The experience of caring for others when they are at their most ill and vulnerable comes with certain responsibilities, challenges and moral distress.
Our digital edition, How to Navigate Nursing Ethics, explores many of the issues nurses face every day. Don’t miss this in-depth look at important topics, such as weighing outcomes versus what the patient wants, using the right language and advocacy.
Ethical problems will arise
Stephanie Seburn, BSN, RN, CCRN a nurse education consultant at Northwestern Medicine in Chicago, tells her own story of working as an ICU nurse for several years and the types of ethical dilemmas that came up in her role.
“As an ICU nurse, I encountered many situations in which families struggled with decisions regarding what care was in the patient’s best interest,” she said. “RNs and MDs had to handle situations in which patients’ requests or refusals of treatment were incongruent with best medical practice. These issues cause caregivers, including myself, to experience moral distress.”
Such issues can be even more difficult when the patient is a child. In “Caring for terminally ill children presents ethical challenges,” author Heather Stringer writes about the debates that can come up in this delicate situation.
The story looks at the case of Charlie Gard, a U.K. infant diagnosed with mitochondrial DNA depletion syndrome — MDDS. The case captured headlines in 2017 when the child’s parents disagreed with the recommendations of British physicians not to pursue experimental treatment in the U.S.
“Nurses are in a particularly ideal position to help parents make informed decisions about their terminally ill children because they typically spend the most time with patients and families — though helping families understand a child’s medical situation is somewhat of an art,” Stringer wrote.
There’s strength in numbers
Understanding the responsibilities surrounding ethics is crucial. Our “6 key principles of ethics” infographic serves as an excellent guideline. In “Are you an ethics champion?,” Carol Taylor, PhD, RN outlines three core responsibilities to which nurses should adhere.
Read how RNs in Delaware are leading successful ethics committees, proving there is strength in numbers when it comes to addressing ethical issues that exist in the nursing profession.
“Nurses involved in ethics committees are those who are willing to go above and beyond their daily responsibilities and provide valuable insight and input into patients’ plans of care. In doing so, nurses will see increased numbers of staff-initiated consults and improved knowledge and communication of staff and the healthcare community at-large on ethical issues,” wrote Janice Petrella Lynch, MSN, RN.
The digital edition also includes an interview with Heather Fitzgerald, MS, RN, a clinical nurse ethicist who leads the ethics nurse liaison program created in 2004 at Colorado Children’s Hospital.
“To help caregivers take action, we developed a moral courage policy stating that caregivers are expected to speak up for patient safety and raise ethical issues, and those to whom concerns are raised are expected to receive these concerns with respect and collaboration,” Fitzgerald said in the interview. “The policy was reviewed by stakeholders at all levels, and it went into effect in 2014. To our knowledge, we are the first hospital in the country to develop this type of policy. We have come a long way from the dynamics of that contentious consult several years ago.”
Also included in the edition are topics such as confidentiality, calling out unsafe practices and end-of-life care. Become engaged in compelling writing, such as the story told by April Hothersall, RN, OCN, CMSRN, a nurse who helped a dying patient make lasting memories with his daughter.
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