Need help with my Health & Medical question – I’m studying for my class.
Many nurses are experiencing moral distress during their current career. During the COVID-19 pandemic many circumstances were and is making it difficult to take appropriate course of action. Moral distress caused by excessive workloads, responsibilities, and challenges being faced with end-of-life decisions are being faced during times of crisis. As you have reviewed justice is the behavior that professionals must demonstrate in ensuing that fairness and nondiscrimination of care is being delivered during care. McDermott et. al (2018) in an engagement of leaning and guidance nurses reviewed the Delphi method that was used in the development of ethical principles for global nursing (p.473). Studies like these are used in education and workplaces so that nurses can demonstrate ethical principles. Furthermore, as you have identified it is important that advance care nurses are able to keep justice in mind. Advance practice nurses hold a education at a master’s-level degree and hold the knowledge and are able to implement justice when delivering care. Great post.
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McDermott, R., Leffers, J., and Mayaka, J. (2018). Ethical principles and guidelines of global health nursing practice. Nursing Outlook, 66(5), 473-481. doi:10.1016/j.outlook.2018.06.013
Great perspective on justice and the current pandemic. Although we should definitely be trying to allocate resources towards the most amount of people, Rhodes (2020) argues that another facet of justice involves prioritizing based on need. More specifically, we must be smart and strategic about the resources we use and who we treat first. As an example, four patients show up to the ER, all needing fluids, but one is in septic shock while the others are just mildly dehydrated. Based on the perspective of justice that Rhodes (2020) describes, it would be wiser to prioritize the patient who was in shock as they are more critically ill. However, as you mentioned, it would not be fair to pour all the resources into a patient who cannot be saved but until the medical team is able to make that determination, we must be able to differentiate criticality when distributing scarce resources. Deciding who to save and who dies is not a black and white situation and we must use our judgement and medical expertise to help make difficult life and death decisions during this time.
During this pandemic, healthcare workers can be faced to make difficult decisions regarding which patient to save first given the scarce resources. The advanced practice nurse will have to utilize the key ethical principles that include, autonomy, beneficence, non-maleficence, fidelity, justice and paternalism. One ethical principle that can be used in that situation is justice. Justice leads us to ensure that care is provided on a fair and equal basis, regardless of the patient’s social or financial status (Davis, 2018). Being that there is a low amount of resources during a pandemic, it is important that the advanced nurse uses justice as a key ethical principle when deciding which patient will be saved first. It is vital that care is distributed fairly to every patient even during a pandemic. All patients have the right to quality care, and any breach of this standard of care by the physician or nurse violates the patient’s right to justice (Wood, 2017). Keeping justice in mind, the advanced nurse should approach the decision based on factors such as, the patient’s potential prognosis or the patient’s age. When making a decision the advanced nurse should identify the problem, apply the code of ethics, determine the nature and dimensions of the dilemma, generate potential courses of action, consider the potential consequences of all options, choose a course of action, evaluate the selected course of action and then implement the course of action (Forester-Miller, 2019).
Davis, C. (2018). Ethical decision making. Nursing Made Incredibly Easy!,16(2), 4-5. doi:10.1097/01.nme.0000529954.89032.f2
Forester-Miller, H. (2019). A Practitioner’s Guide to Ethical Decision Making. Retrieved 2020, from https://www.counseling.org/docs/ethics/practitione…
Wood, J. (2017). Ethical decision making. Journal of PeriAnesthesia Nursing,16(1), 6-10. doi:10.1053/jpan.2001.18202
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