Ethics in pediatric and adolescent nursing essay
Ethical Dilemma: A Pediatric Patient
Adolescents experience many changes in transitioning into adulthood; it is the most plausible period in life to be referred as the time of “storm and stress” (Hockenberry & Wilson, 2014). Self-image is a component in their development that can be easily altered through the thoughts of their peers, the labels in media, family views, etc., which can mislead their perception of health and individual growth. An unfortunate and common impedance towards a healthy development in adolescence is eating disorders; anorexia nervosa being one of the most prevalent of all, can lead to considerable morbidity and mortality if left untreated (Smink, Hoeken, & Hoek, 2012). Ethics in pediatric and adolescent nursing essay Nurse’s face being placed in a difficult position when providing holistic care to the patient with anorexia nervosa becomes an ethical dilemma due to the conflicting beliefs between patients, their parent’s beliefs and the nurses/healthcare team.
Ethical considerations in treating a hospitalized adolescent patient which the nurses face are conflicting values in their duty to providing an optimum level of care to promote an optimum level of health for the patient. It is more difficult when the decisions for treatment go against that of the minor; and therefore, receiving treatment against the minor patient’s will; This then causing tension between the patient and nurse/healthcare provider in achieving a trusting-working relationship.
The American Nurses Association (ANA)has provided nurses with a scope of ethical standards, called the “Code of Ethics for Nurses” with detailed descriptions of the nine provisions, which aid in providing guidance to nurses in providing roles and obligations of nurses when delivering patient care and maintaining an ethical/moral healthcare environment between all healthcare providers (ANA, 2015). Ethics in pediatric and adolescent nursing essay Provision one states, “The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person” (ANA, 2015). Although it is the nurse’s role to respect the rights of the patient without the need for the nurse to agree with decisions made. The patient has “the moral and legal right to determine what will be done with and to their own person” (ANA, 2015) but when the decision of the patient are self-destructive, like the choice of anorexia; it is the nurse’s obligation to address the behavior and provide modifying behavior resources and help to eradicate the potential for any risks for the patient. It is important to promote the patient’s autonomy; therefore, educating the patient and providing them with resources and opportunities to help him/her with making health-promoting decisions is an important aspect in caring for a patient dealing with anorexia.
Another provision made by the ANA that will aid the nurse in caring for the patient with anorexia is Provision four; “The nurse has the authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care”(ANA, 2015). Part of a nurse’s role is to create a trusting nurse-patient relationship, but with a patient that will refuse treatment as a pediatric patient hospitalized for treatment against his/her will this trusting relationship will most likely will be compromised. Provision four understands this possible conflict and endorses nurses to assume authority and responsibility to accept or reject specific role demands in order to provide optimal nursing care. Ethics in pediatric and adolescent nursing essay.
All in all, the desired outcome of this ethical dilemma is to eliminate any health disparities to the patient by educating, caring, and promoting a healthy life to the pediatric patient. Although some ethical dilemmas take time till they are resolved due to non-agreement to medical treatment and enablement of patient self-determination some resources that could help alleviate and hopefully eventually solve in the case of a pediatric patient hospitalized for treatment of anorexia are, family, providing physician, nutritionist, social worker, psychiatrist, and other healthcare staff; it is possible to provide holistic care for the patient and help alleviate or eliminate any conflict in treatment by following the standards of nursing and using the ANA Code of Ethics to aid in providing care Ethics in pediatric and adolescent nursing essay.
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Retrieved from: http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-For-Nurses.html
Hockenberry, M. & Wilson, D. (2014) Wong’s nursing care of infants and children (10th ed.). St. Louis, MO: Elsevier.
Smink, F. R. E., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: incidence, prevalence and mortality rates. Current Psychiatry Reports, 14(4), 406–414. http://doi.org/10.1007/s11920-012-0282-y
The main aim of the Pediatric Acute Care Unit is to prepare graduate nurses for specific opportunities in the care of unstable intensely ill children. These graduates are prepared to provide services in hospital inpatient and outpatient situations such as the Emergency Room and pediatric intensive care, and mastering the crucial care of an extensive variety of clinical problems realized from infancy through young adulthood (Jaynes & Lundy, 2014)
There are ethical dilemmas in this setting ranging from genetics and genomics issues. I came to make this conclusion after visiting one such unit and found a nurse who was having these challenges with his patients and their families (Ladd, Smith, & Pasquerella, 2008)
Privacy and Confidentiality, the nurse was required to observe confidentiality with his adolescent patient and surviving with a revelation of diagnosis to him. His parents were also not adhering to his treatment. There were unpredicted responses from family members after he directed who should have access and control to his genetic information (Garvin & Meares, 2000)
Discrimination .This nurse had been required by the employer to take genetic examinations as a condition of hire. He was concerned about his results being misused, like in employment discrimination and also the genetic information being used to deny insurance coverage or to determine who is hiring or firing (Garvin & Meares, 2000) Ethics in pediatric and adolescent nursing essay
Unequitable access to Genomic equipment, this care had limited equipment, making genomic treatments challenging to offer. He mainly relied on governmental organizations that assisted him in endorsing genetic and genomic treatment by creating numerous tools and assets that address the role of genetics in public health. (Ladd, Smith, & Pasquerella, 2008)
Aiding treatments for genetic ailments affecting a small number of people was also a challenge. He realized that not many people were ready to fund for the treatment in marginalized groups such as the street children since the question about the beneficiary of such treatment was paramount among the potential funders. (Jaynes & Lundy, 2014)
Influence of genetic information. How did the person’s genetic information affect individual and society’s insight of that individual, how did this information affect members of minority communities. He was tasked with explaining to his patients the need for well-versed decision making and making them understand the nature, risks, and benefits of the procedure. (Garvin & Meares, 2000) Ethics in pediatric and adolescent nursing essay
Logical property matters surrounding access to and use of genetic Information. The nurse was involved in finding the patient kinfolk histories. There were situations where it is necessary to collect medical information from the patient’s family members, forcing him to explain the procedure to them and support their written agreement for the release of their medical information (Ladd, Smith, & Pasquerella, 2008)
Decent, lawful and social aspects that influence the conversion of genetic information to improved health (Jaynes & Lundy, 2014)
Issues of conducting genetic research.GWAS studies advocate for the use of traditional accord, binary, and tiered accord. Traditional consent had some participants who only participated and didn’t agree to share their data. This restricted the number of individuals willing to participate in it. A binary accord also saw participants who chose not to share their data (Ladd, Smith, & Pasquerella, 2008) Ethics in pediatric and adolescent nursing essay
Using the genetic information in non-health care situations; Genetic testing on DNA can be done on stored blood that has been collected for other works. Data sets of DNA are being established. The nurse found himself his workmates using their patient’s DNA sample for extra research and testing without the patients’ knowledgeable consent (Garvin & Meares, 2000)
The impact of genomics on the race ethnicity and individual identity are; Baby screening results were linked to psychological jeopardies among parents such as parental guilt in parents who were carriers. Infants recognized as carriers led to misunderstanding between parents, interfering with parent-child relationship resulting in social discrimination (Fowler, 2008)
ANA code of ethics
Respect for humankind. In the provision of care, the nurse ought to abide by the beliefs of the individual. The nurse considers the values of all persons in the professional relationship (Fowler, 2008)
Relationships to patients; Health care is worldwide regardless of patient’s variances. The nurse creates helpful links with patients and respect for the morals and beliefs of the patient should not demand the nurse condone those beliefs on an individual level. (Association, 2011)
Nature of health complications; the nurse should not allow the illness of the patient to control his/her worth. This encompasses the relatives of the patient and the health field. The nurse should offer unbiased information and provide security to the patient even when those measures accelerate death. This prevents suffering in the dying process. The nurse does not act with the individual intent of ending a patient’s life (ANA code of ethics)
Right to self-determination; Patients have the right to choose what is to be done to them and part of this includes the right to information needed to make progressive decision on health care (ANA code of ethics) Ethics in pediatric and adolescent nursing essay
Relationships with colleagues; the nurse upholds caring relationships and is compassionate with commitment to fair handling of others (ANA code of ethics)
Interests of the patient are prime; the vital interest of the nurse is to provide unique care based on the necessities of the patient. The nurse guarantees the patient that he finds the plan of care acceptable (Association, 2011)
Conflict of interest for nurses. Nurses may encounter circumstances with conflicts of interest. The nurse shouldn’t exploit the patient for personal gain. This principle can prevent using Genetic Information in Non-Health Care Settings since it advocates for the nurse to others what he would like done towards him (Association, 2011)
Privacy. The nurse acts as an advocate for the patient’s right to privacy. He safeguard’s the patient’s privacy and sensitive information. This can be used to solve privacy and confidentiality. Dilemma (ANA code of ethics)
Guarding the patients in research; The patient has the right to make a well-versed conclusion on their partaking is an investigation, nurses have an accountability to ensure patients are offered with information on any research performed. This principle relates closely to the challenge of information confidentiality (Fowler, 2008) Ethics in pediatric and adolescent nursing essay
Moral self-respect. Nurses have the moral obligation to self as they do to others. They must uphold self-respect, character, and integrity. This can be used to solve the issue on using Genetic Information in Non-Health Care Settings (Association, 2011)
Difficult interactions with patients and their families on issues like ensuring confidentiality, especially in adolescent care are common.
Challenges in incurable circumstances like accepting the decision of coworkers of admitting the patient in ICU
Health professionals are disagreeing with the breach of confidentiality or inappropriate use of medicines.
Coping with violence against children and neglect where no one was willing to fund them.
The following resources were available at the clinical agency I happened to visit:
Journal of pediatric health care
Journal of pediatric nursing
Pediatric nursing journal
Ethics in pediatric and adolescent nursing essay
A copy of ANA code of ethics.
However, I noticed that these resources were not well utilized and only the ANA code of ethics was being used widely due to its availability. The other resources were scarce and couldn’t be utilized as required.
Association, A. N. (2011). Code of Ethics for Nurses with Interpretive Statements. Retrieved from https://books.google.com/books?isbn=1558101764
Fowler, M. D. (2008). Guide to the Code of Ethics for Nurses. Retrieved from https://books.google.com/books?isbn=1558102582
Garvin, C., & Meares, P. A. (2000). The Handbook of Social Work Direct Practice. Retrieved from https://books.google.com/books?isbn=0761914994
Jaynes, S., & Lundy, K. S. (2014). Community Health Nursing. Retrieved from https://books.google.com/books?isbn=1449691498
Ladd, R. E., Smith, S., & Pasquerella, L. (2008). Ethical Issues in Home Health Care. Retrieved from https://books.google.com/books?isbn=0398085978 Ethics in pediatric and adolescent nursing essay