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Students are required to consider the following scenario.
Sam Mills is an RN working in a GP clinical with five general practitioners and two other RN's. Sam is redressing a chronic the leg wound of a regular client named Lee. Sam and Lee are also next door neighbours. Lee has cerebral palsy, lives in a shared house with a friend and works 3 days a week for an IT firm. It is 6pm, all other staff have gone, and the waiting room is empty. In casual conversation, Sam says 'I have finished work for the day, and heading down the road to Vinny's pasta. I'm starving'.
Lee who is underweight and typically hates eating alone, says ' I was thinking of popping into Vinnys myself for something to eat. Can I join you?
The clinic has no fixed policy on the matter.
How would you decide what to do, and what would you do if you were in Sam's position?
Discuss and analyse the scenario from an ethical perspective.
The nursing profession values the universal human rights and also recognizes the moral responsibility to protect the inherent dignity of individuals as well as uphold the equal worthiness of everyone. This profession realizes the responsibility to provide just, sensitive, responsive, compassionate care to patients despite their cultural diversity or origin. The patients are not just a room number or medical condition to the nurses; rather they are to be given individualized care and proper attention (Montgomery, 2015). The person in question is a patient of cerebral palsy, who needs extra care regarding his day to day activities. The present situation poses a challenge between over involvement and under involvement with the patient. It seems to create a conflict between personal conscience and professional boundaries. The ethical framework and professional boundaries are not contradictory to each other. They are meant to be complimentary to each other and, hence in this case also there is a need of perfect balance between these two. Allowing Lee to join me to Vinny's restaurant for having some pasta will make him feel confident. He will feel secure to share his problems with me frankly and that would be of great help in treating him. On the other hand, if I don't allow him to join me for pasta, he might think that he may have violated the limits. He might abstain from sharing details about his health condition and it may cause health repercussions. The question whether I should allow Lee to join me for having pasta should be decided on comprehensive analysis of the whole situation. In this case, my decision to allow Lee to join me is based on the consideration of human aspect, ethical framework of my profession and well within professional boundaries (Iacobacci, Daly, Lindell & Griffin, 2012).
PERSONAL LIFE, PROFESSIONAL ETHICS & HUMAN BEHAVIOUR
I may not allow Lee to join me for pasta as my work is over, and all other colleagues have already left the office, I may also leave and enjoy my personal life. I can go to Vinny’s restaurant and have some pasta while taking a comfort from my professional activities. Taking a cerebral palsy patient along with me won't be easy, I may have to take care of him and my leisure period would also become a professional one(Dean, 2017). I may plan to meet some of my friends and have fun with them. I may have a relaxed evening with nothing to worry about and rest from my professional work would also keep me refreshed. At the same time, there is no official policy regarding this matter, whether I should take care of my patient irrespective of my work hours. Therefore I may say no to him.
But at the same time, it would create a conflict in my mind. I may regret it later on not helping a human in need due to my conscience (McGarry, 2010). At the same time, it would be against my professional ethics too (Park, 2011). 'Nurses value kindness and respect for self and others.' Kindness in this respect refers to simple acts of generosity, care, and consideration. Kindness decreases the power imbalance between the nurse and the person requiring care and establishes the perfect relationship of a person receiving genuine care at the hands of the nurse (Martin, 2015). Nurses should be informed about the physical as well as psychological well being of a patient. It is their duty not only to heal the physical wounds of a patient but also morally boost them. Nurses should have an active as well as informed participation in the well being of a patient. The quality of a good nurse is not limited to the kindness and empathy towards the patient should not be turned off at the end of the shift, it should be carried on as a part of their lives. Nurses can help the patient to overcome their fears by informal and yet professional contact with the patient. They can be of significant importance in the cases where persons suffer from unbearable pain, has lost the ability of self-determination and are in utmost need of personal and discreet assistance (Rassin, 2008).
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