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Nursing is a noble profession which requires its members to uphold the highest moral and ethical standards. In Australia nurse’s practice is guided by the ANMC Code of ethics and code of conduct, standards of practice and professional boundaries. Nurses must utilise the Australian charter of healthcare rights (ACHR) as guiding principles to all patients when providing care at any setting. This paper seeks to identify the ethical, moral and legal behaviour of Bill (RN), Liz (Nurse Unit Manager), John(patient) and his wife in the case study given.
In this case study one can clearly see that many nursing standards have been violated. According to Registered nurse standards for practice 1.4, nurses must comply with the policies relevant to practice and that includes the workplace policies. Bill did not comply with the hospital policy which states that “no laptop computers are to be taken home for any reason.”
As per Australian Nursing and Midwifery Council (ANMC) code of ethics for Nurses (2008), standard 8 “Nurses should promote and preserve the trust between themselves and people they are caring for” in this case. Bill created a situation where John lost trust on him as his actions were unethical.
In this scenario, Bill grabbed John by his wrist, causing pain and discomfort and threatened him not to say anything to anyone. His actions were in contradiction with the nurse’s guide to professional boundaries, principle 11 which states that “nurses do not withhold care from a person as punishment and recognise that any intent to cause pain or suffering as a retaliatory action in response to behaviour of a person in their care is improper and unprofessional”. He violated this principle of safe practise.
Furthermore, Bill did not adhere to the principle 15 of professional boundaries that nurses should not cause discomfort or pain to patients receiving care when touching or holding them. Bill did not show any kindness or empathy, as per ANMC code of ethics standard 2 Nurses should be kind and respectful to others.
John’s wife asked if there were any issues or concerns about her husband care and Bill denied. He was not honest enough to John’s wife about what had just occurred. He did not abide to Nurses code of profession conduct statement 6, which requires nurses to provide honest and accurate information in relation to clients care and services.
“Criminal laws are concerned with offences against people and property.” In this scenario, Bill took John’s electrical recharging code without his permission which is considered as theft under the criminal law. Furthermore, in his action he caused harm and threatened John which is battery and assault respectively. Additionally, Bill took money from the charity funds for personal use which is fraud.
A Nurse’s conduct is underpinned by moral principles and these include non-maleficence (no harm), beneficence(benefit), veracity (truthfulness), autonomy (right to choose) and justice(fairness). (Atkins et al. pages 81-82) Bill was maleficent as he caused pain to Johns wrist and he did not uphold the principle of veracity which requires nurses to tell the truth always. (Oosthuizen and Pera page 52) He did this by lying to John’s wife about John’s wellbeing and NUM Liz about the whereabouts of the laptop. By not upholding veracity he made Liz to make uninformed decision to appraise him despite what he had done.
Bill acted in utilitarianism school of thought. In this theory actions of an individual are justified by whether they increase pleasure or reduce risk of pain regardless of the cost or means. Utilitarians believe in acting in a way that results in greatest happiness of the greatest number. He was only concerned about the outcome at the end and ignored the fact that he might have a few unhappy people at the end. He was determined to make the charity function possible, without his input it would not occur and disadvantaged children from overseas would have either starved to death or suffered from starvation within the next 12 months. The criticism on utilitarian actions is that one cannot predict the outcomes of their actions. When Bill took money for buying the Lotto ticket he might have had hope that he will win, fortunately he did but he could have lost it. At times, it is also difficult to prioritise hence despite having many happy children John would not be happy with his conduct.
Per Registered Nurse standard of practice 1.5 Nurses should apply critical thinking skills and use ethical decision or theories in their practice. (Holt and Convey 51-56) The ethical decision framework suggests that one should first identify the problem
Atkins, Kim et al. Ethics And Law For Australian Nurses. Port Melbourne, Vic.: Cambridge University Press, 2017. Print.
Holt, Janet and Helen Convey. “Ethical Practice In Nursing Care”. Nursing Standard 27.13 (2012): 51-56. Web.
Oosthuizen, Anne-Mart and Silvia A Pera. Ethics In Healthcare. Lansdowne, South Africa: Juta, 2011. Print.
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