Reflective Practice Portfolio (RUA) Guidelines

Reflective Practice Portfolio (RUA) Guidelines
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Institution
Reflective Practice Portfolio (RUA) Guidelines
Topic – Ethical dilemma.
One of my closest nurse friends once found themselves in an ethical dilemma whereby the patient’s family wanted him to act against the standard procedures of the practice. The family members admitted their patient and waited for the prognosis. It is standard procedure to disclose details of the prognosis to the patient, however, the family requested the hospital to withhold that information from the patient. My friend read them the hospital’s code of conduct and explained to them that such information belongs to the patient and they are not, as per the law, supposed to make such a request. It was evident that they were dissatisfied and they approached my friend’s supervisor and made their case arguing they were acting in the interest of the patient. They provided a few scenarios where the patient had worsened their state because of startling news. However, they were still not convinced and therefore, threatened to sue the hospital in case the condition of the patient worsened. The supervisor, therefore, asked my friend to hold onto the results first and not release them to the patient immediately as it should be done. My friend was, therefore, found himself in one of the most common ethical dilemmas nurses face today. On the one hand, he knew he had to abide by the ethical guidelines of the hospital which borrows significantly from the ANA and ICN codes of ethics which categorically stated that his commitment should only be to the patient. However, the family of the patient also made a very convincing argument, and in such cases, the hospital often gets blamed if they act contrary to the wishes of the family and the patient worsens.
My friend was experiencing what Debra Wood (2016) called moral distress. Moral distress is a state where the nurse encounters a situation that forces them into an ethical dilemma where the option of doing the right thing is not direct. He always confided in me, and the moral burden was heavily weighing on him until one day the patient confronted him about the prognosis. Over time, he had grown close to the patient, and on that particular day, the patient noticed something strange in the way he was talking and the fact that he avoided eye contact. The patient was direct and had noticed the prognosis topic was being ignored or shoved away as soon as it was brought up. However, on this day, he asked my friend directly, and it was clear that he had enough. In the most subtle of ways, my friend explained to him the details of the prognosis and surprisingly, the patient knew more than they had disclosed. He had read about his condition and therefore, knew bits about it. When my friend told the family members that he had revealed the details of the prognosis to the patient, they were angry and sought to speak to the supervisor. Despite the disciplinary hearing my friend was scheduled to appear in, that night he friend slept with a clean conscience.
In the above scenario, decision-making principles are evident: the rights approach and the fairness approach. Velasquez et.al (2015), explains that the rights approach advocates for the right ...