Ethics Game Essay Example
Ethics Game Essay Example

Ethics Game Essay Example

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  • Pages: 5 (1313 words)
  • Published: April 5, 2017
  • Type: Essay
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Reflective Journal

This journal contains my reflections of the Ethics Game simulation assignment. The purpose of this assignment is to help me understand how to make ethical decisions using a decision model.

Ethical Issue #1-Presented during my shift We have a 16 year old pregnant patient (RB), in her tenth hour of labor. Her parents are present and have been with her the entire time. They have chosen to limit medication and assistance available citing personal reasons.

Her primary nurse is (YN) is concerned that given her current status, the situation could become critical for the patient and her unborn child. The fetus is not in distress at this moment but there are indications that this is gradually changing as time goes on. Close observation of the fetus and mother continues with the care team unsure

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if her parents are understand the perils of their daughter’s situation as the baby and the mother move toward irreversible medical danger if the appropriate interventions are not made in a timely manner.

Ethical Issue #2-Presented during my shift. AT was admitted to the ICU and has been unconscious all day with no definitive diagnosis made for him. AT was brought to the ER by his domestic partner YM who stayed with him in the ER till his transfer to the ICU. Once AT was admitted to the ICU, YM was prevented from visiting him by CB, the shift supervisor for the day shift despite hospital policy which clearly states that domestic partners are to be treated as married couples. Decision making process From the readings for this week, I saw there are several steps involved when attempting to resolve any ethical dilemma

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First I needed to define the ilemma in both scenarios within the simulation. “Questions need to be raised about the meaning of the situation to all the participants and how the behavior of the nurse and the decision of the manager will affect them all” (Toren & Wagner, 2010)(p. 395). I need to be attentive, taking in the facts and gathering all the information about the situation that I can. I need to be intelligent, and identify the real issue and identify the primary stakeholders in the case. I need to be reasonable; understand my duties, look for the greater good, see the fairness, and remember my role.

Finally I need to be responsible in that I need to develop a situation that has balance and meets the needs of all the stakeholders and communicate that decision to everyone involved. Applying these steps to issue #1 I gathered all the information I needed from the patient’s chart, went over her care plan, the medical plan and received verbal reports from RB’s nurse. I looked at her care overall and note that she had not received any medications nor was she seen by a physician that was on duty at the time as he/she was attending to an emergency elsewhere.

My priority is to decide how assure that the best care is given to RB and her child. The stakeholders in this situation are as follows:

  • RB-the patient
  • LB-RB’s unborn child
  • RB’s parents
  • Shift supervisor *YN (RN)-nurse caring for RB
  • The Shareholders Using the rights and responsibility lens I could identify my duties as leader in Issue #1.

They include:

  • Duty to support the staff in doing their job
  • Duty to not interfere with staff doing their job
  • Duty to provide the best care possible My responsibility was to find the option that best reflects my core values in this particular situation.
  • I felt I should ask the nurse to do a thorough check to verify that the situation has not reached the point where we would have to compromise the rights of the patient and her parents.

    Applying these steps to issue #2 Again here I needed to identify the problem. This issue included two problems, allowing access to a domestic partner, and ensuring a hospital policy was being followed. I identified the dilemma, and identified the stakeholders they are as follows:

    • AT-ICU patient
    • YM-domestic partner to AT
    • Staff nurse-M CB shift supervisor
    • AF the director of nursing services
    • The Shareholders I identified the rights to the basic liberties of this situation and to the community.

    They are:

    • Right to participate in decision making for an unconscious family member
    • Right to have hospital policy regarding participation by family members implemented
    • Right to be informed that your interpretation of hospital policy is inaccurate I identified the actions need to make sure the basic liberties entitled to the community above were supported.

    They are:

    • Provide all employees with written polices upon hire and periodically reissue and update them
    • Establish a task force consisting of stakeholders to review and change policies as necessary
    • Conducting yearly audits to ensure the policies are being implemented I chose an option I felt supported this liberties and that was to make a Note on AT's chart that YM is to be given access and treated as family and notified the supervisor that hospital policy

    is not being followed. I was responsible in activating a system to protect the one that couldn’t speak for themselves and provided advocacy.

    Ethical lenses The ethical lens provides perspectives to each dilemma. The criterion within the lens as it applies to the situation yields a different ethical decision. By using the lenses I can see different perspectives and make a better decision.

    Lenses used in issue #1 With situation #1 my lens was duty focused (the rights and responsibility lens) and happiness focused (results lens) as my primary concern was the patient. I could identify my obligations as well as the rights in this situation. The results meet the stakeholder’s needs and all were happy.

    Lenses used in Issue #2 Situation 2 employed the use of the relationship lens and the reputation lens. The focus was on processes of an ethical organization. The community based lens of relationship focuses on protection of the basic liberties of all people. How did ethical perspectives/lens influence my decisions? In the first situation the rights and responsibilities lens was first and foremost in my mind. I was duty bound to assure that the care of the patient and her unborn child was not compromised especially for those that can’t speak for themselves.

    I was able to tie in the results lens and ensure that her parents were made an integral part of the care planning process and provide to them with the information available to aid in the decision making process for their daughter and unborn grandchild. In the second situation, the relationship lens and the reputation lens was the best decision making tool. It focused on the system and allowed me

    to incorporate what is best for the system and the community protecting the rights of both. I learned a great deal doing this simulation.

    I work in labor and delivery and we are faced with ethical issues almost every day very similar to the first scenario. Providing the best possible care includes making sure that everyone is clear on their role, responsibility and ethical role within the care team. “Understanding how a nurse acts in a particular situation reveals how nurses enact their ethics in day-to-day nursing” (Salas Santos ; Cameron, 2010). They go on to say, “Our ethical frameworks assist us when we experience serious ethical dilemmas”.This resonated with me very strongly and I can see that my practice will change a bit when facing such dilemmas. I can fine tune my practice to provide ‘ethically superior care’ for my patients by applying what I have learned during this exercise.

    References

    1. EthicsGame. com, LLC. (2007). retrieved from: http://www. ethicsgame. com Salas Santos, A. , ; Cameron, B. L. (2010).
    2. Ethical openings in palliative home care practice. Nursing Ethics, 655-665. Toren, O. , ; Wagner, N. (2010).
    3. Applying an ethical decision-making tool the a nurse management dilema. Nursing Ethics, 393-402.
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