2023 Reply1 Ethical dilemma is a decision making problem between two possible moral imperatives neither of which is unambiguously acceptable or preferable

Reply1

Ethical dilemma is a decision-making problem between two possible moral imperatives,neither of which is unambiguously acceptable or preferable .One action must be chosen, thereby generating a quandary for the person or group who is burdened with the choice. Example,the ethical dilemma which was encountered is in line of patient autonomy.The patient relatives were refusing to have blood transfusion for their child post operatively, despite the possible consequences ,but blood transfusion was necessary for saving the life of the child.With their refusal almost they created the end of life issue situation.

 In the above scenario the other nurse was trying to leave the case by mentioning that patient and relatives are not willing  and are not consenting for blood transfusion.

 I was not against the patient autonomy,but  my intention was to save the life of the child by explaining the consequences of refusal of blood transfusion.At last, they understood the importance of it ,they have been convinced for the blood transfusion and the child was out of danger.

Reply2

Nurses face variety of ethical issues while dealing with patients, colleagues, or other health care personnel. Nurses, as a human being, differ from one another and possess their own intellectual and moral values. The ethical dilemmas vary in different situations depending upon the way we address it. Some nurses deal with the situation easily while it would create a dilemma for others. One of the examples of an ethical dilemma that can occur in our nursing practice is when nurses themselves are not properly equipped to complete their duties like nurses who notice their coworker’s lack of knowledge face an ethical dilemma of whether they should bring the issue to their nurse manager (Duquesne University, n.d.). 

For some nurses, it would not be a problem and whistle blow right away, whereas, for other, it would be dilemma between patient care and the loyalty to colleagues and employer. One of my colleagues had a patient who had Ventricular Tachycardia then CODED at the beginning of the shift soon after taking the report. It was found that patient’s potassium and magnesium level been low for the last 12hrs and EKG showing frequent PVCs which was not addressed. The patient was on Lasix injection and the potassium level was not monitored. In my opinion, it happened because of a delay in patent management due to incompetency. My colleague had a dilemma about whether to report it or not because the nurse who gave a report to her was her best friend. 

Personally, when I notice the incompetency among peers, I critically analyze the situation and if it is a threat to patient safety, I would report because as per the code of ethics as a patient advocator we are obliged to take action when a patient’s right or safety is endangered (Mansbach.,Kushnir., Ziedenberg., & Bachner, 2014). If it is something, we can help our colleague improve incompetency, I privately talk and advice the best way so that the nurse’s license as well as patient’s safety would not be affected.  In that case, I talked to and assessed the knowledge of the nurse who gave the report. She said that she was not so confident to analyze the EKG rhythms and not aware of the protocols of managing patients on Lasix. So, I brought this issue and requested the management for the Inservice education which keeps us up to date in knowledge and skill helping to manage promptly and prevent from reoccurrence of the situation.