Ethical Dilemmas in Nursing

Ethics are principles and values that guide the conduct of people in various aspects of life such as their workplace, learning institutions and even in social functions. Nursing ethics is concerned with activities that take place in the field of nursing. Nursing ethics are vital to making sure that the objectives of the health department are met ensuring that the service users receive high-quality care and that the public image of different clinical settings is safeguarded.

Part One

Staffing patterns are one of the major ethical dilemmas that the LPN is faced with after working for six shifts as an in charge. The LPN feels that since the unit is jam-packed, she has to assume some of the checks she was taught to conduct in school before administering medication to the patients. Moreover, the LPN was placed as an in charge just after four shifts of orientation. The LPN is still new in the profession and the respite care unit. She may not have adequate experience on how to work fast and efficiently, and that is why she not only longs for her off days but feels the need to skip some checks. 

            I feel that the part on ‘responsibility and accountability’ in the CLPNBC standards is under threat in this situation. Responsibility and accountability in the CLPNBC standards emphasize the need to ensure physical, psychological and emotional fitness in practice (CLPNBC, 2014). In this case, the LPN may be fit physically, but she is not psychologically prepared to deal with the respite unit as an in charge. Being her first job since she graduated, she does not have any experience on how to deal with many patients quickly and still ensure that they get high-quality care and that is why she skips some checks that are vital before administering medication.

            As a family member, I would advise the LPN to take time during her off days to evaluate her personality and as such determine her strengths and weaknesses and how she can use them to adapt to the busy schedule in the respite care unit. The issue of self-concept is vital in ensuring that service users get high-quality care from the nursing professionals (Potter & Perry, 2010). Although the clinical setting should enhance the self-concept for this LPN through staff development, she also has a role to play to ensure that she is up to the task of being in charge of the unit. During her off days, this LPN should seek for mentorship and training programs to ensure that she is empowered to handle the respite care unit as the one in charge.  

Part Two

            Client-focused service is the primary ethical responsibility that the LPN faces when she returns for the evening shift. The CLPNBC professional standards emphasize on the need for the nurses to communicate, collaborate and consult with the clients, their primary caregivers and other members of the healthcare team to ensure that service users receive high-quality care (CLPNBC, 2014). However, the LPN feels that the unit is jam-packed and she can hardly answer phone calls from families of some patients who are their primary caregivers. Moreover, she only received a very brief handover from the departing nurse which also undermines proper communication among the healthcare team. It is an ethical responsibility for the LPN to ensure that clients receive focused service even though the unit is abnormally busy.

            The LPN runs the risk of demonstrating unethical behavior since she becomes more anxious as the day progresses on. The standards for ethical practice require that nurses should identify ethical issues, recognize potential conflicts and take action to prevent or resolve them (CLPNBC, 2014). When the Director of Care comes into the unit, the LPN should have taken the opportunity to explain the current state of the unit and that she feels the need to get assistance since the workload is making her anxious. However, the failure to communicate with the Director of Care may lead the LPN to make mistakes which will affect the effectiveness of her actions.

            I would not consider this LPN to be a professional nurse. Professionalism in nursing requires that individuals should demonstrate competence as they practice different skills in the profession (Yoder, 2017). The LPN has shown a lot of incompetence such as failure to communicate to relevant authorities on the need for more nurses in the unit yet she is the one in charge. The LPN also fails to pick up calls and doesn't seek assistance when she realizes that she has forgotten how to operate the phone. She waits until the Director of Care pops up in the unit to check on matters. The LPN has the responsibility to demonstrate competence by creating a healthy working environment. 

Part Three

 One of the new issues that arise from the meeting with the Director of Care is on the need for the LPN to ensure effectiveness in caring for the patients which translates to no maleficence. Non-Maleficence is an ethical duty for the LPN to be at her best and avoid causing harm to the patients especially regarding treatment procedures (Potter & Perry, 2010). The response from the meeting places the LPN at a position where she now has to live up to the expectations of the respite unit. The nurse has to adapt very quickly and learn strategies which she can apply to ensure that the patients receive high-quality care even in a very busy unit.

            The LPN has not yet addressed her professional requirements. The CLPNBC professional standards under responsibility and accountability state that nurses ought to take actions that promote safe, competent and ethical care for clients (CLPNBC, 2014). The principles further state that it is the role of the nurses to advocate for policies and procedures that assist their clinical settings in complying with the CLPNBC standards of practice. Although the LPN has discussed on her progress with the Director of Care and she has highlighted the busy schedule in the department that requires an increase in workforce, there are no policies or measures that have been put in place to ensure that a healthy working environment is created. There is a possibility that the LPN will continue with her incompetence as she tries to settle into the job.   

 Interdisciplinary collaboration in nursing focuses on the need for involvement of all the members of the healthcare team in ensuring that patients access effective and high-quality care (Arnold & Boggs, 2015). In this case, the Director of Care seems to be complacent on the need for interdisciplinary collaboration which is unethical. The Director of Care fails to see the need to add more staff to the unit or even assign the LPN a less involving task considering that she is in her first employment since she graduated. The director only reassures her by telling the LPN that she will go through it failing to recognize that this may affect the quality of care that the patients receive.

Conclusion

Ethical guidelines are very crucial for the LPN. The ethical standards will guide her on the fundamentals of the profession as they assist her to offer high-quality care to the patients. Moreover, the moral guidelines help in creating a healthy working environment characterized by trust and respect between the patients and other professionals in the unit. As the LPN continues to uphold the ethical considerations of the profession and calls for help as advised by her director, she will finally settle into the job and find that she can offer high-quality care to all the patients. 

References

Arnold, E., & Boggs, K. U. (2015). Interpersonal Relationships E-Book: Professional Communication Skills for Nurses. Amsterdam: Elsevier Health Sciences.

CLPNBC. (2014, May). Professional Standards for Licensed Practical Nurses. Retrieved from College of Licensed Practical Nurses of BC: https://clpnbc.org/Documents/Practice-Support-Documents/Professional-Standards-of-Practice-for-Licensed-Pr.aspx

Potter, P. A., & Perry, A. G. (2010). Canadian Fundamentals of Nursing.

Amsterdam: Elsevier Publications.

Yoder, L. (2017). Professionalism in Nursing. MedSurg Nursing, 26(5), 293-295.