Essay On Ethical Principles

Nursing discipline mostly stands on the ethical principles, as these shape the character of a nurse. It governs their code of conduct and imbibes motives, values and beliefs in them. According to Podgorica et al. (2020), nurses are required to make decisions prioritizing maximization of health outcomes of patients. This poster, thus, deals with two of the ethical principles- beneficence and non-maleficence and explores the advantages and disadvantages of upholding the principles in a clinical setting.

The case study is mainly related to geriatric patient care. In several hospitals in Australia, incidents of neglect and abuse of patients by nurses have been observed. Thus, it gives rise to ethical issues involving two ethical principles- beneficence and non-maleficence. According to Podgorica et al. (2020), beneficence refers to the duty of healthcare workers in minimizing harm to patients and promoting their health and wellbeing. Non-maleficence refers to the nurses recognizing the right of patients to no harm. Ibrahim et al. (2020) stated that nurses in aged care settings should avoid taking actions that harm patient dignity and respect. As per the case study, both of these principles were violated by healthcare professionals as their negligence caused severe patient harm and even death. Ljungneck & Forss (2017) stated that the advanced nurse practitioners act as a bridge between doctors and patients and being the front-line workers, it is their duty to maximize patient care. Nazari et al. (2022) stated that it is the duty of nurses to make sound moral decisions during nursing practice. According to Cleland et al. (2020), duty of care of Registered Nurse (RN) involves maintenance of positive relationship with patient; providing comfort and safety; empowering them to make informed decisions; promoting social relationships; and supporting the health and wellbeing of patients. Anderson & Blair (2021) observed that RNs as facility managers may improve the quality of care of patients due to their experience and higher level of training. Arani et al. (2017) explained that it is the duty of nurses to promote positivity to enhance the quality of elderly care. Ostaszkiewicz et al. (2020) explored the negative impacts of negligence by RNs which included development of feelings of degraded status, embarrassment, humiliation, agitation, and anxiousness. It also causes loss of their self-esteem and increases their resistance to care.

Negligence of patient care is regarded as a failure of nurses to perform their duties. It gives rise to both legal and ethical issues in nursing practice. According to Ostaszkiewicz et al. (2020), negligence and undignified patient care can be viewed as a coercive and abusive attitude of nurses toward their patients. The patient feels ashamed, embarrassed, humiliated and becomes distressed and agitated, which impacts their mental health. Nazari et al. (2022) stated that increase in critical situations of decision-making can degrade the quality of care provided, which can also be related to negligence. Anderson & Blair (2021) stated that negligence can lead to the serious harm of patients like increased incidents of falls and pressure sores in hospitals. Cleland et al. (2020) stated that positive relationship with nurses make patients feel comfortable and safe, while negligence makes them scared of the environment, they are living in. Arani et al. (2017) explained that having a negative attitude toward the elderly like stereotyping the population and performing discrimination against them can also be considered as acts of abuse and neglect which diminishes the quality of care of patients. Thus, it can be said that negligence of patients acts as a barrier to the identified ethical principles- beneficence and non-maleficence. Hence, Ibrahim et al. (2019) suggested that the residential care services should be free of abuse and neglect and Ljungbeck & Forss (2017) suggested increase of nursing workforce to reduce incidents of neglect in healthcare facilities. 

1. Nursing strategies must be applied to deal with the issue of negligence, as apparent in the case study. As the issue of negligence decreases the quality of care to patients, three strategies have been formulated below to tackle the situation

 

 

2. Nurses should be compassionate and empathetic toward their patients and recognize their dignity and worth (Ostaszkiewicz et al., 2020). This could have avoided the situation of keeping the patient unclean, as depicted in the case study.

 

 

3. Nurses should build a strong bond with patients and provide them with a safe environment (Cleland et al., 2020). This could avoid the situation of assault of patients, as depicted in the case study.

 

 

4. They should maintain professionalism and promote positivity (Ljungbeck & Forss, 2017), so that incidents of neglect do not happen in the future.

 

Anderson, K., & Blair, A. (2021). What have staff got to do with it? Untangling complex relationships between residential aged care staff, the quality of care they provide, and the quality of life of people with dementia. Archives of gerontology and geriatrics, 94, 104378. https://doi.org/10.1016/j.archger.2021.104378

 

 

Arani, M. M., Aazami, S., Azami, M., & Borji, M. (2017). Assessing attitudes toward elderly among nurses working in the city of Ilam. International journal of nursing sciences, 4(3), 311-313. https://doi.org/10.1016/j.ijnss.2017.06.009

 

 

Cleland, J., Hutchinson, C., Khadka, J., Milte, R., & Ratcliffe, J. (2021). What defines quality of care for older people in aged care? A comprehensive literature review. Geriatrics & Gerontology International, 21(9), 765-778. https://doi.org/10.1111/ggi.14231

 

 

Haddad, L. M., & Geiger, R. A. (2018). Nursing ethical considerations. https://www.ncbi.nlm.nih.gov/books/NBK526054/#:~:text=There%20are%20four%20main%20principles,their%20own%20beliefs%20and%20values. 

 

 

Ibrahim, J. E., Fetherstonhaugh, D., Rayner, J. A., McAuliffe, L., Jain, B., & Bauer, M. (2020). Meeting the needs of older people living in Australian residential aged care: A new conceptual model. Australasian Journal on Ageing, 39(2), 148-155. https://doi.org/10.1111/ajag.12796

 

 

Ljungbeck, B., & Sjögren Forss, K. (2017). Advanced nurse practitioners in municipal healthcare as a way to meet the growing healthcare needs of the frail elderly: a qualitative interview study with managers, doctors and specialist nurses. BMC nursing, 16(1), 1-9. https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-017-0258-7 

 

 

Nazari, S., Poortaghi, S., Sharifi, F., Gorzin, S., & Afshar, P. F. (2022). Relationship between moral sensitivity and the quality of nursing care for the elderly with Covid-19 in Iranian hospitals. BMC Health Services Research, 22(1), 1-6. https://link.springer.com/article/10.1186/s12913-022-08258-x 

 

 

Ostaszkiewicz, J., Dickson-Swift, V., Hutchinson, A., & Wagg, A. (2020). A concept analysis of dignity-protective continence care for care dependent older people in long-term care settings. BMC geriatrics, 20(1), 1-12. https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-020-01673-x 

 

 

Podgorica, N., Flatscher-Thöni, M., Deufert, D., Siebert, U., & Ganner, M. (2021). A systematic review of ethical and legal issues in elder care. Nursing ethics, 28(6), 895-910. https://doi.org/10.1177/0969733020921488