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(Topic 4) DQ1: A recent ethical issue I have faced in my nursing practice was due to a surgeon not following policy and procedure. Surgery can be a stressful environment, especially when you are working with a surgeon who doesn’t value policy and procedure. In fact, these types of surgeons can influence good nurses to cut corners to be validated. This specific case happened when the surgical patient was brought to the room without signing the surgical consent. The surgeon was rushing the staff and circulating room nurse and said that he would sign the consent in the room. The patient was scheduled for a hysterectomy with bilateral Oophorectomy, the consent did not have the Oophorectomy listed on the procedure. Many times, ethically challenging situations that nurses encounter in everyday practice are usually situations in which they know an appropriate course of action to take but do not do so. Sometimes, nurses may have difficulty in recognizing the right course of action (Kim et al., 2021). During the time out, after the patient had been put to sleep, the nurse realized that the surgeon and the patient sill had not signed the consent. This is where the ethical dilemma came into play, the nurse asked if the surgeon would take the consent out to the family and get it signed by them and sign it himself, but he refused.

As nurse we have a code of ethics that we need to abide by and one of those ethics are Nonmaleficence. Medical errors are among the major challenges that threaten patients’ health worldwide (Mohammad et, al. 2019). Nonmaleficence means, “do no harm”. Abiding by the code of ethics for nursing drove the circulating room nurse and the surgical team to do the right thing. The surgeon dropped from the sterile field and went out and talked to the family. Thankfully he did because he had forgotten that the patient had decided at the last minute that she wanted to keep her ovaries. This surgeon would have taken out her ovaries based on the surgical schedule. It is imperative that the surgical team always follow policy and protect the patient. The operating room nurse is the advocate for the sleeping patient at all times.

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DQ 2- Topic 4   see above !!! was base on an ethical dilemma that was experienced in my professional practice, I chose to tell the story about how a choice was made to ensure that no harm came to a patient. The principle of nonmaleficence directs healthcare professionals to “do no harm” to patients (Pallipedia, n.d.). This assignment ask the student to provide a decision tree which will provide the reader a visual module on how the ethical decision was made to “do no harm”. Within the article by Edgar et al 2002, he discussed that by establishing that two core values are in conflict constitutes an ethical dilemma. The first priority is to define core values, and identify which, if any, are in conflict. This awareness is the first checkpoint in the dilemma resolution process. After recognizing an ethical dilemma does exist, the practitioner can then apply the remaining nine checkpoints for ethical decision making (Edgar, 2002). The core values that were in conflict within this authors story were , following policy and ensuring that the patient was safe and the right procedure was done. There are 9 checkpoints in the decision tree that are based on the Checkpoints for Ethical Decision Making,” in the article “Resolving Ethical Dilemmas: Applying the Institute for Global Ethics’ Ethical Fitness’ Model to Occupational and Environmental Health Practice Issues,”1. Determine the moral issue. 2. Determine the actor. 3. Get the facts. 4. Determine if the moral issue is right versus wrong. 5. Test for right versus right by assigning one of the four dilemma paradigms. 6. Apply resolution principles: Ends based. Rules based, or Care based. 7. Identify if a trilemma third option exists. 8. Make the decision. 9. Reflect on the decision. By addressing each one of these points, the readers will be able to identify if the dilemma was ethical in nature. After going through all of the 9 checkpoints, the reader will see that the problem that was discussed in DQ1 was truly an ethical dilemma.

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