Get In Touch : 07923249792

Unit 4 Ethical and Legal Issues Affecting the Nursing Assistant Review

/Unit 4 Ethical and Legal Issues Affecting the Nursing Assistant Review

Unit 4 Ethical and Legal Issues Affecting the Nursing Assistant Review

Referral decisions are likely to exacerbate a strain that health care professionals themselves experience under normal circumstances – a perceived moral and emotional discomfort when making or implementing a decision to cancel medical treatment that contributes to it or keeps a patient alive longer than they would otherwise survive. Health care professionals often intuitively feel that stopping treatment is more morally troubling than abstaining. Nurses reported feeling that stopping life-sustaining treatment or therapy can feel like killing the patient. 14 Health professionals may believe that the decision to stop treatment is more consequential than the decision not to start treatment. In contrast, 15 treatment refusal and discontinuation decisions are generally considered morally equivalent by most bioethicists, legal regulations and international professional guidelines. 16 This “equivalence view” states that if the refusal of a particular treatment is acceptable to a particular patient (for example, because it is unlikely to be effective or cumbersome), discontinuation of treatment is acceptable under otherwise equal conditions (if it proves to be ineffective or cumbersome or becomes after a certain period of time). The need to repeat triage to account for incoming patients who may have a greater chance of recovery is likely a cause of moral distress for clinicians. 17 In some contexts, the relationship between nurses and patients appears to be completely vague, since it may be left to the `discretion of [l]inische [l]ead`. 11 In England, the ratio of nurses to patients is already hotly debated, as there are no statutory minimum quotas (except in intensive care, where ventilated patients are treated strictly on an individual basis). During a surge in Covid-19 cases, even protected conditions must change given the number of patients requiring urgent treatment. A recent NHS England paper suggests that during this pandemic, six ICU patients could be cared for by an ICU nurse with the support of two nurses with previous or recent ICU experience, two nurses with no ICU experience and a support team of four support staff. 12 Although these figures may seem reasonable, the level of competence required remains questionable, as does the question of whether hospitals will be able to comply with those proposed figures. All of this raises a host of practical clinical and ethical questions about what a minimum ratio should be in a public emergency, what care is considered essential, how and what to prioritize for patients (beyond obvious life-saving interventions), and when we start causing harm.

Nursing strength has been shown to influence patient outcomes. 13 It is also unclear how crisis standards apply to care and how or for what caregivers remain responsible. In situations like the Covid crisis, caregivers should be encouraged to remember that circumstances are out of their control and accept that some patients will not survive, even if nurses are working to alleviate their suffering and save as much as possible. The Covid-19 pandemic has highlighted many of the difficult ethical issues facing healthcare professionals in caring for patients and families. The decisions faced by these frontline workers are fraught with uncertainty for all parties involved. We focus on the impact on nurses, who represent the largest healthcare workforce in the world, but whose perspectives are not always fully considered. This essay addresses three broad ethical issues that raise various concerns and are likely to affect nurses around the world in unique ways: the safety of nurses, patients, colleagues, and families; allocation of limited resources; and the changing nature of caregivers` relationships with patients and families. We call on policymakers to ensure that caregivers` voices and perspectives are included in local and global decision-making to minimise the structural injustices that many carers have faced so far. Finally, we urge caregivers to seek sources of support during this pandemic. Contemporary nursing ethics emphasize the relational dimension of all human activities, especially nursing activities, recognizing that nurses` personal and professional lives are often based on interdependent relationships of responsibility and care.

4 Applying this relational representation of care to current practice can help policymakers and health system leaders identify additional risks in nursing work – as well as the emotional weight and practical implications of those risks. This relational context suggests that nurses` concerns about PSA may stem not only from concerns about personal safety, but also from concerns about the transmission of Covid-19 to their loved ones, especially those suffering from illnesses that make them particularly vulnerable, or because they may be the sole support and care of dependent children or adult parents. Nurses regularly and voluntarily care for patients in risky situations. However, their obligation to provide care under inadequate protective conditions (e.g. lack of PPE) compromises their safety, the safety of their loved ones and their ability to provide long-term care. Addressing these conditions requires a disproportionate degree of altruism and self-sacrifice. The COVID-19 pandemic – with nearly two million cases worldwide and 113,030 deaths1 – has highlighted many of the difficult ethical issues healthcare professionals face when caring for patients and families. The decisions faced by these frontline workers are fraught with uncertainty for all parties involved. We focus on the impact on nurses, who represent the largest healthcare workforce in the world, but whose perspectives are not always fully considered. 2 The impact of COVID-19 on nurses and other health care workers is likely to be long-lasting.

We call on policymakers to ensure that caregivers` voices and perspectives are included in local and global decision-making to minimise the structural injustices that many carers have faced so far. Finally, we urge caregivers to seek sources of support during this pandemic. For nurses in North America, many health systems have integrated clinical ethics counseling services with ethicists who can identify and unravel the complex ethical issues that cause moral stress and mitigate the negative effects of these burdens. Other support services and colleagues include employee support programs, clinical psychologists, pastoral services, and mental health helplines to treat mental distress or other concerns that may arise. The unprecedented crisis facing the world community is a lesson in humanity. Nurses bring their expertise, knowledge and skills to the health care system in many ways. Today we see this intrinsic and external value and we must do everything in our power as public citizens to defend everything they do for us. We owe them a great deal of gratitude and respect. The inadequate protection of health workers in all health facilities raises professional and ethical questions about the extent of these workers` duty to care for patients – including the limits of this duty.

The revised 2015 American Nurses Association Code of Ethics states that the primary duty of nurses is to receive care services, whether it is from a patient, family or community. The Code of Ethics also states that caregivers have a duty to promote their own health and safety. 3 These diverse and even competing tasks, especially as they combine or conflict with civic and personal interests, place nurses – many of whom have conditions that make them more vulnerable to Covid – in a dilemma. They seek to balance their charitable obligations with their duty to care for patients with rights and responsibilities to address gaps in their health systems in a manner consistent with the rights and obligations to protect themselves and their loved ones. Dominic Wilkinson et al. suggest strategies that may help healthcare professionals overcome their aversion to stopping treatment, even if it is ethically justified. 18 Under normal conditions, strategies of particular importance to critical care staff and other health professionals involved in stopping life-sustaining interventions include conditionally providing treatment based on measurable treatment goals and conducting time-limited treatment studies. However, these strategies may not be possible under conditions of crisis care standards. Due to the potential resource pressures posed by Covid-19, healthcare has an obligation to make these constraints transparent to patients and the community. Nurses have a long history of trusting their patients. However, many ethical issues have changed the relationship between nurse and patient in the context of Covid-19.

A recent publication from the Hastings Center highlighted the need for nurses, physicians and other clinicians to shift from a patient-centered model of practice and care to one of community-based practice and care during a pandemic. 20 nurses are traditionally motivated by community thinking, and the history of nursing ethics has its roots in a social justice orientation that emphasizes issues of equality, disenfranchisement, and structural forms of oppression. 21 Some of the measures needed to protect the public in this pandemic have created new and unusual tensions between nurses and patients and their families. We see three overarching ethical issues that raise a variety of concerns and are likely to affect nurses around the world in unique ways: the safety of nurses, patients, colleagues and families; allocation of limited resources; and the changing nature of caregivers` relationships with patients and families.

By |2022-12-04T08:34:47+00:00December 4th, 2022|Uncategorized|0 Comments

About the Author:

‘Tent on steroids’: Nonprofit setting up dining hall near downtown pharmacy steroids for sale singapore changi airport: taking your pharma business further | air cargo world