Ethik | Elsevier Pflege Podcast

Summary

In this episode of the nursing podcast, Niklas Luca discusses the crucial role of ethics in healthcare with Frau Keller, a nursing educator. They explore fundamental ethical principles such as patient autonomy, harm prevention, care, and fairness in nursing. The conversation highlights real-world challenges like handling patient refusals, ethical dilemmas in teamwork, and the responsibility of reflecting on one's actions. With practical examples, the discussion emphasizes the importance of ethical decision-making and open communication in ensuring quality care. The episode encourages nursing professionals to critically assess their behaviors and engage in conversations about ethics in their daily practice.

Takeaways

• 😀 Ethics in nursing is about determining what constitutes good or bad actions and decisions in patient care, based on professional principles.
• 😀 Self-determination is a fundamental ethical principle, ensuring that patients retain their autonomy, even when they are ill or admitted to a healthcare facility.
• 😀 Healthcare professionals must navigate challenging situations where a patient's wishes conflict with medical or therapeutic advice, particularly when it comes to life-saving measures.
• 😀 Harm avoidance is a key principle, ensuring that care providers do not cause harm, even in situations like administering injections or providing prophylaxis.
• 😀 The principle of care emphasizes acting in the best interest of the patient, though this can be difficult when the patient's views or needs differ from the healthcare provider's perspective.
• 😀 Healthcare professionals need to balance patient care with their personal values and ethics, but it is important to avoid judgment based on personal biases or assumptions.
• 😀 Justice in nursing means treating all patients equally, regardless of factors like age, gender, background, or personal choices (e.g., alcohol or tobacco use).
• 😀 Ethical challenges can arise in situations involving resource constraints, such as deciding which patients to prioritize when the demand for care exceeds available resources.
• 😀 When witnessing ethically questionable behavior from colleagues, it's important to speak up and address the issue, but doing so requires courage and careful consideration of workplace dynamics.
• 😀 Nurses should continuously reflect on their ethical decision-making and engage in discussions to promote ethical practice, particularly in difficult or high-stress situations.

Q & A

What does 'ethics in nursing' generally refer to?

Ethics in nursing refers to the principles guiding nurses' behavior and decisions in patient care. It involves understanding what is considered 'good' or 'bad' actions in healthcare, reflecting on professional conduct, and ensuring decisions align with ethical standards, such as patient autonomy and the duty to avoid harm.

What is the significance of 'self-determination' in nursing ethics?

'Self-determination' is the patient's right to make their own decisions regarding their care, even if these decisions conflict with medical advice. This principle emphasizes respecting a patient's autonomy, which is crucial in nursing practice.

Can you give an example of how 'self-determination' might be challenged in nursing practice?

An example would be a patient refusing a necessary treatment, such as a surgery or therapy. Even if the treatment is medically recommended, nurses must respect the patient's right to refuse it, provided the patient has the mental capacity to make such a decision.

What does 'damage avoidance' mean in the context of nursing?

'Damage avoidance' refers to the nurse's obligation to prevent harm to patients. For example, if a nurse needs to administer an injection for prophylactic purposes (e.g., thrombosis prevention), they must consider whether it is ethically correct to do so if the patient refuses, as not doing so could lead to harm.

How should nurses handle situations where patient autonomy conflicts with the need to avoid harm?

Nurses should try to find a balance between respecting the patient's autonomy and ensuring their well-being. For example, if a patient refuses a treatment that could prevent harm, the nurse should explain the potential consequences and try to reach an understanding while respecting the patient's wishes.

What role does 'care' play in nursing ethics?

'Care' in nursing ethics involves acting in the best interests of the patient, which can sometimes be challenging when the nurse's understanding of 'best care' may differ from the patient's perspective. It involves working collaboratively with patients and their families to determine what care truly serves their well-being.

What should a nurse do if a patient cannot express their wishes for care?

If a patient cannot express their wishes due to incapacity, a nurse should refer to legal documents such as advance directives or consult with family members to understand what the patient would have wanted, ensuring the patient's best interests are prioritized.

How is 'justice' defined in the context of nursing ethics?

'Justice' in nursing ethics means treating all patients fairly and equitably, regardless of their background, medical history, or personal circumstances. Nurses must avoid discrimination based on factors like age, gender, or social status, ensuring that care is distributed based on medical need rather than personal biases.

What are some ethical dilemmas nurses might face when dealing with colleagues?

Nurses might face ethical dilemmas if they observe a colleague acting unprofessionally, such as being rough with patients, neglecting tasks, or engaging in unethical behavior like falsifying documentation. In these cases, nurses must decide how to handle the situation, whether by reporting the behavior or confronting the colleague.

What advice did Frau Keller give regarding ethical dilemmas in the workplace?

Frau Keller advised nurses to remain vigilant, especially in stressful situations, and to speak up when they observe unethical behavior. She emphasized the importance of teamwork and communication, encouraging nurses to have open discussions about ethical standards to create a supportive environment where difficult situations can be addressed.