Ethical Dilemmas for LPNs

Ethical dilemmas are something that every nurse will eventually run in to. How these dilemmas are handled can drastically change the outcome of many situations. Let’s say an issue comes up, but the nurse is busy and “does not really have time to deal with it at the moment”. This does happen, and unfortunately it can lead to a lot of problems, including legal trouble, nurse exhaustion resulting in quitting the profession, poor patient care outcomes, and/or disciplinary action. Ethics is a serious issue that every nurse should make themselves familiar with. Below you will find a few common ethical issues/dilemmas that nurses face frequently, and some ways to deal with them. As an advantage, nurses should read into the Code of Ethics created by the American Nurses Association (ANA). The four most common healthcare ethics topics are autonomy, beneficence, non-maleficence, and justice.

Involvement of Family

There will be times where the family will become involved and try and make decisions for a patient who is very well able to make decisions for themselves. They may have a medical diagnosis that is rather serious, you may inform the family, and they may tell you not to tell the patient because it will upset them. No matter how hard it may be, any patient who is of age is obligated to know about every decision made about their health and any pertinent information regarding it, as long as they so choose. The family can be as informative and persuasive as they want, but it’s the nurse’s duty to address the patient. For example, the treatment for certain diseases may sometimes be too harsh on the patient, and they may choose to refuse the treatment and try to enjoy their final days as comfortably as possible. The family may not always agree with that, but initially it is not up to them. The three ethical principles that are dealt with here would be autonomy, fidelity, and non-maleficence. Regarding autonomy, anyone who is of age and legal to make their own decisions has the right to know about their medical conditions, information, etc. if they choose. Regarding fidelity, as a nurse you should try to build a rapport with your patient. Rapport builds a relationship that requires trust and loyalty, and without it, things can easily be disrupted. As a good nurse, you should always tell the truth and try to prevent harm when you can. Informing a patient who is of sound mind of their medical conditions is always necessary, no matter what their family or friends’ preferences are.

Consent for Treatment

Informed consent for treatment is first and foremost explained by the physician. The nurse should never explain a surgery, risks, or complications before the provider. You could mislead them, give them false information, etc. However, if the patient is still feeling uneasy and has questions after the physician has talked to them, you can try to explain it as best you can. Some individuals will feel scared or nervous to ask the physician any questions or let them know if they don’t really understand, so they may come to you as the nurse instead. Treatment, no matter the kind, can be stressful; patients and their families will be worried. Be as informative as you can. If you have any questions, ask a healthcare member on your team or bring it up with the physician.  It is the patient’s right to know and fully understand the treatment before they undergo it.

Peers’ Failures

In nursing school, you are taught that if you are aware that a colleague or co-worker is doing anything at all to harm the patient, then you should report it. They even tell you the line of command in which you report it. This is so very important. No matter how close you may be to the person committing the wrong-doing, a patient’s life could be in danger. Imagine if that was your family member that the nurse was taking care of. Nurses may want to report it, but don’t because they are scared the person may get fired and it would hurt the staffing of nurses. The ethics used here are fidelity and non-maleficence. No matter what the outcome may be for that person or your colleagues as a whole, the patient’s health and safety always come first. If you feel more comfortable confronting the individual first, then do so, but it is not always the smartest idea. Confronting the individual yourself can cause drama in the workplace, which is very unprofessional. Follow your line of command that you use within your company and give the patient the safety and security that they deserve. You are their voice when they do not know what is going on - use it! These are just a few of the ethical dilemmas that nurses will face frequently, but there are many more scenarios as you can probably imagine. It helps to think of the patient as your own family member or friend. Always remember your scope of practice, but keep ethics on the forefront of your mind. Be the voice the patients need so desperately.