The health-care community is composed of physicians, nurses, assistants, pharmacists, therapists, researchers, dietitians, and others whose primary role is to provide the services and tools to promote the health of patients. As members of the health-care community, nurses experience many legal, ethical and professional issues similar to other health-care workers. Yet, given their position within the hierarchy of the medical institution, nurses also face some nursing-specific challenges in providing medical care.
A nurses is often involved with the health care of individuals who do not share the same worldview as the nurse. This creates conflict not only regarding what constitutes appropriate medical care, but also how to balance the medical and nonmedical needs of patients.
Nurses with more training, education, development and experience than physicians are supposed to follow the orders of physicians who may be misinformed or inexperienced. In some states nurses are unable to legally practice unless under the supervision of a physician. Nurses must decide whether this is acceptable and how to deal with the issue if it causes problems.
For financial reasons, some hospitals "short-shift" nursing stations, i.e., they do not schedule enough nurses to cover all of a shift. Nurses have to choose whether to leave when their shift is over or "volunteer" their time to ensure that patients receive needed medical care.
Nurses are responsible to provide for reasonable and competent medical care for individuals in medical need; nurses are also responsible to follow the orders of physicians. These obligations may conflict in some situations. For example:
Sometimes physicians make mistakes in patient orders. A nurse has to decide whether to correct the mistake on her own or to report the incident and let the physician deal with the mistake.
Physicians do not always have time to get to know a patient's nonmedical concerns. Nurses often spend more time with patients thus becoming more familiar with the nonmedical aspects. A nurse must learn how to handle situations in which physicians provide for the medical needs of a patient at the expense of the patient's nonmedical wishes.
Patients sometimes don't follow medical advice. Nurses must learn how to treat patients when the patients are acting against their own interest and health.
Shared Issues Among Medical Workers
The needs of society conflict with the needs of a patient. Scarce or limited resources may impact the availability of medical goods or services. Nurses must ascertain how best to distribute scarce or limited resources to patients.
The medical needs of a patient conflict with his non-medical needs. Sometimes a patient needs standard medical care that he does not want. Medical workers must determine whether the medical needs override the nonmedical wishes.
In organizations such as private businesses, public schools or the military, the needs of the organization conflict with the medical needs of an individual. Nurses with responsibilities to these organizations must determine whether to follow their medical responsibilities or their fidelity to their organization.
- Ethical Dilemmas for Nurses: Physicians' Order vs. Patients' Rights
- "In Defense of the Traditional Nurse"; Bioethics, an Anthology; Helga Kuhse, Peter Singer; 1988
- "Biomedical Ethics"; Thomas A. Mappes & David DeGrazia; 1981
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