Everyday Healthcare Ethics Stress and Ethical Issues in Nursing
Everyday Healthcare Ethics Stress and Ethical Issues in Nursing
The nursing is a fundamental sector in the provision of proper healthcare services to the individuals and the society as a whole. The importance of the sector is emphasized as it has a bearing on the health status of the economy. The state of health of the people forming part of the society today is of the essence. Improper health of individual workers affects the output of the workers negatively as they cannot effectively attend to their obligations at work. It results into a nation-wide loss of revenue. A healthy economy thrives in all the sectors as the workers are in a position to effectively deliver in their workplaces. A healthy economy earns good revenues. The inclusion of the issue of economic issues of the nation in the topic of health is of great magnitude. It shows the weight that the issue of healthcare has on the economic progress of the contemporary economy. The topic of nursing is one that cannot be avoided if the fate of the economy is to be established. The health sector in the contemporary society faces several ethical issues in the nursing sector (Baillie, 2013). A major aspect of the ethical issues that are subject to heated debates is the stress factor at the workplace. Critics postulate that the sector contains a large group of nurses who are burdened by stress.
It is dreaded that the continuous contact of the nurses with stressful conditions can negatively impact on their delivery in the job set-up (Baillie, 2013). The extent to which stress affects service delivery in the health sector has not been established, and it attracts substantial attention in research. The stress that the paper capitalizes on is the stress that a nurse worker is exposed to in and off the workplace. It is noted that stress can lead to the sprouting of other ethical challenges (Baillie, 2013). The paper capitalizes on the various ethical challenges exhibited in the nursing profession. It discusses the possible effects of the ethical challenges, causation factors and their relation to stress as a major ethical issue in the provision of healthcare services. The recommends the latest remedies that can be employed to minimize stress. Forms of ethical challenges and causes of stress in the nursing industry
Nurses encounter challenges and dilemmas in circumstances that they cannot get the opportunity to undertake what they think is right (Luhanga et al., 2010). Such circumstances require steady thinking and making of substantial resolutions that can work. The urge of the nurses to be good professionals intensifies the need to meditate on a given situation clouded by dilemma. The circumstances that present the nurse with a tough question to answer often trigger the development of stress within the worker. The stress is experienced at the very stage of making a decision on a given critical issue and also after the decision is made in response to the tough situation. The nurses, therefore, experience a great extent of moral distress. The event of the experience triggers varied reactions in different nurses. Some of the nurses have the courage to speak out their minds while some lack such courage and they go around hiding their problems. Burden of Witnessing an Ailing Patient
The forms of ethical challenges such as stress could be drawn based on the causation factor. There is a burden of witnessing the ailing of the patients in their hospital beds. There are many patients who suffer for a longtime in the hospitals and their conditions keep worsening to the point of death. Such scenarios affect the nurses who provide healthcare services if they are constantly exposed to the similar circumstances. The work of a nurse is to relieve the suffering of the patient. The complex intervention that are resorted to, often lead to more suffering of the patients. The nurses are, therefore, torn between effecting the remedy and letting the patient remain in the state of mild suffering. The thought of being unable to contain the situation when there is an available option that can be exploited poses a great challenge to the nurses. The mental burden of bearing the suffering in their minds for such long durations may affect their service delivery if a remedy is not effected swiftly (Luhanga et al., 2010) Ignorance of the Family Members of the Patient
The ethical challenges obviously had to do with watching the patients suffer: a suffering that the nurses deem to be unnecessary. It is understandable that the available nursing interventions that may be effected may serve to increase the suffering of the patient without causing an outcome for improvement. The other form of challenge that nurses experience could be the stress caused by the ignorance of the family of the patient and the patients about the available treatment options that can be exploited in a given scenario. They do not know the clinical prognosis of the treatment option that is available and the family of the patient do not stop at establishing whether the voice of the patient is taken care of in most situations (Tully, 2014). The family members of the patient often press on the administration of treatments without the knowledge of the resulting repercussions of the said treatment to the patient.
They also criticize and influence the decision that is made by the patient on the appropriate treatment to be administered. The indulgence of the external parties in matters of the patient’s medication or treatment stresses-up nurses and other medics too (Tully, 2014). The stress often comes up when they are forced to administer treatments based on past successful occasion on a patient with a different diagnosis. The problem also comes in after the controversial treatment is effected, and the effects appear to be detrimental to the patient. The latter scenarios are often characterized by fierce criticism of the nurse who participated in administering the treatment. The professionalism of the participating nurse is usually questioned and in some cases the nurse can even end up in a court of law. Such cases are major instances that causes mental stress and shapes the origins or forms in which the said ethical challenges arise in the course of provision of healthcare services. Conflict of Interest
Offering care to the patients presents another form through which stress emerges in the nursing profession. It is the kind of ethical challenge that emanates from a conflict between the interest of the organisation and interest of the individual nurses (Tully, 2014). The health providers including private clinics, public hospitals and other health institutions have their rules that they often regard as ethical. The health providers often strive to push for actions that serve their best interests in the industry of health service. The most prominent organisation that have strict rules are the private entities. The issue of conflict here is usually the payment modalities. It is known that the economic capabilities of patients differ and the methods of making medical payments cannot be the same for all the patients. The rules of the medical institutions provide that payments should be made promptly to the institution for any service that is provided to the patient. Some patients often have no ready cash owing to their economic circumstances and the high cost of medical healthcare. Organisation often insists that payments are to be made immediately before the commencement of treatment even in conditions where the patient is in critical conditions (Ulrich, 2010).
The nurses are the intermediaries between the management and the patients. Therefore, they are the people entitled to further or to carry out the interest of the organisation. They often face the challenge of serving the organisation or providing services to the patient to save a life. The challenge exists in trying to strike a balance between being loyal to the employer and saving the life of an innocent patient in a critical condition. Seeing an innocent and helpless patient die in the event of serving the interest of the employer could be so stressful in real life. As much as money is needed to take care of the medical expenses of the medical provider, the interest of the patient of lower economic status must also be regarded to ensure that the nurses do not suffer from the challenge of divided interest (Ulrich, 2010). The work environment
The contemporary society presents various complications in the field Medicare. The complications are witnessed in the structure of the organisation and in the communication channels that are used in the medical institution (Seedhouse, 2013). The structure of the leadership in a medical institution and the mode of communication can serve to frustrate the nurses in the workplace. Several nurses report difficulties in communication and instances of workplace bullying. The elements mentioned are part of serious work environment ethical concerns in the contemporary society. The present hierarchy of work structure in the management is designed in a manner that does not encourage communication among workers. Most organisation exhibit tall leadership structures. Tall leadership structures contribute to the discouraging of vertical communication among the workers in a medical institution.
The junior employees are placed in a circumstance where they can hardly initiate or communicate to the senior employees about any ethical issue that may arise. Nurses are the employees who are ranked at the lower topology of the leadership organogram just after the subordinate staff. Their placement does not allow them effectively to pass ethical issue to their bosses (Seedhouse, 2013). Stress comes in when the ethical issues such as gender violence at work, bullying at the workplace or any other related mistreatment issues cannot be passed to higher authorities for deliberation. The condition presents a scenario where several issue build-up beyond the control of the employee. The build-up of issues in the minds of the nurses causes them to be stressed up in their workplaces, and this has a negative influence on the quality of the services delivered. Understaffing
The other issue causing stress is the issue of staffing. The society today is characterized by increased levels of ailments and various diseases that come up every day. The presence of chronic diseases, as well as, the occurrence of several accidents presents a scenario where the number of the patients in the health facilities increase tremendously. The increase in the number of patients causes the necessity for an increase in the numbers of nurses who can promptly attend to the patients. Despite the large increase, the nurse to patient ratio has not been any better (Maynard, 2011). The nurses are therefore overloaded with work in their work environments.
Their bosses exert much pressure on them to deliver as per the job description that they signed. The process of striking a balance in attending to many patients is quite stressful and can cause them to deliver poor services to the patients. The nurses are, therefore, forced to dodge certain duties that are assigned to them in genuine terms. Some of the nurses suffer emotional disturbance in instances where they genuinely neglect a duty due to the fact that they were held up in delivering services to the other patients. Understaffing, therefore, causes stress to the nurses through the creating of a hectic working environment that is over-demanding to the nurses (Maynard, 2011). Prioritization of the Patients’ Needs
The patients in the health care institutions do not only have health problems, but they also have emotional disorders. The emotional needs of the patients also deserve to be addressed promptly as they also affect the healing process of the patients. The nurses are individuals specialized in the provision of Medicare services to the patients. They are not adequately trained to address the emotional needs of the patients. At times, situations that demand the addressing of an emotional condition of the patient arises and this calls for the attention of the nurses. Being that the nurses are not well trained in the field and that they have other health duties to attend to, they are often faced with the challenge of taking up the duty to provide emotional support to the respective patient (Mark, 2012).
If they decide to avoid attending to the emotional duty, they may feel that they are not doing any good to the patients who do not receive optimal healthcare. They also feel that the family of the patient may give a negative feedback on their performances in the occasion that they did not get full support. Their attention is divided in prioritizing the nature of the duty to indulge in when such cases arise. The event can cause emotional distress and mental stress to the nurses, hence leading to the causation of other opportunistic ethical nursing problems. Advanced Technology in Healthcare Provision
Technology used in the delivery of healthcare services are becoming more complicated with time. Almost all the tasks in the health institution are performed with the aid of a machine (Maynard, 2011). The nurses are, therefore, placed in a condition where they have no other easy alternative, but to learn how to use the technology. The patients under treatment at times could be more knowledgeable on the respective technologies that the nurse. The resulting situation can possible cause a challenge to the nurse as he will not be comfortable in the process of using the technology on such a patient. The nurses are, therefore, entitled to keep updating themselves on the new technology that is used in the field of healthcare provision. The process of maintaining a regular update on the use of the current technology could cause much stress to the nurses (Ulrich et al., 2010). Nurses are stressed when they cannot balance between learning new tricks at work and providing healthcare services effectively. Recommendation for Reduction of Stress
The elements that cause stress to the nurses in the health organisations deserve to be addressed promptly. It is because stress as an ethical issue causes impacts that stretch to very many fields and varied stakeholders at play. Stress affects the delivery of the nurses in the health sector. The section provides remedies that should be considered in ensuring that the aspects that cause stress in the workplace are negated. The recommendation will also guide in the proper management of the stress whenever it is contracted by the nurses. The recommendations below are specifically tailored for containing the stress condition for the nurses.
Research shows that a scheduled course of guided coaching in mindfulness deliberation or mediation practices, facilitated group discussion, yoga and stretching, home assignments and work, and individually tailored support and instruction can serve to minimize the effects of stress in a nurse (Ulrich et al., 2010). The remedy is justified from a demonstration in a research work that was carried out. The overall health and well-being of the nurses who participated in the demonstration was surveyed at three points namely 2 weeks prior to research, immediately after the program, and four months following the program. Results displayed statistical improvement in the wellness and overall health of the nurses at each point of intervention (Clark, 2010). The program can be recommended for use by the nurses. Stress prevention can be initiated through the initiation of measures that prevent the occurrence of other ethical issues as stress is indirectly connected to them (Opie et al., 2013). Most of the ethical issues cause stress and, therefore, their prevention results into minimization of the occurrence of stress among medical nurses.
The administration of the health institutions should look for ways that encourage the realization of community obligation to the patient, with partnership in answering questions and conversing about ethical issues. It helps the families and the community at large to understand the circumstances under which the nurses undertake their obligation (Hussain, 2009). It will save the nurses from receiving intensive criticism when a given treatment responds negatively, hence the nurse concerned will be less stressed. The administration should ensure that the nurses are trained to provide emotional support to the patients who need such services to avoid the development of the feeling that shoddy work has been done. Nurses should reflect on how they can manage to complete obligations. Nurses should call on their team members, for instance to help them balance between talking and tasks with a patient who is dismayed (Clark, 2010). As nurses develop and advance in experience, they become better. Relevant training must be done to the nurses on the usage of technology in the delivery of health services to clients so as to avoid embarrassing situations. The nurses can advocates for the availability of adequate staffing that is suitable for the patient population (Clark, 2010). They should also know how to resolve issues when there is inadequate staffing Conclusion
The development in the contemporary society presents complications in various sectors. Health sector is not an exception. Many ethical issues that cause stress are seen to arise in the healthcare sector. The ethical issue arises from the unfavorable work environments of the workers, poor leadership structures, and lack of effective communication among workers, understaffing, and ignorance of the community among others. The effective implementation of the recommendation will serve to restore sanity in nursing as they will aid in preventing ethical conditions that cause stress to the nurses. As a result, the provision of healthcare services by the nurses will be improved to adequate levels.
Baillie, H. W. (2013). Health care ethics (6th Ed.). Boston: Prentice Hall. Clark, A. C. (2010). Anxiety and Stress Management Toolkit Anxiety and Stress Management Toolkit. Nursing Standard, 15(52), 29-29. Hussain, F. (2009). Handbook for Health Care Ethics Committees (review). Journal of Health Care for the Poor and Underserved, 20(3), 929-930. Luhanga, F., Myrick, F., & Yonge, O. (2010). The Preceptorship Experience: An Examination of Ethical and Accountability Issues. Journal of Professional Nursing, 26(5), 264-271. Mark, F. (2012). Posttraumatic Stress Disorder in Nursing. Journal of Neuroscience Nursing, 37(4), 179. Maynard, A. (2011). Ethics and health care ‘underfunding’. Journal of Medical Ethics, 27(4), 223-227. Opie, T., Dollard, M., Lenthall, S., & Knight, S. (2013). Occupational Stress in Remote Area Nursing: Development of the Remote Area Nursing Stress Scale
(RANSS). Journal of Nursing Measurement, 21(2), 246-263. Seedhouse, D. (2013). What is the difference between health care ethics, medical ethics and nursing ethics? Health Care Analysis, 5(4), 267-274. Tully, A. (2014). Stress, sources of stress and ways of coping among psychiatric nursing students. Journal of Psychiatric and Mental Health Nursing, 11(1), 43-47. Ulrich, C. M., Taylor, C., Soeken, K., O. Donnell, P., Farrar, A., Danis, M., et al. (2010). Everyday Ethics: Ethical Issues and Stress in Nursing Practice. Journal of Advanced Nursing, 66(11), 2510-2519.