An RN working in the Intensive Care Unit (ICU) is caring for a patient with an acute
gastrointestinal hemorrhage related to liver failure that resulted from alcoholic cirrhosis.
During hand-off report at the end of the shift, the outgoing RN states to the incoming RN, I
have been in that room all day, transfusing blood products and giving medications. It’s so
much work for really no reason. I don’t know why this patient drank to the degree he did
to destroy his liver. He did this to himself. What a waste of resources. I heard his family
wants to get him on a list for a liver transplant.
Answer the following Questions:
1-What is the most appropriate way for the incoming RN to approach this situation?
Include ethical and legal considerations.
2-What is the role of the RN in regard to addressing the value system of other health care
workers that may have a negative impact of the delivery of patient care? Include ethical
and legal considerations.
Emotions Interfering With Care
The incoming RN must stick to the treatment regiments for the patient. The main
function of a nurse is helping the patient and improves the patient’s outcome. It is clear that the
outgoing RN is not interested in caring for the patient and is instead blaming the patients for the
condition of the patient. From a legal perspective, the incoming RN has a duty of care to the
patient (Brunner and Suddarthâ, 2015). This is to say, the incoming RN will be liable for
negligence in case he considers the advice of the outgoing RN. But there is also an ethical
perspective of the situation. The incoming RN is in an ethical dilemma on whether to withdraw
services or continue with the service.
EMOTIONS INTERFERING WITH CARE 2
Moral dilemmas are situations most healthcare professionals would want to find
themselves in owing to the difficulty in weighing how much to give and take. Healthcare
professionals are expected to hold onto certain codes of practice in order to remain within the
guidelines of practice. However, when moral dilemmas come in, they tend to influence an
individual’s moral values and beliefs in the process (Hinkle & Cheever, 2013). There are various
ethical principles that are central to nursing care and which are relevant to this case. One of them
is non-beneficence which requires medical practitioners, other things remaining constant, to do
good, that which will enhance the interest of the patient (Hinkle & Cheever, 2013). The principle
of non-malfeasance requires that, other things remaining constant, the healthcare professionals
should by all means avoid doing any harm to the patient, or that which may go against the
interests of the patient. By neglecting the patient as the outgoing RN has suggested, the RNs will
be causing harm to the patient rather than reducing harm. Another ethical principle is that of
justice, which requires that the medical goods and services are fairly distributed.
RNs have a bigger role to play in emphasizing the functions of nurses, especially to those
nurses who might be having negative attitudes towards their profession or the patients. One of
the functions of RNS is supervision and oversight on junior nurses or peers that might be
struggling in certain nursing areas. To this end, RNs have the responsibility of emphasizing to
other nurses that nursing’s main objective is taking care of people (Kangasniemi, Pakkanen &
Korhonen, 2015). In order to prevent the negative attitude, the RN should make it clear that the
law recognizes nurses as individuals who nurtures people, protects them from harm and provides
them with comfort to the best of her ability until they are able to fend for themselves. Legally,
therefore, a nurse should be prepared to care for the sick and dying with skill and compassion.
EMOTIONS INTERFERING WITH CARE 3
Among other things, it is incumbent upon a healthcare professional to tell a patient the
truth about the condition of the illness in order to let her make choice by herself. Further, it is
important that the nurses exhaust all possible alternatives before recommending the patient for
organ transplant. In order to deal with the negative attitude, the RN must be reminded that
besides the duty of care, RNs must learn to make the most of life, focus on the people and things
that matter. Consequently, in order to offer the best care, RNs must consider ethical principles,
including rights, beneficence, non-maleficence, justice, and fidelity (Brunner and Suddarthâ
(2015). That is to say, a nurse is not capable of providing the holistic needs of a patient without
applying ethics or ethical concepts.
Brunner and Suddarthâ (2015). Textbook of medical-surgical nursing. Chapter 49: Assessment
and Management of Patients With Hepatic Disorders.
Hinkle, J., & Cheever, K. (2014). Brunner and Suddarthâ€™s textbook of medical-surgical
nursing (13th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Kangasniemi, M., Pakkanen, P., & Korhonen, A. (2015). Professional ethics in nursing: an
integrative review. Journal Of Advanced Nursing, 71(8), 1744-1757.