A nurse has a special obligation to protect his patients rights. While a nurse would be expected to provide care when there is little to no chance of personal harm, there is no such expectation in a situation where personal harm is all but guaranteed, as might be the case with the transmission of a highly infectious agent (Benedetti et al., 2021; Hilliard, 2007). As patient advocates, it is imperative that nurses ensure that patients receive all medical information, education, and options in order to choose the option that is best for them. This helps our nervous system regain balance so we don't become stuck in fight, flight, or freeze. HHS Vulnerability Disclosure, Help MeSH , & , The ANA recognizes there may be limits to the personal risk of harm nurses can be expected to accept as an ethical duty. HHS Vulnerability Disclosure, Help However, the American Nurses Association Code of Ethics is clear: Nurses have the same obligations to self as to others. (2015). Denson, N. National Library of Medicine They are considered to be liaisons between the healthcare and legal systems in cases of personal injury, medical malpractice or criminal law. Received 2021 Jun 21; Revised 2021 Jul 25; Accepted 2021 Aug 1. "We in uncharted territory in response to the magnitude of the pandemic," says . Unfortunately, violence against nurses at the hands of recipients of care is increasingly common. A person with limited cognitive capacity is not expected to bear the same kind of responsibility as someone with full capacity and therefore is not held accountable in the same way. J Adv Nurs. There is a much stronger obligation to uphold the duty to provide care in situations where the absence of care would lead to an outcome of death rather than a simple inconvenience (Beattie et al., 2020; Benedetti et al., 2021). Lin, C.C. , "We in uncharted territory in response to the magnitude of the pandemic," says Cynda Rushton, a professor at the Johns Hopkins School of Nursing and Berman Institute of Bioethics known as an international leader in nursing ethics. , & official website and that any information you provide is encrypted Ethical decision-making in intensive care: are nurses suitable patient advocates? (2021). 1994 Sep;20(3):152-6. doi: 10.1136/jme.20.3.152. For example, a person with advanced dementia is dependent on care providers for sustenance and safety, making them highly vulnerable to the care provider's actions and choices. 1 Prevention of psychological harm presents a greater challenge to employers than physical violence where perpetrators can be overpowered or disarmed. Careers, Unable to load your collection due to an error. Manitoba Nurses Union , That doesn't mean we don't have obligations to our own well-being and families. A prominent feature of this quest has been the assertion by nurses and nurse writers that the nurse has a specific and special function as patient advocate. Babiarczyk, B. Turbiarz, A. Unaddressed ethical issues make it even harder. Pandemics and beyond: Considerations when personal risk and professional obligations converge. Hardest College Majors Sancho Cantus, D. Velasquez Reyes, D. There are ethical challenges to consider even when the withdrawal of direct care is justified. The Code The Code of Ethics for Nurses with Interpretive Statements, or "The Code", is a vital tool for nurses now and in the future. The complex interplay of contextual vulnerabilities determines whether the risk a nurse faces at the hands of a violent patient is reasonable or unreasonable. Nurses also really benefit from finding outlets. This notion will be unpacked further in the following section, starting with the recipient of care. The vulnerabilities of the recipient of care are determined based on their dependency on care as well as their capacity to appreciate the impacts of their actions. Do you have an active, unencumbered U.S. issued RN license? Links to PubMed are also available for Selected References. Respect for his patients regardless of race, sex, economical status or other discrimination factors is important for a nurse to remain objective. The implications of vulnerability on a nurse's duty to provide care are directly related to the recipient's level of dependency, as well as on their cognitive capacity. What is Nursing? Your Questions Answered | ANA Lee, H.L. 13 Important Nursing Responsibilities | Indeed.com An official website of the United States government. Paradies, Y. Provision 3. Online Pharmacy School This site needs JavaScript to work properly. Making up for the biggest healthcare job in the U.S., nurses play a vital role in medical facilities and enjoy a large number of job opportunities. There is a level of risk that is unreasonable for a nurse to accept in the discharge of their professional duties. Harte, J. M. The decisions that nurses need to make when faced with physical or emotional violence are fundamentally complex. - Stacy N. At the end of this crisis, we'll identify key participants and summarize themes to create a report for the American Journal of Nursing. Stifani, S. Investment in one's well-being is not optional; it's a moral mandate. As a library, NLM provides access to scientific literature. Much of the literature on duty to care in nursing relates to situations where there is a risk of personal harm to the nurse, as in the context of disasters and infectious disease (see fore.g., Benedetti et al., 2021; Hilliard, 2007; Malm et al., 2008; McConnell, 2020; McDougall et al., 2020; Pfrimmer, 2009; Reid, 2005). As discussed previously, the duty to provide care is strongest when the recipient is highly dependent on care for survival or significant health outcomes, and/or when they are less capable of anticipating or appreciating the outcomes of their actions. With these kinds of psychological violence, the limits on the duty to provide care are not as clear as they might be with physical violence because the potential impacts on the nurse are harder to assess, although no less significant. Prevalence and effect of workplace violence against emergency nurses at a tertiary hospital in Kenya: A crosssectional study. Priest, N. Regardless, nurses have a duty to provide whatever care is possible in ways that maintain the person's dignity while also minimizing the risk of harm to the nurse and to others in the area, thereby addressing, as appropriate and possible, the nurse's own and other's vulnerability. Delaney, E. Perhats, C. LewisNewby, M. 8600 Rockville Pike On the other hand, a nurse who is less prepared or lacks the required support may assess the level of risk to be unreasonable. In some instances, in the events of natural disasters where supplies and medications are running low, nurses have had to be responsible for making the ethical decision of choosing which patients would get treatment and which ones are just made comfortable till supplies were replenished. Alternatively, if a person becomes violent in an emergency department simply because they are tired of waiting to be assessed for a nonurgent condition, they are choosing to act out despite being capable of appreciating the implications of their behavior. Before What are the Legal Responsibilities of being a Nurse? , & Mayo Clinic, Rights and Responsibilities of Patients Some of the most prominent sources are discussed below: The American Medical Association (AMA) Code of Medical Ethics Opinion 1.1.3 lists a number of patient rights. Workplace violence in health care has generated a significant body of literature (Ashton et al., 2018; Babiarczyk et al., 2020; Beattie et al., 2019, 2020; Ferri et al., 2020; van Leeuwen & Harte, 2011; Morphet et al., 2018; Wand & Coulson, 2006; Whittington, 2002; Wolf et al., 2014; Zuzelo, 2020). A nurse is obligated to stay up-to-date on all the latest developments regarding a patients care. Nurses have many duties, including caring for patients, communicating with doctors, administering medicine and checking vital signs. , HealthCare.gov, Rights & Protections Innes, K. Construction Management A nurse may be obligated to provide care in spite of risks when an individual is experiencing transient delirium or lacks awareness of the harm caused by reactive behaviors. For example, nurses will recognize that there is a stronger obligation to provide care when the recipient will die without the nurse's intervention, and a weaker obligation when there is an excessive level of risk for harm or injury to the nurse, or when the care is nonurgent (Benedetti et al., 2021). , (2019). When a situation exceeds the limits of a nurse's duty to provide care, the nurse may need to shift their obligations to meet the patient's ongoing needs. Disclaimer. Manitoba, Please enable it to take advantage of the complete set of features! Water, T. Updated December 19, 2022 Nurses play an important role in providing care for patients to help manage their physical needs, treat health conditions and prevent illnesses. This space will be available 24/7 until America exits this crisis. Nurses have the right to practice in a manner that fulfills their obligations to society and to those who receive nursing care. Illinois General Assembly, Illinois Compiled Statutes Situations such as, a Do Not Resuscitate order or issues addressing pro-life versus pro-choice are just two examples where you must respect the patients wishes even if you do not agree with them. Accessibility McDougall, R. J. Ashton, R. A. Griffiths, D. Reporting of workplace violence towards nurses in 5 European countries: A crosssectional study, International Journal of Occupational Medicine and Environmental Health. In cases where the recipient appears capable of understanding the implications of their actions, the strength of the duty to provide care depends on the physical vulnerability of the recipient. Nursing World: Code of Ethics for Nurses with Interpretive Statements, U.S. Bureau of Labor Statistics: Registered Nurses. Before I've written about the concept of moral resilience for health care workers. Violence in health care settings will continue to raise ethical questions and challenges for nurses. Several other characteristics can also affect vulnerability. The .gov means its official. The harms caused by any type of assault, including verbal, are known to be traumatic and can significantly affect nurses' physical and mental health (Paradies et al., 2015). He must avoid any conflicts of interest while caring for a patient and put the care and interests of his patients ahead of his own. Home Academics Griffin Guides What Do Nurses Do? A nurse monitors her patients and typically records any changes in a patient's health and/or reports them directly to the caring physician. Feeling part of a community, even a virtual one, can help.". , Similarly, there may be significant implications of a workplace injury for a single parent with no alternative income or family to assist with childcare. 21 st Century nursing is the glue that holds a patient's health care journey together. It is generally supported in the literature that health care professionals will uphold their duty to provide care in situations of high risk unless the risk of harm exceeds what is deemed reasonable (Bensimon et al., 2007; Geppert, 2020; Malm et al., 2008; McConnell, 2020; McDougall et al., 2020; Reid, 2005; Water et al., 2017). In such a situation, it might be justifiable to remove that person from the department, and refuse to provide care at all, as long as the level of dependency does not reach a threshold where it confers a duty to provide care.
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