help from a curandero.

A curandero is ann Hispanic folk medicine practitioner. “Curandero use a range of procedures from messages, herbal supplement, prayer, magic, and talk therapy to treat people. The strong focus on talking to the patient and embracing often deeply held superstitious beliefs offers a fertile ground for the placebo effect”. (RationalWiki, 2010). The patient has not taken his prescribe medication and his eating habits are also noncompliant. The patient is dealing with the death of his wife and the patient’s daughter believes he is acting this way on purpose and is unable to care for him properly.

The aughter does not want to tell the doctor about the patient seeing a Curandero,but wants her father to be admitted into a nursing home in order for him to receive the proper care he needs. The nurse would need to consult with the Code of ethics book on the nursing floor to proceed with the best possible solution to the problem. The code of Ethic for Nurses is a guide for carrying out nursing responsibilities in a consistent manner with a certain quality in nursing care(American Nursing Association, 2001). There are ethical principles that a nurse should learn to apply to each situation that they feel an ethical decision will need to be made.

The history of ethics has been around for a long time. Nurses have an ethical obligation to care for patientsand do no harm. Ethical conflicts and dilemmas occur every day in the health care world. “Ethics is defined as the rules or standards governing the conduct of a person or the members of a profession”(FARLEX, 2011). The nurse should have the adequate skills and experience to provide great care to the patient. Nurses should always accept their moral and responsibilities that come along with their job and title. Nurses help to minimize risks and provide safety measure for the individual who is receiving care.

There are several ways the nurse can approach this situation. The first is to help easy patient’s S. Z. daughter’s fears about her father. The nurse will need to talk with the daughter and they both can collaborate on how they can get her father to comply with doctor’s orders. The second is to educate patient S. Z. on the importance of eating right, taking prescribe medication, and the dangers of combing his medication with herbal medication. The third, is to speak with the doctor and inform the physician on the patient situation and all the information that the daughter has informed her on.

The first two choices leave the doctor out of the equation. The best possible solution will be to speak with the doctor and let him know what is going on with the patient. The doctor will need to know everything that is going on with the patient in order for the doctor to give the patient adequate care. This solution will allow the doctor, the nurse, and the patient’s daughter to collaborate and set up a care plan for the patient. “Collaboration is not just cooperation but it is the concerted effort of individuals and groups to attain a shared goal”(Ruth Ludwick & Mary Cipriano Silva, 2011).

Collaboration requires a mutual understanding and respect among the healthcare team providing the care for the patient and having an open dialogue amongst the people involved. The doctor, the nurse, the daughter, and the patient will need to discuss how to care for the patient once discharged from the hospital. The patient’s daughter may not want to voice her concerns in front of the patient, but the patient will need to be informed on why he is going to an assistant living facility instead of home with his daughter.

The nurse and doctor will be the ones to inform patient S. Z. on the reason he his being discharge to a nursing home in a matter that he can understand and avoid letting him know his daughter cannot provide adequate care for him at her home. The doctor will need to have a psychologist assess the patient because of his depression and admit him into an assistant living factuality so they can help watch over him like his wife use to. In order for patient S. Z. to receive the care that he needs the nurse will need to inform the doctor on what is going on with the patient.

The standard of nursing practice and the nurse’s responsibility to provide quality care requires that relevant data be shared with those members of the healthcare team who need to know”(Ruth Ludwick & Mary Cipriano Silva, 2011). Only the information that pertains to the patient treatment and wellbeing should be disclosed. With patient S. Z. having diabetes and substituting his medication for herbals medication can put his life in danger. Keeping his cultural beliefs in mind, the nursewill need to educate the patient on the importance of taking his medication in order to keep his blood sugar under control.

Ask him for a list of his herbal medication that he is currently taking, to see if it is safe for him to take with his prescribe medication. Allowing the patient to combine his beliefs with his care plan will bring a better out come for the patient’s health. If the doctor is unaware of the patient’s holistic approach to his health can prescribe him medication that iscontraindicateand can cause the patient harm. Taking what the daughter’s concerns into consideration, the nurse will have to make the ethical decision to inform the physician on every detail about the patient’s health.

If the nurse can help the daughter understands that it is her goal to ensure the best possible help for her father. In order for the patient to receive that care, she will have to disclose the information that she entrusted her with. “Interactions with the patients and their families who are struggling with these issues are emotionally demanding and fraught with the potential for understanding. In the midst of anger, confusion, and often dysfunction healthcare professionals are expected to provide safe care and arrange for optimum disposition or placement”(Richard A. Bryan & Childers, 2004).

The patient’s daughter should come to the understanding that it is in the best interest for her and her father. The American Nursing Association (ANA) codes of ethic are the guidelines in which nurse’s follow to help them determine the course of action to take. The Code of Ethics compels nurses to do the right thing in the patient’s best interest. This case study raises several questions on how to provide the patient with the care and help he needs while incorporating the family wishes. It is important for the nurse to help the family cope with the situation as well as the patient.

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