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The healthcare industry faces different challenges every day. There are many major issues that involve legal and ethical issues that constantly surrounds our health care providers. The goal of treating the patients and providing the best care is most of the time involves ethical decisions that the tests the workers daily. There have been a lot of ethical issues that have occurred the past few months. This COVID-19 pandemic has caused the country so much chaos, hatred, and division among people.
A very sad reality to see.
The first article that I came across was from NBC. A nurse from Washington, DC was interviewed and was asked about her experience during this pandemic. She stated that during all the chaos, federal safety protocols for all health care workers started to falter early March during the height of the pandemic. She mentioned that the Centers for Disease Control and Prevention guidelines concerning personal protective equipment are always changed and that the nurses in one of the hospitals that they would have to restrict access on masks and should have to reuse them, the reason being that the facility is running low on their stock.
The nurse for this interview handed her resignation because of the risk that she might get her family sick. The article also mentioned about the number nurses that died due to this pandemic and how the hospital administrators, state, and federal government failed to do their job. This article also tackled the criticisms that the nurses received from quitting their jobs.
In New York, more than 3000 nurses filed lawsuits against the State Health Department and two hospitals over the health and safety of nurses in treating COVID-19 patients. It is also about mentioned about nurse burnout and mental issues resulting from this problem (Ali, 2020).
This article really got my attention. There were a number of legal and ethical issues highlighted in this paper. First, the dilemma of having to work in a safe environment, second, the question of are you going to quit or continue your fulfill your professional responsibility, 3rd, the issue of having to voice out, report or file a law suit against the facility’s for lack of preparedness in times of pandemic compromising the health of their workers, 4th, the nurses professional responsibility commitment to patient, and their own families and the moral distress that most of the nurses experienced from all this turmoil. The impact of all this is exactly what the article pointed out, a lawsuit, resignation, stress, and burnout. This can result in monetary loss and a negative impression on the hospital’s integrity. For the nurses, this can result in mental health issues and unemployment. The constant stress that they endure every day will sooner or later get to them. The way I see it, health care organizations should always be ready for something like this to happen. As an institution of healthcare and safety, they should know better where to allocate their budget. Most especially on supplies and equipment. Prioritizing their employee’s safety should have been a major part of their agenda. They are liable for all the employees and they should provide all the necessary tools for them to do their jobs. The healthcare facilities are very stringent about their rules and regulations and yet how can they expect their staff to work effectively when their safety is compromised. I express sympathy to all those nurses who had to endure all those long hour shifts worrying if they would get sick. Worrying if they can ever go home to their families. Worrying about their future. But, they still have a professional obligation to work amidst the uncertainty. These problems would never arise if the hospital administrators and government were preparing to deal with this type of circumstances. Although they have done a lot of active measures, they are still some areas that need to be prioritized. Regarding the lawsuit, I support the nurses on their sentiments. They have a solid case to file for a complaint. Nurses need to be heard and protected. What they face every day is not an easy task, if they are not taken care of, how can they provide proper care to their patients. It is every right of nurses to be able to work in an environment conducive to function to the best of their abilities. As a matter of fact, it was written in the American Nurses’ Bill of Rights, on the sixth statement about the nurses right to work in an environment that is safe for themselves and for their patients. Now, should they be blamed for filing a resignation? My opinion is no. The blatant disregard of staff safety is reason enough for their action. Another issue would arise if the nurses get sick. Who are going to take care of this patient? As I have earlier emphasized, medical health workers need to be protected or nobody can take care of the sick. And lastly for the stress and burnout of nurses, hospital administrators should have their support care or therapy readily available for their staff. It is already hard enough what they have to deal with, providing assistance would greatly help the nurses.
The second article I chose happened in our state. As a matter of fact, I had my clinical rounds in one of their hospitals. This article made an impact because this involves the Arizona nurse front liners who face off with the anti-lockdown protesters during the height of COVID pandemic. The stay at home order and lockdown have prompted a protest calling for Governor Doug Ducey to end the lockdown. A group of Phoenix Banner University Medical Center nurses armed with their uniform and N95 face masks, counter-protested in front of the Capitol building in support of the local government. About 500 protesters gathered in the State Capitol filling the streets expressing their opinions about the governor’s order, ignoring the Center of Disease guideline of 6 feet social distancing (Wallace, 2020). The ethical issue for this is 1st, the decision of the nurses to stand up for what they believe in and support the government’s decision or to stay quiet and leave the authorities to handle the situation. 2nd, the moral and social duty of a nurse toward the general public surpasses beyond the four corners of the hospital room. 3rd, the responsibility to actively participate in relevant issues that promote safety and well-being of patients and the community. 4th, nurses have the right as professionals to be part in advocating for safety, standards of care, and healthy workplace. The outcome of their action helps build awareness to the people and the government officials. Their presence would serve as a peaceful and diplomatic demonstration that may decrease the chances of the protesters to result in violence. The nurses can also serve as a mediator between the officials and the people. I applaud the nurse for standing up for what they believe in. For being an advocate to the people who cannot speak. On the Bill of Rights, they have the right to practice in a manner that fulfills their duties to society and to those that are receiving nursing care and the right to advocate freely and openly not just for themselves but also to their patients, without the fear of retribution. For peacefully getting their message across. For patiently standing up against to the public’s anger. For being a true healthcare professional. As a student, it gives you a sense of responsibility to society. To stand up for what is right. To be active in the protection of the patient’s welfare. With the chaos, sometimes the issue lies from ignorance. The lack of education and awareness can cause discord. It can also come from the issue of personal financial constrain. The lockdown has forced people not to work and provide for their families which can trigger the resentment. This goes back to government’s readiness to manage this situation. The focus on restructuring and prioritizing the needs of society and all sectors of the community in times of pandemic should be properly addressed.
The final article that I came across is not related to the pandemic but very interesting which I think all healthcare workers should read. It is entitled “Do Not Resuscitate’ tattoo causes ER ethical dilemma”. This happened in the department of the University of Miami Hospital. An unconscious patient was brought to the emergency room by the paramedics with a do not resuscitate tattooed on his chest. The patient was diabetic, with elevated blood alcohol and a history of pulmonary disease. Initially, the doctors started treating the patient. Although the tattoo is not considered valid in Florida Department of Health and the doctors were unable to locate any of the family members, they started giving the patient antibiotics and IV fluids on the grounds of “invoking the principle of not choosing an irreversible path when faced with uncertainty”. With this dilemma, the doctors decided to consult the ethics committee recognizing the patient’s efforts making his wishes known through his tattoo, which is somehow like an advance directive. The ethics consultant response was to honor his tattoo which likely represented his wishes. The DNR was written and soon enough, the officials found the patient DNR request from the Florida Department of health. The patient died overnight without lifesaving efforts (Re, 2020). The issue for this article is, 1st should the doctors recognize the DNR tattoo, 2nd is a tattoo legally recognized as an advance directive, and 3rd should they go against the patient’s wish just relying from the tattoo, 4th patient’s right of autonomy. The law is not clear enough regarding patient centered care and supporting the patient’s interest. It is only right that the doctors requested for an ethics consultation. As a future nurse, if I encounter this type of situation, I would definitely inform the doctor in-charge and acknowledge the tattoo. The Ethics committee should certainly be consulted. I am not familiar of the law about tattoos as a directive but patients should also check the state where they reside if tattoos are recognized as an advance directive. Although the tattoo would seem as a clear instruction, ethics committee consultation should always be done and let them decide the right solution. We must make sure that the patient’s right to autonomy and self-determination is not violated. This issue can be a slippery slope and can cause a lawsuit to the facility. Regulations musts be prepared and organized, should an issue such as this arise. All efforts must be done to look for the patients records. Health practitioners are bound by law to treat, protect, and advocate for patients, but they are also required to recognize their rights. This is one of the reasons why ethics committee is important, because situations like this where health workers are put in a position where the legal and ethical right is unclear, they serve to oversee and resolve ethical issues encountered in their facility as well as protecting the patient’s interest. Staff education is relevant for this situation.
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