Ethical Challenges in Practice Discussion Board Instructions Initial post: Review the two case examples below and respond to the analysis questions. Respond in agreement to at least one of your peer’s postings, and in disagreement with another. Justify your position with evidence and discuss the application of ethical principles in your response. Related resource: American Nurses Association Code of Ethics for Nurses http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-For-Nurses.html (Links to an external site.) ANA Code of Ethics: See attachment at bottom of page Case Example #1 You are making a home visit to a patient who was discharged after having a stroke and falling. This fall caused a hip fracture and the patient still has significant pain, but you believe that he should begin more ambulation in his home. You review the level of narcotic pain medication that has been charted as given several times a day by one of the visiting nurses. As you begin your assessment, the patient complains of excessive pain and wishes to stop the ambulation exercises you are doing with him. You determine that he is having significant pain and ask him if he thinks that he needs more medicine. He says, “I haven’t taken any medicine since last week except Tylenol. That’s all the nurse says I need.” By your assessment, the patient is clear, aware, and not forgetful. You then examine all his medication and find that even though prescribed, there are no narcotics, only Tylenol. Case Example #2 You work closely with several people at your small clinic and have started meeting socially to have a few drinks. You notice one of your fellow nurses, Brad, tends to drink more than the rest of the group. He lives nearby, walks home, and never seems abusive, so you never mention it until one day you return from lunch and you see Brad leaving a bar. In the clinic, you return a patient record to Brad and you smell liquor on his breath. He takes the record, smiles and says, “Thanks, I needed this record. I’m seeing her in ten minutes.” What concerns do you have as you return to your desk? The quality of Brad’s patient care has never been questioned and patients always compliment him. What professional obligations do you have and how should they be carried out? Analysis Questions 1. What is your obligation to report each situation to your superior? 2. How quickly must the nurse act in reporting each situation? 3. How does loyalty to your co-worker (Brad) factor into your decision to act? 4. What other factors weaken the willingness of a nurse to confront behaviors (of others) that present immediate risk of harm to patients? Reference: Fowler, M.D. (Ed.) (2008). Guide to the Code of Ethics for Nurses: Interpretation and Application. Silver Spring, MD: American Nurses Association.

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