Running head: ETHICS

1
Ethics
Salena Barnes, RN, BSN
NRSG 7410
Georgia College and State University

ETHICS

Ethics in the nursing profession is simply rules of behavior in which we base our life
decisions on, in terms of what is good or bad and right or wrong. Various ethical theories are
utilized to offer a rationale to our position when making a decision. There are four commonly
accepted principles of health care ethics, which are the principle of respect for autonomy,
nonmaleficence, beneficence, and the principle of justice. Autonomy is having respect for the
right of individuals to make their own decisions and nonmaleficence is one should avoid causing
harm. In addition, beneficence is one should take positive steps to help others, and justice
ensures the benefits, as well as risks should be fairly distributed. When a moral dilemma presents
itself, you should ask yourself the following: What is the ethical question? What are the relevant
facts? Who or what could be affected by the way the question is resolved? What are the relevant
ethical considerations?
Reflection on where you were on ethics when starting the program.
Before I decided to pursue an MSN, I worked in a variety of settings as a registered nurse
(RN) to include Medical-Surgical, Surgical Trauma Intensive Care Unit (ICU), Orthopedics, and
at a Pain Management Clinic. In regards to ethics, I have always been concerned with offering
safe patient care that included respect for human dignity in my relationships with patients. I
further believe that the relationships I had with my colleagues were also respectful and ethical.
My role as an RN involved caring out orders. When a patient refuses a medication in the
hospital, as an RN my job was to determine why the patient was refusing, notify the physician,
and document the refusal. I would always reeducate the patient, especially if they were refusing
any medication. When I worked on a Medical-Surgical floor, I had a patient that refused all of
her medications. It would have been unethical of me to just accept the refusal and notify the
physician without attempting to discover why she had refused. After much discussion, I

ETHICS

determined that the patient was experiencing a change in her level of consciousness associated
with an electrolyte imbalance. This was my first night with the patient and the prior nurse had
not mentioned any issues with the patients mental status. I believe this is a good example of how
ethical decision-making contributes to safe patient care.
What parts of the program helped you to become more proficient in ethics?
I can recite several components of the program that aided me in becoming more
proficient where ethics are concerned. My experiences at Daybreak were some of my first
introductions into the role of the nurse practitioner in the clinical setting. From some of these
experiences, I learned the importance of providing a safe, nonthreatening environment for this
population of patients. I truly felt the need to provide care that was respectful of human dignity,
even though these patients were homeless. I felt that providing the right to self-determination for
these patients was equally important, as they have so few things that are within their control in
their daily lives. As a result, I also gained additional insight into the role of the nurse practitioner
from the clinical faculty.
In addition, our Pediatrics course offered insight into ethical dilemmas we will face in
practice. Dr. Coke discussed offering Gardasil vaccinations to pediatric patients and related it to
the parents viewing it as condoning participation in sexual activity. Further, confidential
conversations with teens without their parents present regarding their sexual orientation, history,
and use of contraception was another issue discussed. Also, if a teen has given birth to a child,
they have the right to determine medical treatment for their child, yet the teen cannot consent to
their own vaccinations. Moreover, counseling teens on what is considered sexual abuse requires
a unique approach in this population. Through these class discussions, I have learned a great deal
about the patient the right to self-determination and autonomy.

ETHICS

Additionally, the trip to Honduras was an experience immersed in ethical consideration.

For example, protecting the Hondurans right to privacy was not a priority in their hospitals. In
the postpartum area of the hospital, there were two patients to some beds. The beds were aligned
in one large open room, providing no privacy for the patients. Additionally, it raised questions
regarding how confidentiality and dignity was preserved in the facility. This experience caused
me to pause and think about the importance of providing care in a respectful, dignified manner to
all patients. Although in that setting, there was no way to provide optimal privacy, dignity and
respect was still essential.
Furthermore, another experience that comes to mind is our treatment of the Hondurans
with anti-parasitic medications. Initially, we were passing out these medications to all family
members, even if all members were unable to come to the clinic. However, when our supplies
began to run low, we had to make the decision to issue the medication to those that were present.
It made me feel somewhat helpless to have to make that choice, but I understood the rationale.
What did you do to help yourself meet this outcome?
Participating in a variety of clinical experiences has helped me to meet this outcome.
Throughout this program, I have traveled to Honduras, worked in various clinical settings, and
read the Code of Ethics for Nurses from the American Nurses Association (ANA). I have
demonstrated the ability to protect patients rights to privacy and confidentiality, provide care
with dignity and respect, and identify any conflicts of interest within my practice. I believe the
totality of these experiences equate to a deeper understanding of ethics within the role of the
nurse practitioner (NP).

ETHICS

5
What could you have done better to become more proficient?

To become more proficient in ethical decision-making, I should participate in selfreflection frequently to be sure that I am always aware of any conflicts of interest or personal
bias. I should also be more assertive now that I am more proficient in addressing any
questionable practices that I may witness. Lastly, I must not assume that someone does not want
me to assess him or her just because he or she knows me. At Dr. Kumars office one semester, I
ran into a person that I knew personally and automatically decided that she would be
uncomfortable with me seeing her. Yet, I never thought about the fact that it may have been me
that was uncomfortable seeing her. I now know that I have to evaluate my own feelings and I
also have to learn to ask the question, Would it bother you to have me assess you? By doing
this, it will help me to face up to potentially awkward situations and handle them professionally
and ethically.
What could the SON have done better to help you or other students with this outcome?
Overall, I believe the SON did a good job of providing opportunities to improve my
understanding of ethics and the role of the NP. I would suggest providing an unfolding case study
to illustrate how NPs should handle certain situations such as questionable practices, conflicts of
interests, or professional boundaries.