Posted at 11.19.2018
When defining a personal nursing philosophy, the individual nurse should never simply review his / her own schema of principles and values, but must reassert their own private self-assurance in their value system. By firmly taking under consideration the frameworks of theorists, such as Kohlberg (1981) and Gilligan (1982), nurses will better understand their own private worth as well as the prices of the career (Burkhardt & Nathaniel, 2008). Theorists of the recent times must be looked at with a professional respect in order to ensure that a nurse getting into an increasingly difficult health care environment has a main sense of these own private and professional prices and it is also flexible enough to react to individual obstacles, that they may encounter during the period of their nursing job.
The purpose of this paper is to spell it out an event in which several personal beliefs were proven and illustrate how these beliefs affected the professional decisions that were made. It'll further assess the level of development of these values. Personal beliefs will be differentiated from those of the institution and in will be discussed where these prices are appropriate and where they result in conflict. Finally, it will express how these values align with the precise tenets of the American Nurses Association Code of Ethics.
Nurses have one patient and one event that stick with them throughout their profession. It's the patient that they never forget, the connections that will influence all future interactions, and the function that contributes to their self-awareness.
I experienced this very patient, the one who required me to reconcile my worth with those I pledged to look after, early in my job on the intermediate unit. His examination was pulmonary fibrosis. My challenge was to keep up his air saturation. His care consumed nearly all my time, as I had him on both a nasal cannula and nonrebreather mask to maintain sufficient oxygenation. I helped him in his all self-care activities in order to conserve his energy and supervised him to all his lab tests that shift. Each day, I discovered he was a widower, possessed two daughters, and was an avid ballroom dancer.
When I came back to the unit the next day, he was again assigned to me. As I was getting record, the ward secretary recommended me his air saturation had lowered to 70%. I visited check up on him and found him very stressed, and attempting to inhale. I knew I had developed to determine his code position and commenced to ask him why he was so anxious. His response was his daughters would occur from out of town in a couple of hours and he recognized he didn't have that long. In those days I began to discuss whether he required intubated and the implications of such a heroic work, explaining that he would more than likely never survive extubation. He begged me to do what was necessary for his daughters to see him one more time.
I called his doctor, received an order for Ativan, and was recommended to have the house officer start to see the patient. The house officer found its way to the area and understanding his poor prognosis, recommended me to just continue comfort steps. However, since I put mentioned this at great period with the individual and was aware of his wants, I felt compelled to act more aggressively. I again called his medical doctor and explained to him the dialogue I had developed with the patient. He gave me the order to call anesthesia and have the individual intubated and transferred to the Coronary Care Unit.
Once the patient was intubated, I followed him to the Coronary Care Unit and advised them his daughters would be arriving soon. Shortly after returning to the machine, I was paged to the phone. Coronary Care wished to speak with me. The patient's nurse advised me that he previously expired minutes prior to his daughters achieving the hospital. These were requesting to speak to me, as I was the previous person to talk to their dad.
Throughout this experience, I maintained my personal ideals of family, compassion for others, integrity, and credibility. Although I understood as a nurse, intubating this patient was futile, I had developed to honor his hopes. However, I had been also obligated to be sure he was up to date of his prognosis and the consequences of intubation.
Personal ideals are unique specific beliefs, attitudes, benchmarks, and ideals that guide tendencies, life experience, and decision making. These principles are organized in a hierarchy predicated on the level of importance the average person places on each value. It is therefore critical that nurses notice that another's personal value system mat differ from their own. Discovering one's own value system through introspection and self-reflection is the first rung on the ladder in moral decision making (Bandman & Bandman, 1995). The second step is understanding the worthiness system of others, and acknowledging and respecting them as evenly valid as one's own system (Yeo & Morehouse, 1996).
In this situation, I recognized intubating the patient had not been effecting his prognosis, but his strong family values compelled me to advocate for the fulfillment of his wants. Through our honest interaction, I got comfortable that the individual was well informed that was a way to prolong the inescapable. I recognized he was wanting to give his daughters closure. Of all nursing activities over both days I looked after this patient, the most important if you ask me was enough time I spent chatting with this patient. I could relate with his daughters and truly relay his previous conversations, conveying how important family was to him. More importantly, I known his family prices and why he was requesting intubation.
Psychologist Lawrence Kohlberg revised and expanded after Jean Piaget's (1963) work to form a theory that discussed the introduction of moral reasoning. Kohlberg's (1981) theory of moral development discussed six phases within three different levels. Kohlberg long Piaget's (1963) theory, proposing that moral development is a continual process that occurs throughout the life expectancy. Through an understanding of Kohlberg's (1981) theory, nurses better understand their values and exactly how they relate to the ethical decisions they make (Burkhardt & Nathaniel, 2008).
The post-conventional level, also called the principled level, involves phases five and six of moral development (Kohlberg, 1981). There is a growing realization that individuals are distinct entities from world, and that the individual's own point of view might take precedence over society's view; they may disobey rules inconsistent with the own ideas. Post-conventional morality views guidelines as useful but changeable mechanisms-ideally rules can keep up with the general cultural order and protect human rights (Kohlberg, 1981).
In Level Five (public contract influenced), the planet can be regarded as holding different thoughts, rights and values. Such perspectives should be mutually respected as unique to each person or community. Guidelines that not promote the general welfare should be transformed when necessary to meet "the best good for the best amount of people" (Kohlberg, 1981). This is achieved through compromise. My degree of value development falls into this level, when i was able to respect the worth of my patient and platform my health care on his prices.
Several congruencies can be found between my personal worth and the institution's principles. The words in the quest declaration that are emphasized are patient-centered healing, quality good care, and healthy priorities related to patient care, community commitment, financial health insurance and physician and staff well-being. My personal values include a strong sense of compassion for individuals and a interest for superiority.
However, incongruencies exist when individual determination is insufficient to keep patients safe and their good care effective. There is a direct correlation between staff collaboration and patient outcomes. Responsibility for fostering an environment of teamwork rests on the shoulder blades of management, which is currently falling brief of like the best interest of the patients and all users of the medical team in their decision making. That is a period for change within the business, as we've been recently bought with a for-profit corporation. I foresee these incongruencies as momentary.
My ideals are in alignment with the ANA Code of Ethics (2001) tenet 1. 4, which declares that the nurse respects the patient's right to self-determination or autonomy (Burkhardt & Nathaniel, 2008). It further declares that the nurse is obligated to provide accurate, complete and appropriate information that will aid the individual in the decision-making process. I personally did not support my patient's decision, but well known his privileges and was comfortable that he previously appropriate information to make his decision.
According to Burkhardt and Nathaniel (2008), ethical interactions are grounded in a self-awareness of your respective own ideals and the self confidence to talk about these principles with others. We must be focused on the ever evolving process of value development and value the values of others. These concepts are the foundation for honest decision making and aid the nurse in conflict image resolution when personal, professional and institutional worth are not in alignment.