18 hours ago
week 2 main post
When thinking about ethical dilemmas, one may think that this is a serious issue, which it is, but it does not always have to be the worst-case scenario. Ethical issues happen when choices need to be made, the answers may not be clear, and the options are not ideal. The result could be declines in the quality of patient care; problematic clinical relationships; and moral distress, which is defined as knowing the right thing to do but not being allowed or able to do it (Duquesne University School of Nursing’, 2020). While in clinicals, many things may come up as ethical that you may not have thought off. Many times, speaking on a patient’s condition in a public area can become an ethical issue because you may not know who is around or listening and it may be a friend or family member. In this scenario, the students are facing a dilemma of “special treatment” to another student that is pregnant. In order to have an understanding for all parties a meeting should be held to inform all students of the current situation at hand. Educating the students on pregnancy and the effects it have on the body while in clinical may help the other students to understand the situation at hand. During this nine month journey a woman experiences lots of internal and external changes: morning sickness, nausea due to hormonal imbalance, fatigue, lack of energy, dizziness, mood swings, swollen feet, breast tenderness and physical strain due to enlarged belly are not easy symptoms to carry in normal routine life. Continuing that along with studies would create a huge burden mentally for a woman, for that reason extraordinary care and attention will be required in all stages to prevent both lives from harm (Gilliani, 2018). This scenario falls under the ethics of care. The ethic of care stresses the role of emotion or sentiment in constituting good character; the ethic of justice stresses the role of reason in per forming right actions (Sorbello, 2008). Maybe offering a longer break in effort to ensure all students feel they have a fair number of breaks may be one solution. For example, the pregnant student maybe able to have a chance to sit down every hour of no more than 5 minutes in exchange for the other students having a 45-minute lunch break instead 30 minutes.
Duquesne University School of Nursing’. (2020). Ethical Issues in Nursing: Explanations & Solutions. Retrieved from Duquesne University School of Nursing’: https://onlinenursing.duq.edu/blog/ethical-issues-in-nursing/
Gilliani, A. (2018, March 2). Should pregnant student nurses be allowed to continue attending universities? Retrieved from Journal of Pioneering Medical Sciences: https://blogs.jpmsonline.com/2018/03/02/should-pregnant-student-nurses-be-allowed-to-continue-attending-universities/
Sorbello, B. (2008, May 5). The Nurse Administrator as Caring Person:A Synoptic Analysis Applying Caring Philosophy, Ray^s Ethical Theory of Existential Authenticity, The Ethic of Justice, and The Ethic of Care. Retrieved from Walden University : https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=1&sid=2b6fcde2-c99b-482c-a960-424a47bbfd78%40sdc-v-sessmgr01fe Cauley
Week 2 Discussion-Initial
According to Masoumpoor et al. (2017), “uncivil behavior affects all ethical, communicational, and learning aspects”. If uncivil behaviors are left unchecked while a student is engaged in the clinical and academic settings, transition from student stage to professional stage with accompanying uncivil behaviors can endanger patients (Masoumpoor et al., 2017). The purpose of this discussion is to explain how the presented scenario may lead to legal challenges. A solution to the dilemma in the scenario from the perspective of ethics of care and the ethic of justice perspective will be pondered. Certified nurse educators (CNEs) must be comfortable with speaking with future registered nurses (RNs) about unacceptable and unprofessional behavior. Ensuring that future RNs exemply professional behavior is the epitome of social change because the safety of patients comes first.
Scenario to Evaluate
The beautiful thing about the United States (US) is that we are a country governed by laws. The first organization that I thought about after reading this scenario was the United States Equal Employment Opportunity Commission [USEEOC]. Pregnant women are a protected entity within the workplace, and in most circumstances pregnancy is considered a disability. According to the Pregnancy Discrimination Act (PDA) under the jurisdiction of the USEEOC, if a woman is temporarily unable to perform her job due to a pregnancy related medical condition, including childbirth, the employer (or covered entity) must treat her in the same way as any other temporarily disabled employee (n.d.). For example, the employer (or school) may have to provide light duty, alternative assignments, disability leave, or unpaid leave to pregnant employees if it does so for other temporarily disabled employees (USEEOC, n.d.). Therefore, the pregnant student presented in the scenario should be granted frequent breaks to elevate her swollen feet. As long as she is carrying out the rest of her duties to the best of her ability, this should not pose a problem.
The PDA further emphasizes that it is unlawful to harass or discriminate against a woman because of pregnancy, childbirth, or a medical condition related to pregnancy or childbirth (USEEOC, n.d.). Harassment is illegal, creating a hostile work (or school) environment that results in the victim being fired or demoted (USEEOC, n.d.). The harasser can be the victim’s supervisor (or CNE), a superior from another department, a co-worker (or classmate), or someone who is not an employee of the employer, such as a client or customer [or patient] (USEEOC, n.d.). Harassment is punishable by law. Therefore, it is imperative for the CNE to educate the nursing students to respect the pregnant student and the laws of the land. I am sure someone respected their mother when she was pregnant with them. I would also emphasize that if one of them had a situation, more than likely they would want to be accommodated too. I remember when I was pregnant with Malcolm, the registered nurses (RNs) I worked with did not allow me to push or pull any patients. I returned the favor after my son was born and did not allow any pregnant RNs to put too much stress on their bodies. The manager at the time also granted me a schedule where I only worked weekends so I could be at home during the week with my son. I did not breastfeed, but other new moms were allowed additional breaks to pump milk. Recently, I precepted a new graduate that was pregnant, and we did not allow her to care for Covid-19 patients. We shifted our assignments so she would still receive a thorough orientation. She now has a healthy baby girl. While this is the law, this is also teamwork and being compassionate towards your fellow co-worker.
Both the ethic of care and ethic of justice applies in the above scenario. While the ethic of care emphasizes communal relationships, the ethic of justice emphasizes individual rights (Sorbello & Lynn, 2008). The ethic of care stresses the role of emotion or sentiment in constituting good character, while the ethic of justice stresses the role of reason in performing right actions (Sorbello & Lynn, 2008). As RNs we are taught to practice “by the book” or according to the facility’s protocols, but what about the occasional gray areas? Do we become stoic and uncompassionate, or do we “bend the rules” a bit to accommodate according to the circumstances?
I have noticed that compassion between RNs and other healthcare providers has dwindled during this Covid19 crisis. I understand this pandemic is stressful, but what good are we if we can be compassionate to our patients and families but not to each other? In reading the provided peer-reviewed journal by Masoumpoor et al. (2017), I was appauled by the behaviors from both the CNEs and students. Violence is something I do not tolerate, whether it is verbal, mental, or physical. Even though we may disagree, dispute, and debate, there is a way to do so without becoming rude, condescending, and disrespectful (Masoumpoor et al., 2017). Mutual respect involves respecting the views and opinions of our peers even though we may not necessarily agree. Reaching common ground in the clinical setting is more important than trying to persuade someone to share only your views.
In conclusion, respect must be given to pregnant women and individuals from all walks of life. We should want to do the right thing not because we may face a judge and jury, but because we have compassion for our fellow peers. Whether your life is governed by the perspective of ethics of care or the ethic of justice, compassion should be your bottom line.
Masoumpoor, A., Borhani, F., Abbaszadeh, A. & Rassouli, M. (2017). Nursing instructors’
perception of students’ uncivil behaviors: A qualitative study. Nursing Ethics, 24(4). 483–492. https://journals-sagepub-com.ezp.waldenulibrary.org/doi/full/10.1177/0969733015611071
Sorbello, B. & Lynn, C. (2008). The nurse administrator as caring person: A synoptic analysis
applying caring philosophy, ray’s ethical theory of existential authenticity, the ethic of
justice, and the ethic of care. International Journal for Human Caring, 12(1), 44-49.
United States Equal Employment Opportunity Commission [USEEOC]. (n.d.). Pregnancy
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