Our Purpose

All of our group members continuously face similar ethical dilemmas resulting in the inability to provide competent and safe care that patients are entitled to. We as a group, have decided to come together to develop a plan on how we, as nurses, can affect change. It is vital for nurses to empower one another and provide support during stressful situations in the workplace. Equality in the work environment reduces power imbalances. Lastly, it is imperative that nurses unite to have stronger voices in creating policies and rules that ensure the best outcomes for the patients are achieved.

Ethical Situation

A situation arose where a nurse could not live out the value in providing safe, compassionate, competent and ethical care occurred on a busy evening shift on a sub-acute floor. On this particular evening, the nurse had 7 total-care heavy patients, and was expected to administer numerous medications, and provide evening care. During that evening, two of this nurses’ patients fell, and she also had to attend to her partner’s patient, who also had a fall. After ensuring all patients were uninjured, administration of medications, and completion of all assessments, the nurse barely had time to provide evening care. Two of the patients went to bed without being washed. The nurse was unable to do hourly safety checks on her patients, and she felt as if she had gone all evening without seeing some of her patients. She had to stay after her shift to complete two incident reports.

This experience affected the nurse deeply, and she did not feel in the least that she was safely providing care to these patients. The speed at which this nurse had to complete her tasks put her and her patients at risk, and the whole shift felt chaotic. This incident occurred approximately three years ago, and she still has not accepted another shift on the sub acute floor.

The barrier the nurse faced in being able to live this ethical value occurred at an organizational level, and is brought back to budget cuts. This heavy workload occurred because of the cost associated with hiring more nurses, or care aids, to reduce the workload. Another issue may have been staffing issues for this floor; turnover may be high, as other nurses may have similar experiences.

Tuesday, February 15, 2011

Consequentialism: Applying Ethical Principles to Case Study


Consequentialism
Looks at the moral rightness of an action solely based on its consequence.  Is the outcome beneficial to that individual?  The principle of utility is used as a decision making procedure.  Moral worth of an actions is determined by it's usefulness in maximizing utility and minimizing negative utility
Utility is defined as pleasure, preference satisfaction, knowledge or other things.  Utilitarianism is a form of Consequentialism.  The difference between Cosequentialism and Utilitarianism is that Consequentialism focuses on the greatest good for each individual, where as Utilitarianism focuses on the greatest good in greatest numbers.  There are many other forms of Consequentialism, each version vary slightly (Armstrong, 2006).

More information on Consequentialism:
http://plato.stanford.edu/entries/consequentialism/

Following Consequentialism, based on the case study, the greatest good for those individual patients were definitely not carried out.  Because of cost cuts and staff shortage, the workload that the nurse had on her plate was too heavy for her to handle.  With the heavy assignment, the quality of care for each patient was affected.  For these reasons, the outcome was tragic, and harm came about to three patients.  The falls could have been prevented, if each nurse had fewer patients or if there were extra staff to help out.  Even for patients that were not harmed, their quality of care was affected, as the nurse felt that she had little time to spend with some of her patients and had to neglect them since they were of  lower priority.  Some of the patients went to bed without their baths and hourly checks were impossible.  According to Consequentialism, we should weigh the possible outcomes to guide our decision on what the best action should be, thus in this case scenario the nurse should have the right to ask for additional help and such request should be carried out by management.  Cost cuts should not hold merit over patient and nurse safety.

References
Armstrong, S. Walter. (2006).  Stanford Encyclopedia of Philosophy.  Retrieved Feb 13, 2011 from       http://plato.stanford.edu/entries/consequentialism/
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