My Nursing Ethics Kelly Martinez Grand Canyon University: Introduction to the Study of Ethics 10/14/2012 My Nursing Ethic PASSION: Why am I here? As a child I was always attracted to the smaller, weakened animal I found in my yard, i. e. dying birds, kittens, bugs, etc. The animals we owned were never neutered which resulted in a numerous amount of puppies and kittens. I was intrigued by the cycle of life. Originally I wanted to become a veterinarian. The financial strain on my family made it apparent that it would not be possible.
As fate would have it, there was a two year waiting list for nursing school, but I was readily accepted into a two year respiratory program. At the end of the respiratory program, I stayed for one more year to specialize in NICU. As time passed, I became very passionate about the patient care aspect; however the nurse always pulled rank on my practice. It was at this point in my career that I knew I wanted to be the nurse. I felt I knew everything there was to know about nursing; luckily I was mentored by a group of seasoned nurses who molded me to be the nurse I am today.
They taught me who I was and what I was made of. I learned that I had very strong traditions of the Contemporary medical care culture. I was raised a strict Catholic and believe that the Physician held the same status as that of the Priest. Both were held in the highest regard and you never questioned their word. You were religious about visitation, immunizations and treatment. I never questioned the physician in regards to treatment plan or care. I was a stickler for following the rules no matter what my own personal morals or beliefs were.
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MOTIVATION: What moves me to act? For the most part, I worked in a predominately white middle class community hospital which had roughly the same ethical morals, values and beliefs as I did. Rarely did we care for a minority. As I matured and began to recognize what my nursing ethics were all about, I began to question physician orders when I felt they were not in the best interest of the patient. I began to question treatments that I was performing which seemed to have little or no effect.
Because of my strong moral convictions, when a family member questioned the treatment I was providing, which I didn’t have a real answer for except, “your doctor ordered it” made me uncomfortable. I was unhappy with this response as was the family. I needed answers for myself as well as the patient. I needed to believe that I was practicing medicine to the best of my ability. I had a moral obligation to my patients to do the right thing regardless of the physicians written orders. I was the one caring for the patient and their families for 72hrs. t a stretch, while the physician was there for only 15 minutes. I came to understand the patient’s culture, values and beliefs. I wanted to advocate for their wishes. I need to do more than carry out orders written in a chart. INSPIRATION: What keeps me in motion? Because of my personal values and beliefs and how it related to my nursing philosophy I felt obligated to stand up for what I believed in. As luck would have it, I was at the beginning of the, “Evidence Based Practice”, era. I jumped on every class, committee, and program I could find to support my nursing convictions.
I taught one of the first “Culture Sensitivity” classes at my facility. I rewrote the ICU visitation policy to include families during CPR if they were so inclined. I attended classes on wound care and followed home care nurses to learn how they treated unstageable non healing wounds. I was no longer willing to follow doctor’s orders just because they were written in a chart. I needed to know that the care I provided was morally and ethically sound. LOYALTY: Whom do I serve? One late Sunday afternoon I received a very obese restless, combative full arrest from the ED.
I was challenged to keep him in the bed and from pulling out his ET tube. I turned to his family for assistance in finding out why he was so angry. His wife was a very small timid abused woman who was afraid of her own shadow. He was an abusive alcoholic and a diabetic. He was non-compliant with any medical regimen. His legs were swollen with weeping wounds. He refused any medical treatment and had told his wife if she took him to the hospital he would surely kill her. Because of this woman’s own personal morals and convictions, when she thought he was near death, she called 911.
I reassured her that she had done the right thing. I called the doctor to receive orders for comfort measures and also ask if he was aware of the patient’s wishes for medical treatment. He was very clear that he knew the patient’s wishes to be a No Code, however; due to his age and diagnosis, he also knew this patient could be cured of his medical aliments. Ironically, the patient pulled out his ET tube with his tongue. As soon as the tube was out, the patient arrested. I started CPR as per protocol. I encouraged the physician to talk with the wife and respect the patient‘s wishes.
I was in a moral dilemma with caring out physician orders vs. the patient’s wishes. I was uncomfortable ordering care for a patient that I clearly knew did not want it. The physician was in his own dilemma because he knew the patient’s medical status could be cured if he was given the chance. After much debate, the patient was re- intubated and made a full DNR. Later I heard the patient worked his ET tube out again with his tongue and died. The physician did not speak to me for a very long time because of this incident.
It is because of this journey that I now oversee the Palliative Care Department. I assist patient in understanding the implications and ramification of their advanced care directives. References: Characteristics of Ethical Dilemmas, (2012). Retrieved on October 14, 2012, from www. nln. org/ce/mcgovern/tslg015. htm Doherty, R. , Purtilo, R. (2011). Ethical dimensions in the health professions. (5th ed. ) (57-58). St. Louis:Mosby. http://www11. georgetown. edu/research/nrcbl/pcbe/bookshelf/reader/chapter3. html
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