Nursing Ethics: Balancing Duty, Standards, and Avoiding Negligence

Introduction

As a nurse, I make judgment that would affect patients' health every day; I am aware that I have a great duty to ensure my patient's safety to maintain the public trust (Chitty & Black, 2011).

Get quality help now

writer-Charlotte

Verified writer

Proficient in: Health

4.7 (348)

“ Amazing as always, gave her a week to finish a big assignment and came through way ahead of time. ”

+84 relevant experts are online

Hire writer

This reflective essay delves into my experiences and learnings from a module that enhanced my understanding of managing legal and ethical issues in nursing. The complexities of healthcare require nurses to navigate a delicate balance between legal obligations and ethical principles. This essay explores key considerations in nursing ethics, emphasizing the importance of upholding the duty of care, adhering to the standard of care, and avoiding medical negligence for the overall well-being of patients.

Understanding Legal and Ethical Challenges

In the contemporary healthcare landscape, the public's awareness of legal issues is heightened, with information readily available through the internet. This has contributed to a surge in medical litigation claims, primarily stemming from medical negligence (Tay, 2001). As a nurse, I am personally accountable for my practice, and any failure to adhere to the reasonable standard of care could lead to legal consequences (Chitty & Black, 2011).

Research indicates various errors that can culminate in nursing negligence, including the failure to follow standards of care, improper use of equipment, inadequate communication, lapses in documentation, insufficient assessment and monitoring, and neglecting to act as a patient advocate (Croke, 2003). The legal criteria for establishing medical negligence involve proving that the nurse owed a duty of care, breached this duty by failing to provide the required standard of care, and that this breach caused harm to the patient (Hurwitz, 1998).

Consider a practical example from my own experience—a 55-year-old patient admitted for chest pain and on telemetry monitoring. The patient's request to shower independently led to a critical situation, raising questions about the nurse's potential negligence and ethical considerations.

Learning Points

Duty of Care

When a patient seeks treatment, a contractual relationship is established between the hospital and the patient. The hospital, in fulfilling its duty to provide quality treatment, extends this duty to its employees, including nurses. A nurse, therefore, holds a duty of care in treating the patient, and this duty extends to providing reasonable and competent care (Staunton & Whyburn, 1996; Hurwitz, 1998).

In this scenario, I have a bond with my patient; therefore, I owe a duty to provide reasonable and competent care to my patient (Hurwitz, 1998).

Standard of Care

The nursing standard of care is determined by what a reasonably prudent nurse would do in similar circumstances (Staunton & Whyburn, 1996). In Singapore, adherence to the standard of care is guided by the country's nursing board, emphasizing the need to respect patient autonomy while delivering responsible and accountable care (Singapore Nursing Board, 2011).

In this case, the patient's determination to shower without assistance is his autonomy (Tay, 2001). According to the value statement of the code of ethics, I respected the patient's individual needs and privacy and also respected and promoted the patient's autonomy by allowing the patient to do so (Singapore Nursing Board, 2011). However, there is a conflict between respecting the patient's autonomy and providing care in a responsible and accountable manner. I need to make a choice between two alternatives. There is no absolutely right or wrong decision (Keilman & Dontje, 2002).

The decision made by me is to respect the patient's autonomy, but this may violate the principle of non-maleficence, as this decision of allowing the patient to shower alone may delay the time to find out the patient has collapsed, then it unintentionally caused harm, so I failed to provide responsible and accountable care (Chitty & Black, 2011). If I choose to provide care in a responsible and accountable manner, I should have insisted on accompanying the patient, but by doing so, I may violate the patient's autonomy. According to the standard of care of nurses and midwives, I should communicate with the client effectively and provide appropriate information to the patient (Singapore nursing board, 2011). I should inform the patient that he is at high risk of developing a heart attack and shall be monitored closely. Failure to communicate effectively leads to a breach of duty.

Avoiding Medical Negligence

Preventing medical negligence requires a commitment to maintaining the duty of care. The Bolam test suggests that adhering to the standard of care is essential in avoiding a breach of duty (Hurwitz, 1998). In order to meet the standard of care, I need to be a knowledgeable and safe practitioner, be technically competent, and keep up-to-date with current practice (Chitty & Black, 2011).

We must be familiarized with the standard in nursing practice. When we use them to guide our daily practice, we are acting in the best interest of the patient (Singapore Nursing Board, 2011). When making decisions, I need to ask myself, "Have I followed the standard of care?" Nowadays, "the nurses are also being encouraged to act as advocates for their patients, to safeguard standards of care and to speak out where those standards may be at risk" (McHale & Tingle, 2001, p36). I think our role as an advocate needs to improve, as nurses do not have the courage to interrogate the doctor's order.

Conclusion

In conclusion, this reflective exploration underscores the critical importance of navigating legal and ethical challenges in nursing. Upholding the duty of care, adhering to the standard of care, and avoiding medical negligence require a delicate balance. The evolving role of nurses as advocates necessitates improved communication and assertiveness in ensuring the best interests of patients.

As the healthcare landscape continues to evolve, nurses must remain vigilant in embracing ethical principles and legal standards. Future improvements could include setting clear hospital policies, comprehensive staff education, and establishing protocols for patient situations involving potential risks. By enhancing these aspects, nurses can effectively navigate complex scenarios, contribute to improved patient outcomes, and ensure the delivery of ethically sound and legally compliant care.