The article review assesses the ethical dilemmas in the article by Davies et al., (2015) on Safe sleeping positions practices. The ethical dimension being investigated concerns healthcare practice among the nurses in managing infants with cleft lift palate. Ethical dilemma identified is the position of sleeping pattern for the children with an aim to reduce respiratory problems. The study also assesses the moral issues affecting the nursing dilemma and the concern ethical principles guiding the ethical dilemma state. Moral values which inform the decision making process for the nurses has also been highlighted, the discussion of these concepts has been highlighted below.
The article provides research based knowledge on the care provided for cleft palate infants in informing bets practices towards reduction of the risks of infant death. Infants with cleft palate, disorder often face challenges with regard to respiratory process and air way pathways. The paper has presented research on the current advice on sleep positioning provided to parents and caretakers of infants and the decisions made by the clinical practitioners. The ethical dilemmas in this review are that the practitioners often face challenges in recommending supine sleep positioning and lateral positioning.
Health care practitioners have the sole mandate of ensuring that they provide ethical and individualized care, which enable patients to reach highest level of well being. Ethical challenges are bound to be evident in these practices, the ethical dilemmas are vast and scope, in a study by Nalwadda et al, (2015), ethical challenges are common in the work place, thus ethical decisions are relevant in approaching this issues. Nurses often face grave challenge in grappling with ethical challenges. In the nursing arena rarely do ethical challenges is often discussed, however this ignorance has led to burn among the nursing fraternity. This has even led to nurses quitting their jobs. This demand for nursing ability is increasingly rising; this has been argued to have major implications in future health care practice. The ethical dilemmas faced by nurses often including opening up about the decision making to offer the care givers on the right sleeping position in the article study. They are intertwined in between birth complications and end of life issues for those vulnerable like the children. Ethics impacts in health care are diverse and nurses have unique challenges in providing best care for the families and the patients.
Moral issues in the nursing care dilemma
Moral issues underpinning in the ethical dilemma above is ethical distress faced by the nurse. The expression of this ethical distress is classified as expression of the nurse sensitivity to the morals aspect of care practice, which involve patient’s vulnerability and values embraced while following the code of ethics for registered nurses, (Numminen, & Leino-Kilpi,2007). Ethical distress by the nurse, leads to awakening for the nurse to improve their care skills. Unresolved ethical distress has been associated with burn out, (Garbarin, Cuomo, Chiorri & Magnavita, 2013). The physical and emotional aspects of ethical distress have an effect on nursing lives. Nurses have been ranked as the highest sickers in Canada, spending more time being ill, (Canadian Institute for health Information, 2001). This phenomenon in Canada has been linked to ethical distress.
Ethical distresses in the article review has occurred due to the choice of making decision making process with regard to what one believes it is right or wrong, and play a key role in preventing the patient from making key decision towards completing the action. Nurses perceive ethical issues and accept ethical responsibility and makes ethical judgement about the action of advising the mothers on the appropriate sleeping positions, (Numminene & Leino, 2007).
Another major issue in the ethical dilemma is the minor dilemma. Working with infant care presents a unique ethical challenge. The nurses must ensure that the best inters of the patient, however they must balance against the wishes and values of the caregivers. Often patients, families and physicians aligned themselves in the in the ideal world, however in the real world ethical moral issues do arise, (Oh & Gastamans, 2015).
Ethical principles in the dilemma
In nursing practice, there bound to be have advantages and disadvantages. Health care practice with regard to child care is often plagued with heavy work. Principles of bio medic ethics have been long offered practical guidelines with regard to making the right decision making process. The ethical principle with regard to these situation concerns beneficence and non-maleficence, (Herring, 2014).
Principle of beneficence concerns with the health care nurses doing all they can to provide the best medical practice in every situation they face. The situation at hand is making the right decision with regard to recommending the right sleeping position in a manner that don’t cause airway blockage and thus endangering the life of the infant. The critical dilemma at hand is adherence of to standard back to back sleep and responding to clinical assessment of respiratory action for the infants with cleft palate. In ensuring beneficence nurses must develop and maintain high standards of skill and ensure they give the best advice and guidance, with regard to the infant individual circumstance and consider what is good for the child in preventing respiratory problems.
Principle of non maleficence ensures that the nurse should offer the care with an aim of doing no harm. The goal of the principle is intended to be end aim for all. The nurse must provide whether the advice offering will harm the infants towards applying the right sleeping position. The maleficence decision should be made with the intuition of the nurse to provide the best benefit for the infant.
Morality and ethics work hand in hand. The interplay functions on how human beings relate and treat each other so as to promote the mutual association, growth and harmony so as to strive for good. Values represent set of beliefs and personal attitudes about life. Values are the initial step of morality and ethics, thus forming an interaction on values, morals and ethics, (Keyko, 2014). In the study personal values of life, reflects itself on how it should respect life. The values of goodness or rightness with regard to the dilemma issue are significant. There is need for promotion of goodness and safety of the infant care, ensuring that the care process causes no harm and prevent harm. For the parental, guide value of honesty and truth telling is essential in providing meaningful communication for the benefit of offering best care knowledge practice, (Soneshein, 2007).
Relating the moral values to practice
In nursing care your are always confronted with various issues and situations which needs action and way forward, which needs your action. How to deal with the problems will be based on the values and moral standpoint at hand. Many of the issues and cases require values such as honesty and valuing other people worth and fair standing point on issues. When availing health care to those in need as a beginner, challenges on own values and solutions may require acquisition of decision that reject personal beliefs. In nursing world on the society, there is need for providing anti discriminatory health care, thus components like responsibility, accountability and negligence need to be explored in relation to personal values and nursing practices which promote positive health. In nursing care we are often influenced in varying degrees by values of culture, family, religion, education and social networks. Thus identifying own values will always be helpful in working well with the care givers and parents in providing care for the infants. Our values are largely borrowed from group networks, community or cultural events. These values inform our approach in providing care in health care practice, (Osingada et al, 2015).
The article review has provided a critical thinking assessment on ethical dimension in nursing care. In the paper, the ethical dilemma observed include the challenge the nurses have towards recommending sleep positioning for infants with cleft lift palate, towards assessing risks of respiratory airway condition. The two sleeping positions in dilemma include the supine position and the lateral position. It is the duty of the health care practitioners to provide a discerning towards this dilemma. Moral issues in managing the issues involve is assessment of moral distress among the patients, in making the right decision for the parents and caregivers. Other moral issue is offering help to minor patients as observed in the article, there is challenge of ensuring positive health status of the infants with regards to sleeping position and the occurrence of respiratory airway blockage. The ethical concerns highlighted in the review include the principles of beneficence and maleficence. Which are both concerned with ensuring nursing professionals provide adequate care for the infants and their practice is informed with the duty of providing no harm. Associated moral values involve the provision of honest care for the infant and being accountable for your actions. Our moral values are largely informing the care nursing practicing, thus need for positive values for positive impact.
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