Ethical dilemma in nursing advocacy

d. Case Scenario Greg worked as an emergency room nurse at a small hospital where they offered basic primary care services as well as basic emergency care services to patients presenting to the hospital. During one of the days, Greg was working the day shift with a primary care physician who saw the patients in the emergency room. A patient was brought in by relatives with complaints of painful chest and difficulty in breathing. The patient has a history of hypertension but was well until a few moments ago when he started to complain of left-hand pain and pain in the scapula region which cleared and was followed by increased chest pains which he described as unbearable. The patient who had previously been diagnosed with hypertension was rushed to the hospital with characteristic signs and symptoms of a heart attack.

Cardiovascular complications such as heart failure in hypertensive patients can occur due to the increased workload due to high blood pressure which can lead to atherosclerosis which clogs the coronary arteries supplying blood to the heart (Messerli, Fischer, Rimoldi & Bangalore, 2017). Blockage of the coronary arteries can result in progressive and sudden attacks such as in the patient’s case (Messerli, Fischer, Rimoldi & Bangalore, 2017). In an episode of heart attack, a patient may die due to decreased oxygen and nutrient supply to key organs such as the brain which can occur within a short period without medical interventions such as cardiopulmonary resuscitation. In this scenario, hence immediate action was critical to prevent death or disability for the patient. The disadvantage of doing so is that the decision would be based on a non-existent advance directive with no actual proof of the patient own wishes or those of a surrogate.

Such a decision would also violate the nurse ethical principle of beneficence and nonmaleficence as well as violate the duty of care owed to the patient. Violation of the duty of care constitutes negligence and can be actionable in a court of law hence placing legal liability to the nurse for failing to provide care to the patient. There are no foreseen benefits of taking this alternative decision both the patient or the providers. Following up on the decision made, it is imperative to ensure that the patient, as well as their families, are educated on advance care directives and the statutes that define and guide their utilization and the functions as well as the legal application. Nursing ethics (4th ed.