Ethical Issues

Introduction

Ethical Decision Making In Nursing Paper

NURS 412 – Ethics, Law, Economics, and Policy

Purpose of Assignment

The purpose of this assignment is to examine the health care delivery through and ethical framework.

Approach to Assignment

My approach to this assignment was to consider the vulnerable population I was care for at that time and the ethical issues which impacted their health and well-being. At the time when I wrote this paper, I was working with individuals who suffered from substance abuse disorder (SUDs). It happens that I was care for a young woman, who hours prior to being admitted to the detox unit, delivered a baby girl who tested positive for addictive substances and removed from her mother care. This young woman was distraught by the removal of her infant daughter and the requirement of many months’ worth of recovery work ahead of her. I found myself having an opinion about the situation and decided this would be a perfect subject for my ethics paper.

Reason for Inclusion

I included this assignment because substance abuse disorders are impacting everyone in our society. From the newborn to the elderly and everyone in between. I wanted to know what the research said about this very public ethical issue and how the removal of babies from their mothers at birth was affecting the recovery of the mothers. I also was curious about the out comes for the infants. What I found was very interesting. Our society has two viewpoints about SUDs. Some people that SUDs are a moral failing other a disease which needs to be treated. There are numerous ethical issues related to the treatment of individual’s suffering from SUDs, the subject of my paper was just scratching the surface.

Critical Thinking

Evaluates nursing care outcomes through the acquisition of data and the questioning of inconsistencies.

I have worked on the detox unit for several years with individuals who suffered from SUDs. I have worked with numerous woman who had their children and infants removed from their care. I think the requirement for this assignment and at the same time having a client who had just had her infant removed made me question the inconsistencies of our current system handling this population. The situation had me considering the outcomes of the treatment of mother and child. I wanted to know what the research stated about the consequences as a result. I wanted to know does removing the child from the mother at birth really influence to mom to work harder at recovery, is this truly persuasive.

Nursing Practice

Implements nursing care practices as appropriate to provide holistic health care to diverse population across the lifespan.

This assignment required me to look at my nursing care and if I was making a moral judgement about the mothers who used drugs during pregnancy. I questioned the nursing care I was delivering. I believe that punishing a person of their drug use just makes their addictions worse. The end up feeling even more isolated and alone. Caring and compassion for them in their disease is a holistic health care approach for everyone, the mothers and their infants. The mom I was care for at the time of this assignment shared her concerns about not being able to even know who had her infant not to mention more than six months of required clean time before she would be reunited with her baby. Every generation is impacted, the baby, the mother, the grandmother, everyone in the family is touched by the disease in some way or another.

Communication

Uses therapeutic communication within the nurse-patient relationship.

Because of this assignment I think I listened deeper to this young woman. I wanted to know what was going on inside of her. I communicated with her in a therapeutic manner without judgement for her situation, giving her an opportunity to honestly express her worries and concerns. She thanked me for being nice to her. It brought a tear to my eye, and I said of course I wouldn’t think of being any other way. She said most of the nurses on the maternity unit were not very good to her, punishing her for her choices. This experience thought me I needed to use a more therapeutic communication technique with all clients.

Teaching

Provides relevant and sensitive health education information and counseling to patients, and families.

Recently Region 10, Charlottesville, Virginia, has opened a detox recovery facility which offers inpatient care for woman and their children. The women can keep their babies with them during the recovery process. I shared this information with the young woman in my care and suggested she might ask her support coordinator if it would be an opinion. I discussed all the community supports in place for her continued success at recovery. Her mother called into check on her and I was able to share information on Al-anon family groups. I discussed how her, and her daughter could attend meetings and work on some recovery together. I wanted to give my client and her family hope for improved outcomes from treatment.

Research

Applies research-based knowledge from nursing as the basis for culturally sensitive practice.

I review numerous research articles and literature based on this serious ethical issue. It is a culturally sensitive topic due to the disease of SUDs does not discriminate. It involves everyone regardless of cultural backgrounds. Some cultural groups are struggling with ignoring the disease due to the stigma attached. The research I found showed that increased long term psychological damage was done to the infant by being removed them from their addictive mothers than was done by leaving them with mom and monitoring them. The recovery facility in Charlottesville was putting evidence-based care into practice and keeping families together. This approach to treatment allows the mothers to learn new life skills, how to manage recovery and children, teaches parenting skills, employment skills, and nutrition.

Leadership

Assumes a leadership role within one’s scope of practice as a designer, manger, and coordinator of health care to meet the needs of the population.

This assignment gave me an opportunity within this vulnerable population to understand the approach to care, manage the care being delivered and supporting the needs of woman in recovery through my nursing care. This young woman looked to me as an example of what persistence could achieve. I didn’t become a nurse until I myself worked on recovery from alcoholism. I was able to share my story of recovery, being a single mother going to school, and learning how to be a health productive woman in society. I encouraged her to just take it one day at a time, do the next right thing, recovery does happen and life changes for the better if you do the work. I continue to be active in the 12-step recovery fellowship to maintain my sobriety.

Professionalism

Understands the effect of legal and regulatory processes on nursing practice and health care delivery.

This ethical health care issue is directly impacted by the legal and regulatory process. A shift in perspective needs to occur within our society due to the stigma attached to SUDs and their treatment. Our current culture treats SUDs as a criminal offense not a healthcare issue. Which is backwards. Individuals suffering from SUDs need caring and compassionate treatment to have the hope and determination to successfully daily abstain from substances. Currently there are alternative treatment to 12-step recovery fellowship meetings, such as medication assisted treatment (MAT), and case management which works through the recovery process for many months with individuals with some follow-up care. More is being done to identify individuals which are at the beginning stages of SUDs by primary care physicians and obstetricians. As a society we are attempting to approach this disease from a different angle but were not there yet.

Culture

Articulates an understanding of how human behavior is affected by culture, race, religion, gender, lifestyle, and age.

I find this ethical topic complex due to the affected of culture, race, religion, gender, lifestyle and age on human behavior as related to substance abuse disorder. Each culture has a different way of addressing the disease. One of the symptoms of SUDs is isolation making it even more isolated depending on the cultural impact. Many families feel like they can handle the disease on their own without assistance from healthcare providers. Some religions see SUDs as moral failings which also isolate individuals from healthcare. Men and woman are dealt with differently by society as related to SUDs. Individual born and raised in poverty are more effected by SUDs possibly exposing individual to addictive substances at an early age. Providing non-judgmental care when treating individuals with SUDs is key to good honest healthcare which leads to improved outcomes for everyone.