HI6006 Competitive Strategy Editing Service
Delivery in day(s): 4
Nursing profession is subject to a vast sum of legal, professional and ethical duties that the nurses must comply with during course of providing care (Arnetz et al, 2015). In the course of work, the ethical dilemmas may arise owing to contradictions between the two aspects of the practice. Overriding of such obligations and duties may subject the nurse to legal consequences and prosecutions in the court of law of the respective nations (Parker, 2016). The main legal and ethical duty is the right to patient’s autonomy and the duty of nursing care and the case is discussed in the study below.
The criminal history of any person in case of the United States is available to any person through name or birth of date details. This has implications on the nursing profession and care as impacting the duty of care of nurses and rights of the nurses along with the quality of care provisions (Storch, 2015). Thus the study is mainly focused at discussion about an article ‘Is it morally permissible for hospital nurses to access prisoner-patient’s criminal histories?’ by Paul Neilson.
The ethics in Nursing has many principles that are common with medical ethics such as Respect for patient autonomy and beneficence. The Nursing code of Ethics at US was developed by American Nursing Association (ANA) in order to guide nursing practice that matches quality care along with ethical practice. The nursing ethics is based on the nature of appropriate care and is based on the exploration of the everyday interactions taking place between the nurse and the patient (Crampton 2015). In the past days the nursing ethics was said to be focused on demonstration of loyalty to the practitioners and focused less on the patient at the care. Presently the International Council of Nurses had obligated the nurses to respect the human rights of the patient at care as a part of ethical nursing. The nursing ethics cannot be forgone as unethical and illegal behaviors on part of nurses are punishable or prosecutable in court of law (Pschudin, 2013). I agree to the article and to the point that nurses do try hard to meet out their duties while involving in care.
I agree that nurses must access prisoner patient’s information as in US as this help the nurses in care planning and delivery considerations but as discussed in the article this has an impact on quality of care nurses offer to ‘prisoners’ owing to bias and perception issues. According to the Law of Privacy, ‘Respect for Autonomy’ is an important consideration for the nursing practice which means that unless the patient at care gives consent over the treatment after being completely aware of the needs and the care provision as per needs of the client as per the ‘Informed consent’ consideration in the nursing or care practice in the respective nation (Pschudin, 2013). As in case of the prisoner patients, they may not be informed because of being severely ill stressed and in shock situation. As per the autonomy considerations, it is unethical to make decisions on the part of the prisoner patients, who is not informed or being taken consent about own care and treatment. The ethical dilemmas are a part of nursing profession as any other and the nurses may argue that they have the right to access the prisoner patient’s past or criminal history on the ground that this helps them in making care decision or knowing needs of the person at care (Crampton 2015). On the contrary this may be impacting their duty of care or the care provisions as allowing bias in the relationship between the nurse and the patient as discussed in the article (Arnetz et al, 2015). I think nurses may involve families of such person enhancing the quality care delivery.
I agree gaining access to prisoner information is right as most of the developed nations including US make use of the Person- centered care approach which implies that patient or their family members if they are incapable of making sound and informed decisions must participate in care planning and the needs assessment in the course of treatment (Pschudin, 2013). As in case of many prisoner patients, the nurses shall have access to the criminal histories and the other information of the person in order to allow informed care. Thus the knowledge and information about the prisoner patients and their religion, ethnicities, etc will help in making better care planning in consultancy with their respective families and cultures. Thus the nurses must have the right to access the prisoner patient’s information as available to every normal resident in case of America through name and date of birth (Gastman’s, 2013). The dilemma is whether the nurses shall allow the care delivery based on the information about their ethnicity, families, criminal history, etc or make decisions overriding the person centered care approach.
I do not agree to point in the article that nurses must use observational skills in care planning and delivery. I agree to point that nurses must form caring relationship with prisoner patients and it is correct as per the ‘Beneficence’ in the ethical principle of the nursing profession, the nurses must make the decisions in making care provisions that are nest in the interest of the patient or prisoner patient’s as in this case (Pschudin, 2013). The practitioner or the nurse as per this principle has to promote the good things and eliminate all the negative or bad things for the prisoner patient’s. This is helped by having the details about the prisoner patient’s present situation based on accessing his criminal or other relevant information as available in America and informing the prisoner patient’s friends or families or relatives about his present situation (Crampton 2015). This helps the nurses to have the background of making best decisions in the favor of the patient as the person may be disoriented, depressed, intoxicated or unstable thus incapable of making decisions. Thus the nurses have the right to have access to the prisoner patient’s information in order to follow the Beneficence principle of the nursing ethics. However the nurse and the doctors must with medical tests and examinations approve that person at care or the prisoner patient is incapable of making decisions (Arnetz et al, 2015).
I agree that having access to prisoner information is supporting the ‘Non-maleficence’ ethical principle, which stat that practitioner or the nurses has the duty towards not infliction of any harm to the patient with an intention (Storch, 2015). Nurses may plan for their safety precautions in case of patients where risk of violent incidents is high as discussed in the article (Parker, 2016). One of the solution to the ethical dilemma is that the nurse and the practitioners must support patient’s conditions with medical reports in order to demonstrate that decisions taken by nurse is best in favor of patient.
I agree it is important to consider the ‘Right to personal safety’ at the work implies that the nurse or the professional has the right and the duty to be responsible and cautions about their own safety concerns (Storch, 2015). I agree that nurses have faced violent incidents with prisoners at care as discussed in article thus they must be allowed information for own safety. As the care at times may involve patients that may harm them knowingly or unknowingly vulnerable individuals, dementia or mentally disordered people, criminals or prisoner patients thus nurses have rights to be equipped about self safety at practice. As per this right the nurses must have access to the prisoner patient’s information and criminal history in order to make them aware of the patient’s behavior and psychological aspects in the past and allowing them to ensure their own safety (Parker, 2016).
I agree that Equality in care is not possible through providing nurses with prisoner information as being murderer or like. Nurses may not provide equal care to prisoners as to non prisoners. ‘Duty of Care’ this kind of bias is not allowed and is said to violate the care duties of the nurses and impacts overall care quality and provisions to prisoner patients (Iliopoulos, 2012). As discussed in article, nurses had denied care and even harmed prisoner patients. Thus it is also correct that having information impacts their moral duties and behaviors.
I think it is correct to certain extent that accessing the prisoner patient’s criminal histories, the nurses may not be providing care or implying by their care duty as they would have been doing in absence of this information about prisoner patient (Armstring, 2014). Thus we can say that the access to the prisoner patient’s information interrupts with the ‘Duty of Care’ requirements of the nursing profession. Nurses are also human beings and they must be provided information accessible by all other human beings in case of US as this is in lieu with their ‘Human or basic rights’ and not allowing them to access the prisoner patient information is in violation with their basic right and differentiated behaviors by not allowing access to nurses (Storch, 2015). The nurses may have bias in delivering care provisions to prisoner patient and their personal values may impact their profession. They may be doing so in order to guide their own safety but their personal values are not supposed or acceptable in the profession. Thus again there is dilemma between the personal and the professional aspects of the nursing profession but I think personal aspects or nurses safety is important.
In my opinion, time must not be wasted in gaining information about the personal criminal information and wait for their consent, begin the treatment or care as the person’s life may be at risk (Parker, 2016). The accessing of the prisoner patients information may take some of the time while as per the moral duty of nursing profession and ethical considerations, this is their first duty to save the life of the patient at care. The Autonomy of the patient needs to be respect while the nurses must first uphold their professional duties of providing care to a human being who may be at life threatening risk (Parker, 2016). Thus again there is an ethical dilemma as whether to wait for gaining the prisoner patients information and details or just involve in provision of the best possible care to the person in need of care as may be at life threatening risk.
In my opinion nurses must be allowed criminal information but this shall not impact their moral behaviors and care quality towards prisoners. I suggest that Nurses may need to consult the legislation, guidelines and regulations and may need to develop active involvement in the Hospital Ethics Committee and meetings helps in development of ethical decision making and addressing the needs of the ethical dilemmas in nursing profession (Arnetz et al, 2015). The nurses must respect patient rights for the autonomy in care and the treatments of self and sticking to principles of beneficence helps the nurses in development of ethical decision making. ANA ethical code also helps nurses through providing guidelines regarding rights of patients at care which nurses must abide by. Nurses may have access to criminal record and other information of the prisoner patient but they must show non biased attitudes in care delivery and must have support evidence to show decisions taken by the respective nurses during course of care were best in favor of the patients. I agree that hospitals must invest in their training and making them to act ethically, legally and morally in abiding by their duty of care requirements and make sure the prisoner patient information is only used to guide their personal safety provisions during course of care.
In the course of work, the ethical dilemmas may arise owing to contradictions between the two aspects of the practice. ‘Respect for Autonomy’ is an important consideration for the nursing practice which means that unless the patient at care gives consent over the treatment after being completely aware of the needs and the care provision as per needs of the client. On the contrary this may be impacting their duty of care or the care provisions as allowing bias in the relationship between the nurse and the patient (Parker, 2016). Also the patient is first a human being and must be provided care rather than wasting time in the accessing of the information about the person. Also the Right to personal safety of the nurses and the Duty of care are at contradiction thus causing the dilemma as whether or not to allow the nurses to access the information about the prisoner patient’s (Pschudin, 2013). It can be said that the access to the prisoner patient’s information interrupt with the ‘Duty of Care’ requirements of the nursing profession. Nurses must well trained to act ethically, legally and morally in abiding by their duty of care requirements and make sure the prisoner patient information is only used to guide their personal safety provisions during course of care.
Storch, J.L. (2015). "Ethics in Nursing Practice". In Kuhse H & Singer P. A Companion to Bioethics. Chichester UK: Blackwells. pp. 551–562
Tschudin, V. (2013). Ethics in Nursing: the caring relationship (3rd ed.). Edinburgh: Butterworth-Heinemann.
Gastmans, C. (2013). "Dignity-enhancing nursing care: A foundational ethical framework". Nursing Ethics. SAGE Publications. 20 (2): 142–149
Armstrong, A. (2014). Nursing Ethics: A Virtue-Based Approach. Palgrave Macmillan.
Crampton R. (2014) Caring for prisoners-patients: a quandary for registered nurses. J Perianesth Nurs 2014; 29(2): 107–118.
Occupational Safety and Health Administration (OSHA). (2016) Worker safety in your hospital, online at https://www.osha.gov/dsg/hospitals/understanding_problem.html last accessed 22 March 2017
Arnetz, J., Hamblin, L., Essenmacher, M. (2015) Understanding patient-to-worker violence in hospitals: a qualitative analysis of documented incident reports. J Adv Nurs 2015; 71(2): 338–348.
Iliopoulos J. (2012) Foucault’s notion of power and current psychiatric practice. Philos Psychiatr Psychol 2012; 19(1): 49–58
Code of Ethics- ANA (2016) online available at http://www.nursingworld.org/codeofethics last accessed 22 March 2017
Parker, F., (2016) Ethics Column: "The Power of One" OJIN: Online Journal of Issues in Nursing. Vol. 13, No. 1 online athttp://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/Columns/Ethics/Power.htmllast accessed 22 March 2017