As an advanced practice nurse, I frequently encounter challenging situations in my job, especially when it comes to dealing with patients. Maintaining a balance between adhering to a patient or their family's wishes and upholding my ethical code can be difficult. To address these concerns, I will analyze three scenarios involving different individuals.
The first scenario involves a 5-year-old boy who needs various vaccinations according to the "recommended immunization schedule of persons aged through 0-6 years - United States 2009." These vaccines include hepatitis B1, rotavirus2, tetanus, poliovirus, and rubella among others. It is crucial for all children under the age of 5 to receive these vaccines as they help prevent emergencies and acute health issues. Even parents cannot prohibit these vaccinations regardless of the recommended age.
The fourth scenario pertains to a single mother with two underage daughters who want
...to be put on birth control. This situation raises significant ethical considerations that require careful evaluation.
Lastly, the fifth scenario revolves around a 17-year-old boy which presents its own unique set of ethical challenges that require examination.
As a nurse, my responsibility is to follow ethical guidelines and educate parents about the importance of vaccinating their children. When parents decide not to vaccinate, they violate their children's rights. It is essential for every woman to have a comprehensive examination of her pelvic organs, which includes assessing the size of the vagina, cervix, uterus, and ovaries. This examination also helps in identifying vaginal infections as well as sexually transmitted infections such as herpes, human papillomavirus (HPV), and gonorrhea. According to Gibbs (2008), these tests should ideally be done at age 18 or when sexual activity begins.
The checkup is recommended
for Scenario 4, but family planning services are only advised for married adults. The mother wants her daughters to avoid pregnancy, but they are too young for these services. Despite feeling conflicted about this case, I couldn't fulfill their request. Instead, I explained the potential consequences of underage family planning and adhered to our code of ethics. Accidents can occur in various situations like on roads, in workshops, or while playing, and patients should seek medical assistance in such cases. In Scenario 5, it is my duty to provide medical help to the 17-year-old boy by prescribing treatment and admitting or discharging him as necessary.
As the responsible party in this situation, it is my duty to determine when the boy should resume playing. However, since he is a child and lacks decision-making abilities regarding his medication, I cannot comply with his wishes unless accompanied by his parents or legal guardian.
The presence of ethical concerns in nursing is an ongoing issue that can have adverse consequences for both patients and healthcare professionals if not properly addressed. While I value patient input and respect their right to make decisions, certain choices must be made by individuals who are legally mature and mentally capable. Neglecting these factors may result in ethical dilemmas.
References
- Gibbs, R. S., ; Danforth, D. N. (2008). Danforth's obstetrics and gynecology.
Philadelphia: Lippincott Williams & Wilkins.
Maternal & child health nursing: Care of the childbearing & childrearing family. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
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