Practicum Journal Entry: Analyzing an Ethical Decision
Analyze salient ethical issues in psychiatric mental health practice
Compare ethical dilemmas with state health laws and regulations
Analyze ethical decision-making processes
To prepare:
Review literature for moral/ethical issues encountered by a PMHNP.
Select one of the articles you found that was published within the last 5 years to use as a focus for this assignment Practicum Journal Entry: Analyzing an Ethical Decision.
Write a 2-page paper in which you do the following:
Summarize the moral/ethical issue in the article (no more than 1 paragraph).
Describe the moral and ethical dilemmas surrounding the issue. Practicum Journal Entry: Analyzing an Ethical Decision.
Analyze the ethical issue and compare them to the state health laws and regulations in your state.
Outline the process of ethical decision making you would use to address this ethical dilemma.
Analyzing an Ethical Decision
Summarize the moral/ethical issue in the article (no more than 1 paragraph).
Harris (2016) discusses the issue of moral distress in psychiatry. In this case, moral distress is defined as being institutionally constrained from pursuing the right course of action. This an issue of importance of nurses, particularly those working in psychiatry, when established ethics becomes impractical and they must contend with the consequence to the patient when making a decision that is considered right but is harmful to the patient. For that matter, the nurse contends with a lack of control and power over the capacity to fulfil nursing obligations to the patient. The issue is exacerbated in psychiatry by the fact that patients could lack the capacity to judge accurately, logically reason and discern reality. Practicum Journal Entry: Analyzing an Ethical Decision. The nurse substitutes his or her judgment for the patient who is mentally ill. Although the nurse substitutes for the patient’s will, the power to make decisions for the patient is accompanied by responsibility to both the society and patient with the nurse mediating between the two thus resulting in conflicting responsibilities (Harris, 2016).
Describe the moral and ethical dilemmas surrounding the issue.
The ethical dilemma surrounding the issue is how the nurse should decide between responsibilities to conflicting parties when faced with a moral distress. It is true that the nurse should mediate between responsibilities to different parties, but which party should take precedence when the two are in conflict or have an antagonistic relationship. On one hand, the nurse should always act in the best interest of the patient, while on the other hand the nurse should act in accordance with the law and in fear of legal reprisal. Practicum Journal Entry: Analyzing an Ethical Decision. In essence, the clear description of psychiatry nurses’ limitations and responsibilities means that they will always carry a burden of inadequacy and guilt in professional practice. The burden, occasioned by moral distress, calls for clear thought in addressing ethics even as the nurse acts for the good of the society and patients, all while retaining and preserving the capacity to professionally function with integrity (Harris, 2016).
Analyze the ethical issue and compare them to the state health laws and regulations in your state.
The link between moral distress and the New York State health laws and regulations can be considered as a systemic issue that takes different forms. Firstly, there are general laws that govern how medical personnel interact with patients. Secondly, there are rules and laws that govern nursing practice Practicum Journal Entry: Analyzing an Ethical Decision. Finally, there are adherence and compliance regulations that present professional accreditation criteria and financial management (Gallagher & Hodge, 2012). These three act as the source of distress, particularly when they conflict with what is best for the patient.
Outline the process of ethical decision making you would use to address this ethical dilemma.
When faced with moral distress owing to conflict between what is best for the patient and prevailing laws, it would be prudent for the nurse to apply three steps in ameliorating the moral distress. Firstly, the issue should be resolved from the patient level through respectful, honest and open. The communication should make it clear that although everyone can have an opinion about what is right, at the minimum, each person should be allowed to express an opinion that would then be respected. Secondly, the distress should be resolved at the institutional level where past situations of a similar nature are evaluated and used to inform the current case. Finally, a nursing-wide initiative should be undertaken to review the culture, processes and policies that influence care, focusing on the aspects that recognize and proactively address the current case (Ulrich & Grady, 2018). Applying the three steps is anticipated to reduce the impact (if not resolve) the moral distress. Practicum Journal Entry: Analyzing an Ethical Decision.
References
Gallagher, A. & Hodge, S. (2012). Ethics, Law and Professional Issues: A practice-based approach for health professionals. New York, NY: Palgrave Macmillan.
Harris, J. (2016). Moral Distress and the Importance of Psychiatric Ethics. American Journal of Psychiatry Residents’ Journal, 11(05), 2. doi: 10.1176/appi.ajp-rj.2016.110501
Ulrich, C. & Grady, C. (2018). Moral Distress in the Health Professions. Cham: Springer International Publication. Practicum Journal Entry: Analyzing an Ethical Decision.
