Nurses have the greatest power to improve the outcomes and to assure that patients get the right treatment, medications and efficiency care. In clinical, nurses need to understand the professional responsibilities which provides safe practice for patients and other people. Thus, interventions must be therapeutic and avoid any harms to patients. Nurses practice and act based on these values that they believe. According to Burkhardt and Nathaniel “Values are ideals, beliefs, customs, modes of conduct, qualities, or goals that are highly prized or preferred by individuals, groups, or society” (p. 93). Ethical dilemmas are situations that occur in every practice. Mike is 15 years old, diagnosed with acute myelocytic leukemia (AML) for 8 years and in the hospital for chemotherapy administration. He has several treatments such as bone marrow transplants, intravenous immunoglobulin, and blood transfusions. Mike looks fatigue, weak and tells the nurse to stop the treatments. On the other hand, Mike’s parents want to continue with another round of treatments to treat his condition. However, it is time to administer the first chemotherapy to Mike. What should the nurse do? The nurse should make the decision whether administering the medication or discontinue it. The purpose of this paper is to define and discuss personal and professional values that could influence nursing practice for Mike’s situation.
Professional Values
Professional values are an important foundation for guiding nurses to practice and to make decisions. Nursing organizations establish and present conceptions of these values. Understanding these concepts could connect the profession and provide competent care.
Autonomy
Autonomy is a professional value that nurses have essential knowledge and authority to make decisions, and practice in clinical. Nurses have a strong autonomy would improve patient care and patient pleasure rate. Autonomy is self-legislation and self- determination with voluntariness. (American Nurses Association [ANA], 2015). Autonomous nurses must take accountability for the outcome. As nurses increase autonomy, they would have greater accountability (Potter, Perry, Stockert, and Hall, 2017). However, nurses also need to respect patient autonomy. Patients have the legal right to determine their care. In this scenario, nurses could protect Mike’s autonomy by providing all the information needed for him to make a decision about the new course of treatment. Nurses could support Mike as necessary in the decision- making process. Besides that, nurses have the autonomy to educate Mike’s parents, ensure they understand all the information and recommend strategies for the decision-making process.
Altruism
Altruistic nurses would focus on the benefit and avoid harms to patients regard for rewards. The American Association of Colleges of Nursing (AACN) states “Altruism is a concern for the welfare and well-being of others (2008, pg. 27). Additionally, altruism means nurses are advocating and caring for patients with compassionate and generous. Nurses make sure patients are obtaining informed consent about the treatment plan and receiving the best care.
In Mike’s case, nurses should advocate and make a decision with Mike’s interest that he does not want any treatments. Nurses could be altruistic by being supportive of Mike’s wish and discontinue the medication. It would build the rapport, trust and healthy relationship between Mike and his nurses. However, Mike is minor, and his parents are legal to make decisions for him. Nurses also need to be supportive to the parents. The parents have hopefulness to the treatments and do not want Mike to die. They could collaborate with the interdisciplinary team to evaluate and provide their son the high quality of care. Nurses can advocate for the parents by talking and explaining to Mike about his parents’ feelings and their decisions about the treatments.
Personal Values
Personal values emphasize what nurses stand for. These values guide nurses’ behaviors, decisions, and practices in clinical. Strong personal values would impact on nursing professional. It is important and necessary for nurses to know their own values to make the right decision.
Respect
Respect is one of my personal values. I could not define myself without respect value. I define respect is honoring all people with dignity. I would treat everyone with equality and politeness. Since I was a kid, I had taught to be respectful of others. Those lessons also showed me that respect is accepting others and not changing them. I am a certificated nursing assistant (CNA) in the nursing home and I work with dementia residents. As a caregiver, I illustrate the respect by giving the residents attention, mindfulness, and determination to meet their needs and preferences. I want to give those residents a high quality of care and respect their decision. Dementia residents often confuse and refuse to take medications. Even though I do not want them to miss the medications, but I still respect and try different ways to approach instead force and restraint them down to take medications.
For nurses, it is important to show respect to the patient’s decision. In Mike’s situation, he decided to discontinue the treatment and expect nurses to act on this decision. If nurses ignore Mike’s wish, it would disrespect his decision and break down the trust relationship between nurses and him. Mike also feels disparage that he is not capable to make decisions for his own life. Likewise, nurses need to respect Mike’s parents. Family-centered care encourages patients and family to participate and communicate in the decision-making process with the interdisciplinary healthcare team to get the greatest outcome of the patient’s condition. Nurses should respect Mike’s parent’s belief in the treatments that could save their son.
Empathy
The Fundamental of Nursing defines empathy is “the ability to understand and accept another person’s reality, accurately perceive feelings, and communicate this understanding to the other” (Potter et al., 2017, pg. 328). Empathy is another personal value that I choose to practice. I usually care, empathize, support and listen about someone’s joy and pain. I could highly attune to other people’s feelings. Sometimes, it could be negative or positive effects such as anxiety, anger or love, peace. In obstetrics and gynecology clinical, I cried when I saw the patients were giving birth because I empathized the mother’s love and joy when they saw their baby.
Nurses could recognize patients’ perspective or circumstance whether nurses agree with patients or not. A nurse, I think I could put myself in Mike’s shoes, see situations from his perspective and understand how he reacts to this situation. If I was Mike, I also feel the pain and discourage about to go through the new course of treatment. Mike could not have a greater quality of life because he must spend more time in the hospital than in school or at home. I believe his mental and physical would be more at peace when he could decide for his own life. However, if I put myself in the parents’ shoes, I would empathize and understand their pain about hopeless and suffer the loss of a child if Mike passed.
Conclusion
There are no right or wrong decisions in Mike’s situation. Besides that, nurses should consider and view carefully on each side. In ethical dilemmas, nurses need to understand professional and personal values to guide in the decision-making process. Nurses should educate and inform patients and family with all the information and the outcomes of each decision. However, nurses still need to make a decision that they believe is right and autonomy, altruism, respect, and empathy are considering values that might help nurses.
References
- American Association of Colleges of Nursing (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC.
- American Nurses Association (2015). Guide to the code of ethics for nurses with interpretive statements. Washington, DC.
- Burkhardt, M. A., & Nathaniel, A. K. (2014). Ethics & issues in contemporary nursing. Fourth edition. Australia: Cengage Learning.
- Potter, P.A., Perry, A.G., Stockert, P.A., & Hall, A.M. (2017). Fundamentals of Nursing (9th ed.). St. Louis: Elsevier/Mosby.
