Victoria Weller is a registered nurse who offers sexual advice to the young individuals. She finds herself in an ethical dilemma when attending to Stella Nguyen who has suffered from physical abuse from her Aunt’s boyfriend. The patient pleads with the nurse not to tell the doctor about the bruises on her arms. Stella is also seeking confidentiality from the nurse against disclosing her relationship status to her aunt. The patient visited the hospital for advice on treatment and contraceptive pills. The nurse carries her duty by giving the information on the medicines and their side effects.
This essay will populate the ethical and legal reasoning framework to analyse the case study. The write-up will discuss the issues and evaluate those occurrences using ICN codes of ethics and the moral principles. The paper will also look at the appropriate course of action, implementation and assess the outcome of the activities.
The parties in the case study are the nurse, patient, doctor, the aunt and her boyfriend, and Stella’s boyfriend. The patient is below the age of the majority and needs the advice to stay away from sexual relationships. The registered nurse should inform the doctor and the patient’s aunt about the physical abuse towards the patient. The nurse should also notify the aunt of the relationship of the patient. However, Stella wants her information to remain private.
The first code is about the relationship between nurses and the patients. The nurse should provide care that respects spiritual beliefs, customs, values, and human rights (Kennedy et al., 2015). The caregiver should also ensure that the patient receives timely, sufficient, and accurate information that is in tandem with their cultural beliefs. Nurse Victoria fulfilled the requirements of the first code by giving Stella the relevant details of the morning after pills. The nurse also discloses the side effects of the drugs to the patient. However, the nurse is in a dilemma on whether to inform the doctor about the physical abuse of the patient or otherwise.
The second code requires the nurse to be accountable and responsible for the medical attention towards the patient. The caregiver should maintain her health to avoid compromising the quality of healthcare (Scanlon, Cashin, Bryce, Kelly, & Buckely, 2016). The care provider should create room for open dialogue with the patient and uphold ethical principles. Victoria provides an opportunity for the conversation that enables Stella to explain her sexual relationship with her boyfriend. The patient asks the nurse not to disclose her relationship status to the doctor. Stella also urges Nurse Victoria not to talk to her Aunt about her sexual relationship.
The third ICN code talks about the roles of caregivers in their line of duty. Nurses should determine and implement acceptable clinical standards of practice (Kangasniemi, Pakkanen, & Korhonen, 2015). The caregiver should also develop and sustain professional values in the provision of medical attention. The nurse should advocate for ethical practices and discourage unethical therapeutic actions. The physical abuse of Stella by her Aunt’s boyfriend is unethical, and the nurse should report the incidence to the doctor. However, the nurse should advise the patient against the sexual relationship due to Stella’s young age. Additionally, the nurse should discuss the relationship of Stella with her Aunt.
The fourth code talks about the working interaction of nurses and their colleagues. The caregiver should respect and collaborate with the co-workers to improve the quality of care (Pickles, de Lacey, & King, 2017). Nurse Victoria should seek the help of Doctor Howe on the confusing case of the teenage patient. The ICN code also requires nurses to protect patients and their families from potential harm from the by the caregiver’s colleagues. Victoria should not discuss Stella’s plight with the Doctor if the nurse feels that the action would harm the patient. The nurse should also avoid talking to the Aunt of Stella if the effect is unfavourable to the patient.
Autonomy
The principle requires individuals to respect the opinions of the others regarding their lives (Tobiano, Bucknall, Marshall, Guinane, & Chaboyer, 2015). Stella wants the nurse to keep her relationship status private from her Aunt. Additionally, Stella wants Victoria not to discuss the bruising by her Aunt’s boyfriend with Doctor Howe. Nurse Victoria should respect the opinion of Stella and keep her information confidentially. The decisions of individuals deserve respect if those opinions do not interfere with other people. Therefore, keeping Stella’s information secret obeys the principle of Autonomy. Nurse Victoria should not discuss the patient’s situation with the Doctor or her Aunt.
Beneficence
The principle requires that the action of an individual should result in the benefit of another person (Tong, Tong, & Low, 2018). The nurse should avoid sharing Stella’s information with both the Doctor and the patient’s Aunt if the action can cause harm to Stella. Discussing the patient’s situation with the parties involved is both harmful and useful to the patient. The nurse should address the physical abuse with the Aunt to stop the Aunt’s boyfriend from physically abusing the patient. The caregiver should also review the plight of Stella with the doctor to seek for appropriate legal action for the Aunt’s boyfriend.
Non-maleficence
The principle requires individuals to avoid harming the others with their actions (Doody, & Noonan, 2016). However, if people cannot prevent harm, they should minimise the effects of the impending damage. Stella’s condition poses an ethical dilemma as sharing her information can harm her feelings and also benefit her well-being. The nurse should share her knowledge with the nurse to enable the patient to obtain proper advice on sexual relationships. Additionally, the Doctor should advise on the legal action against the individual who physically abused Stella. However, the nurse should not disclose the information if it would hurt Stella’s feelings.
Justice
The principle requires individuals to practice fairness towards the others (Ingham-Broomfield, 2017). Therefore, individuals should get what rightfully belongs to them. A person should treat the others how they would wish to get the same treatment. Thus, reciprocity, equity, and impartiality are all essential in the course of action. The physical abuse towards Stella is unfair, and the Nurse should report it to the Doctor to seek for legal action towards the Aunt’s boyfriend. However, it is fair for the nurse to keep the relationship status of the patient secret as that is the wish of the patient.
Incompetence is the lack of knowledge, qualification, or ability to do a specific activity (Montgomery v. Lanarkshire Health Board). Stella is slightly incompetent as she is unsure of her next course of action after her conversation with the patient. Negligence is an activity that can harm the patient (Obergell v. Hodges). The failure of the nurse to report the bruising incidence can make the patient undergo adverse physical abuse.
(a) NMBA Code of Conduct
The Code on professional behaviour requires nurses to combine compassion, respect, honesty, and integrity in their line of duty (Cashin et al., 2015). Victoria should respect the wish of the patient and avoid discussing Stella’s relationship with the Aunt. The codes also require nurses to uphold privacy and confidentiality in medical attention (Chiarella, & Adrian, 2014). The nurse should request for the permission of the patient before disclosing personal information. Victoria should convince the patient of the essence of sharing information with others.
(b) Steps for Action
The Nurse should convince Stella to end her sexual relationship with her boyfriend and concentrate on her studies. Secondly, the caregiver should assure the patient that she will keep the information about her relationship secret from her Aunt. The nurse should then explain the usage and the side effects of the post-sex pills to the patient. The caregiver should then convince the patient of the need to discuss the physical abuse by her Aunt’s boyfriend with the doctor.
The nurse should advise on the harmful effects of sexual relationships before the age of eighteen. The caregiver should also advise against unprotected sex and explains the impacts of Stella’s actions. Victoria should keep Stella’s relationship status secret and avoid disclosing details to the patient’s Aunt. However, the nurse should discuss the legal efforts against the patient’s physical abuse with the doctor.
The action of discouraging the patient from the sexual relationship would hurt her emotional feelings due to her attachment to her boyfriend. However, the nurse can experience an ethical dilemma since individuals under the age of eighteen should not be in sexual attachments. Keeping the details of the relationship from the patient’s Aunt enhances peaceful co-existence between the patient and the aunt. The process of reporting the physical abuse to the Authorities improves the well-being of the patient.
Conclusion
Stella’s situation creates an ethical dilemma as the nurse wonders whether to disclose the patient’s information to the third party or not. The nurse can draw reference from the ethical principles after collecting the adequate information about the case study. Additionally, ICN codes of ethics can assist Nurse Victoria to solve the moral dilemma. Legal issues such as incompetency and negligence are arising from the case study. NMBA codes of conduct require nurses to apply privacy and confidentiality in medical attention. The nurse should use the above information to decide, implement, and evaluate the cause of action.
References
Cashin, A., Buckley, T., Donoghue, J., Heartfield, M., Bryce, J., Cox, D., … & Dunn, S. V. (2015). Development of the nurse practitioner standards for practice Australia. Policy, Politics, & Nursing Practice, 16(1-2), 27-37.
Chiarella, M., & Adrian, A. (2014). Boundary violations, gender and the nature of nursing work. Nursing Ethics, 21(3), 267-277.
Doody, O., & Noonan, M. (2016). Nursing research ethics, guidance and application in practice. British Journal of Nursing, 25(14), 803-807.
Ingham-Broomfield, R. (2017). A nurses’ guide to ethical considerations and the process for ethical approval of nursing research. Australian Journal of Advanced Nursing, The, 35(1), 40.
Kangasniemi, M., Pakkanen, P., & Korhonen, A. (2015). Professional ethics in nursing: an integrative review. Journal of advanced nursing, 71(8), 1744-1757.
Kennedy, C., O’reilly, P., Fealy, G., Casey, M., Brady, A. M., McNamara, M., … & Hegarty, J. (2015). Comparative analysis of nursing and midwifery regulatory and professional bodies’ scope of practice and associated decision?making frameworks: a discussion paper. Journal of advanced nursing, 71(8), 1797-1811.
Montgomery v. Lanarkshire Health Board, 2015 U.K.S.C. 11 (2015).
Obergell v. Hodges, 135 S. Ct. 1039, 576 U.S., 190 L. Ed. 2d 908 (2015).
Pickles, D., de Lacey, S., & King, L. (2017). The conflict between a nursing student’s personal beliefs and professional nursing values. Nursing ethics, 0969733017738132.
Scanlon, A., Cashin, A., Bryce, J., Kelly, J. G., & Buckely, T. (2016). The complexities of defining nurse practitioner scope of practice in the Australian context. Collegian, 23(1), 129-142.
Tobiano, G., Bucknall, T., Marshall, A., Guinane, J., & Chaboyer, W. (2015). Nurses’ views on patient participation in nursing care. Journal of advanced nursing, 71(12), 2741-2752.
Tong, S. F., Tong, W. T., & Low, W. Y. (2018). Ethical Issues in Qualitative Data Collection Among Vulnerable Populations in Healthcare Setting. In Ensuring Research Integrity and the Ethical Management of Data (pp. 80-97).
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