Ethical Dilemmas in Nursing Essay Assignment

Ethical Dilemma Paper
An ethical dilemma is the basis on which health care professionals decide whether specific actions about the patients’ health outcomes are right and whether one ought to do something right or wrong. Nursing decisions affect people, and thus nurses ought to have the power to provide good or harm to the clients (Rainer et al., 2018). My ethical dilemma paper will reflect Joyleen’s case study in the ethical case study document.
Step1- Definition of the Problem
Defining the problem is the initial step in ethical decision-making. The highlighted case of focus involves a client named Joyleen. Joyleen is an older person aged 87 years, living in a nursing home with no family or friends. Joyce had chronic hypertension and hearing and motion deficits. Joyleen’s state of well-being deteriorates two weeks after admission in the nursing home setting. Blood tests, physical exams, and chest X-rays were all normal, but the final developed shortness of breath, and she ended up hospitalized. She had mild problems with oxygenation as a result of pulmonary edema. After 2 hours of hospitalization, she had multiple medical interventions, such as an IV, cardiac monitor. Her diagnosis continued to worsen despite the medical interventions placed on her. Her condition worsened, and she was finally put on mechanical ventilation. The problem is defined by Joyleen’s surfacing condition, which the client had to make an informed decision. Since Joyleen could direct yes or no to questions regarding her comfort, she still showed little insight and attention. Respect for autonomy will not occur, and the nurse had not to withdraw or withhold any medication given to Joyce. The nursing team was obliged to look for further information by doing a follow up to determine the relatives of the patients. Ethical Dilemmas in Nursing Essay Assignment

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Step 2 Analysis of Factors to Facilitate Shared Decision Making
The well-being of Mrs. Joyleen is not satisfactory for her to make an informed choice. She can indicate yes or no regarding the state of her health but shows little insight or attention. Joyce is not competent to fully make an informed decision. The patient’s rights and the decision are not fully given since she is unaware of making decisions regarding her health. The decision regarding the client’s state of health relied on the hospice staff since she was not fully conscious of making a decision. The ethical components of the decision regarding the client are clear irrespective of the worsening state of well-being. The client has no guardian, nor did the relatives; hence full information regarding Joyleen’s health lie among the hospice staff. The patient cannot reverse her care decision since the condition is worsening. The inability of the hospice team to make a flow up of the client’s relatives inhibited the medical team from taking an autopsy to rule out the exact diagnosis; hence, the client was dying with an unknown diagnosis.
Step -3 Identification of the Ethical Issue
The ethical choice surrounding joyleen is that she can indicate yes or no to questions about her comfort but showed little insight or attention. This statement did not satisfy the care team satisfactorily because the patient did not have full consciousness. The decision thus relied on the care team since the patient had no guardians. The ethical dilemma between the care team is either to withdraw or withhold treatment. The care team anguished to continue or not take action to intensive care unit to establish a clear diagnosis. The principle of beneficence and respect for autonomy is the key moral principle that supports the joyleen situation (Varkey, 2021). The care team had to provide benefits and balance between benefits and harm.

Step 4- Design Regarding Ethical Choices
The ethical choice revolving around the client above include withholding and withdrawing treatment. The care team was in a dilemma to either take a biopsy or not. The patient’s inability to consent and no relatives to stand beside her made the care team not take action but rather abide and institute a hospice–type care. Joyleen is not free to make an informed decision because the state of health does not allow her to take action consistent with her values, moral principles, lifestyle, and goals. The care team thus consulted the hospice team and finally came up with an informed decision according to t hospice type of care. The hospice team and the care team were so supportive until the end of their life of joyleen, despite Joyleen having no parents. Ethical Dilemmas in Nursing Essay Assignment
Step 5- Implementation of the Moral Decision
After care team met to discuss, the care team decided to institute and follow palliative hospice–type care since Joyleen initially resided in palliative care before her condition worsening.

References
Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An integrative review. Journal of Clinical Nursing, 27(19-20), 3446-3461.
Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17-28. Ethical Dilemmas in Nursing Essay Assignment