Posted at 10.01.2018
Nurses are subject to a large variety of moral, legal and professional tasks which can be so many to be talked about in this article so that's the reason only main important ethical and legal responsibilities will be talked about in this article. Based on the scenario, these main ethical and legal obligations will be admiration of patient's autonomy and the work of care which is given to all the patients. These tasks are professional and legal in New Zealand and even across the world which when breached can result in legal implications. These responsibilities are ethical tasks as well because honest considerations arise when these tasks are breached, factors such as when can these responsibilities be contemplated, so there for these obligations are ethical duties as well. In this article, the complete critical conversation will be about the professional, honest and legal issues that arise based on the given scenario.
According to medical council of New Zealand, nursing vocation is bounded by its own code of ethics. Ethics is thought as the branch of idea that addresses questions about morality, that is, concepts such nearly as good and wicked, right and wrong, justice, virtue, etc. In such a critical dialogue, Autonomy will be the key aspect, autonomy of patient and judgement of doctor in betterment of the individual. The competencies and rules related to the above mentioned scenario corresponding to nurse perspective are that the nurses should take action ethically preserving the standards of practice and nurses should respect the privileges of the clients. These codes found in this situation actually mean that a nurse should recognize and allows the personality of an person, should act in a culturally safe manner, should use knowledge and skills for the good thing about the patients, nurse is in charge of maintain benchmarks in her professional practice and really should practice in her own scope of practice.
A registered nurse is actually defined as the person who uses medical knowledge and critical nursing judgement to evaluate health needs of an individual so the best healthcare can be provided and advises visitors to self control their health. In this particular scenario, the individual suggests the pain report as 8/10 after three hours of experiencing morphine and the physician thinks the individual has become dependent on morphine. Being a nurse one should ask the patent to hold back for another hour so that he can have another dosage of morphine and then nurse should determine if the patient is actually reliant on morphine or he is actually in pain. Like a nurse, she will need courage, honesty and should maintain the advocacy role. With this scenario, it is very critical to decide that if the patient has become reliant on morphine or is it the doctor who thinks the patient has become centered, being a recorded nurse; you need to keep up with the autonomy of the individual keeping the standards of healthcare provided to the individual. "Autonomy identifies the human capacity for self-determination and freedom" (Journal of clinical oncology:2001). Autonomy has two aspects, one from the nurse's view and another one from patient's perspective, so n this article we will discuss autonomy issues from perspectives of nurse and the patient.
In this circumstance Mr. S is making continuous requests for having 40mgs of morphine which is recommended to him every 4hours PRN. He also says that the morphine is not actually reducing his pain and after three hours of having morphine he asks for another dose. Doctors feel that the patient is becoming dependent on morphine therefore the doctors prescribe him for a placebo of normal saline instead. There is a research study which is pertaining to about issues in autonomy of patients which is mainly focused on nurses understanding of patient's autonomy and group of regaining autonomy in patients. The autonomy of patients is usually influenced by circumstances such as family, health care provider, community etc. It is assumed that the autonomy issue can only be resolved with a team effort, which can include processes of health education, self management etc (Proot et al: 2002).
The main point of concern in this situation is that the individual is given a placebo rather than the morphine, so that the patient wouldn't normally require morphine over and over. "The justification for giving placebos is the fact that in the judgement of the giver, the function is effective to the patient" (Rumbold. G, 1999). This point has both negative and positive impacts on the individual and on medical professionals and the nurses. That is also relating to Health Practitioners Competence Assurance Function 2003 that the individual should be safe. "MEDICAL Practitioners Competence Confidence Act 2003 offers a framework for the regulation of doctors in order to protect the general public where there's a risk of damage from the practice of the career" (Ministry of health: 2010). The positive point is that if the patient has become dependent on the morphine, which is bad in line with the patient's health, which is why prescribing a placebo would be an improved substitute for patient's health. This is actually the good point of the scenario based on the nurse's perspective as the nurse would always help the better health of the patient which can only become excellent results for them rather than them being reliant on any medication. There is another positive point according to the nurse perspective which could be a priority that the patient is demanding morphine regularly to make him feel satisfied and relieved from pain, but in line with the nurse's assessment, the individual feels satisfied and relieved psychologically but that is not true, actually the individual has become emotionally trapped that morphine s the only real medication which can treat his pain. So, supplying him placebo is a much better option.
There are some negative tips as well. Based on the New Zealand legislation, this step of nurses comes against The Human Rights Take action 1993, which states that every specific has the right to know the truth. In this circumstance, the individual is unknown to the fact that he has been given for a saline instead of morphine.
According to a nurse, the largest moral, legal and the professional concern here's autonomy of the patient. Autonomy is an extremely powerful aspect of ethical construction of virtually all over the world. "Autonomy is an idea within moral, politics, and bioethical idea" (Autonomy: 2010, July). In these contexts, it identifies the capability of an individual to make the best decision. "In moral and political idea, autonomy is often used as the basis for deciding moral responsibility for your activities" (Autonomy: 2010, July). Autonomy methods to respect protection under the law of others to determine a course of action. So in this scenario, according to the right of autonomy based on standards of ethics, nurses should respect the patient's decision and really should respect of what they want. Health professionals haven't any right to deny patient's decision. Nurses should value patient's decisions and their autonomy to develop a dependable and professional relationship. According to this scenario, the patient's autonomy should be respected as the individual expresses the pain rating of 8/10 after three hours of having morphine. Mr. S has a right to choose if the morphine is alleviating his pain or not and the health professionals are designed to value his decision as patient is the individual who is suffering from an extremely severe pain. Nurses should provide proper education to the patient and should inform about the consequences of experiencing morphine repeatedly so the patient can find the best possible treatment for him.
The patient also has the to have the educated consent about any medication which is recommended to him. If he is given an mysterious medication without his consent, it comes against legal issues and can cause legal implications. In Mr. S circumstance, if placebo of saline instead of morphine is given to the patient without his consent, then he gets the right of action to state that the medication was given to him minus the consent and it can make legal implications. So, before prescribing or administering any medication to the individual, doctors or nurses must have full consent of the patient. Therefore informed consent can be an ethical, legal and a professional responsibility of nurses and even every doctor.
Consent is very effective in abiding ethical and legal tasks. Sometimes, regarding to a nurse, it could be effective for a patient not being enlightened about the medication, to get positive outcomes for patient's health. It really is effective according to the nurse, but it is actually permitting patient's decision and his condition. In some cases if a patient struggles to express what he needs, only a nurse can decide what is best for the individual but a person like Mr. S, who are able to point out his condition must be up to date of the placebo of saline.
The nurse has a work to prevent the individual from anything worse taking place to the individual but if the patient is not psychologically ill, he/ she should have full to take any decision for the kids. If the patient says that morphine is not reducing his pain this means that it's not really working for him. It isn't good to state that the individual has become dependent on morphine. For example, if nurse administer Mr. S a placebo of saline instead of morphine, his pain can go most detrimental which is not good for the patient which is not the best practice of an nurse.
The New Zealand legislation says that a person deserves to be informed and a right to have liberty. It is under Man Right Act of 1993 which when applied ensures that a person has a right to decide what they need without any interference of another person. With this act there is a point of experiencing informed treatment and one has right to chose if indeed they want the procedure or not.
Ethical issues and changes in population are responsible for nurse-client romance. The role of the nurse is to keep up client's autonomy, maintain and improve health insurance and promote a specialist romance of trust. "The key ethical guidelines of value for persons, autonomy, beneficence, nonmaleficence, justice, and veracity should be inclusive in the models of the provider-patient relationship" (Margret. M, 1998, para. 1 ). There are a few contracts in nurse-client romance which are limitations, confidentiality and restorative nurse behaviours. Healing nurse behaviours are self awareness, being genuine, respectful, culturally safe, accountable and moral practice. They are the things which are expected from a nurse by a client and the world. All these contracts are applicable internationally. Nurses being culturally safe with clients have grown to be the medical practice more powerful. This concept of cultural protection was first released from New Zealand and is now used all around the globe. Cultural protection is to keep own culture in mind and respecting other's culture and practicing very much the same.
In this essay, we looked at the truth of Mr. S who's in severe pain and it is in need of another dose of morphine. He declares pain credit score of 8/10 and doctors feel that the patient would depend on morphine which he'd never realise that is recovering his pain or not. Mr. S condition efficiently states the moral, legal and professional issues that surrounds nurse's and patient's autonomy as patient's need of morphine would be conveyed by the nurse to the physician. Here patient's condition has been critically mentioned and the main affect is on patient's autonomy and informed consent of the patient. Nurses roles and the code of ethics have also been discussed in the essay.