THE RELATIONSHIP BETWEEN ETHICAL CHALLENGES AND PROFESSIONAL NURSING PRACTICE
CHAPTER ONE
INTRODUCTION
BACKGROUND OF THE STUDY: The Hippocratic Oath, which constitutes the moral foundation of clinical practice, is presently interpreted dialectically, according to Jameton (2017). With unstoppable advances in medicine and commercialization, key publications like as the Nuremberg code and Helsinki declaration redefine the ethical foundations of clinical practice. The applicability of healthcare ethics in a given nation mirrors the prevalent law. In addition, economic limitations and modern societal ideals frequently impact and decide ethical behaviour.
Ethics in healthcare is a nuanced framework ingrained in the professionalism of medical practitioners. Noncompliance with healthcare ethics and inadequate case management and resolution not only pose a danger to doctor-patient relationships, but may also result in suboptimal service delivery and cause incidents of violence and abuse. There have been reports of medical students, resident physicians, and nurses engaging in unethical behavior in various circumstances (Jameton, 2017). The four fundamental principles of medical ethics (autonomy, fairness, beneficence, and non-maleficence) serve as the basis for health practitioners to determine whether therapeutic procedures are acceptable. These fundamental ethical principles are based on the primary sources of healthcare ethics (the Hippocratic Oath, the Nuremberg code, and the Helsinki statement), as referenced by the International Council of Nurses (2017). As early as possible in their careers, future physicians and nurses are expected to study and adhere by these ethical concepts and guidelines. This necessitates proper education of such concepts; nonetheless, obstacles persist in resource-poor countries such as third world countries, where curriculum scarcely demand the didactic instruction of medical ethics. In addition, instruction and exercises on medical ethics during medical students' early clinical practice are frequently disregarded and, as a result, deprioritized. It has been shown that students and junior doctors in medical schools learn healthcare ethics covertly from their elders, a phenomenon sometimes referred to as the hidden or silent curriculum.
Physicians and nurses are the primary pillars of healthcare delivery; however, as their education, professional responsibilities, and perceptions of medical norms and conducts differ, there is an urgent need for standardization and uniformity in medical ethics among all health care professionals (American Nurses Association (ANA), 2021). A lack of uniformity in health care ethics may let doctors and nurses to practice in accordance with their own perceptions of acceptable standards and behaviour.
Nursing is a dynamic and interesting profession. With this enthusiasm come ethical problems, high lawsuit rates in obstetrics, and the difficulty of providing safe, evidence-based nursing care that is attentive to the needs of women and families. According to Anarado (2016), ethics is the determination of what is good, right, and fair. Every day, ethical challenges occur in healthcare, and everyone has a responsibility to ensure the ethical delivery of treatment. Possibly due to their interactions with patients and customers in the reproductive age groups, health care providers, notably midwives, perinatal and neonatal nurses, encounter ethical concerns.
There are a multitude of challenging ethical concerns involving patients. Nursing is a process including judgment and action with the purpose of preserving, enhancing, and restoring the human system's equilibrium. The requirement for judgment and action prompted the moral quandary of whether responsibility is ethical or bad. The ultimate goal of nursing is the well-being of other people (Anarado, 2016).
The American Organization for Nursing Leadership (2019) recognizes nursing as an ethically relevant activity. In daily practice, nurses are required to demonstrate ethical behavior. Social expectations of what it means to be a "good nurse" have evolved since the time of Florence Nightingale; nowadays, the role of nurses as advocates for patients and their families is acknowledged as a crucial practice of a "good nurse." Consequently, nurses must not only make their own ethical choices
During nursing practice, nurses not only support their patients' decision-making, but actively encourage it. Identifying and comprehending ethical concerns related to patient care is the first step in making ethical nursing decisions.
With technological advancements and the increasing complexity of the healthcare system, ethical concerns in nursing are becoming more diverse and complicated, and these developments have had a significant influence on nursing. When nurses are regularly confronted with ethical dilemmas and need to make judgments in the course of their everyday nursing practice, they are likely to be disturbed by these circumstances Occasionally, such concerns can have detrimental effects on nursing practice, such as an increase in burnout, a decrease in job satisfaction, a danger to the quality of patient care, or job attrition. Thus, ethical concerns are the top priority of nursing leadership (Savage, 2016).
STATEMENT OF THE PROBLEM
Ethics are vital to the integrity of the nursing profession because they contribute to improved patient care. Nursing is an extremely fast-paced profession with new issues appearing every day, and nurse supervisors around the nation face comparable ethical dilemmas. Many of these circumstances stem from a lack of patient rights protection, proper personnel, sophisticated decision-making, and high-quality patient care. Unfortunately, due to the high number of untrained nurses joining the field, many of them are unfamiliar with nursing ethics (Savage, 2016).
When caring for several patients, nurses frequently encounter ethical quandaries. These ethical concerns might take several forms. Sometimes these challenges arise from a patient's discomfort with therapy, refusal of therapies based on personal or cultural beliefs, or when patients and their families must make life-or-death decisions regarding their health state. In these circumstances, nurses must not only offer exceptional treatment, but also adhere to the official Code of Ethics for Nurses (Walker, 2015).
OBJECTIVES OF THE STUDY
The primary objective of this study is to assess the relationship between ethical challenges and professional nursing practice. Specifically, other objectives of this study are:
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To determine the extent of nurses knowledge on nursing ethics.
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To determine whether ethical challenges affects professional nursing practice.
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To examine the different types of ethical issues encountered by nurses.
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To recommend ways ethical challenges in the nursing profession can be prevented.
RESEARCH QUESTIONS
The following research questions will be answered in this study:
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What is the extent of nurses knowledge on nursing ethics?
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Does ethical challenges affect professional nursing practice?
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What are the different types of ethical issues encountered by nurses?
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What are the ways ethical challenges in the nursing profession can be prevented?
SIGNIFCANCE OF THE STUDY
This study contributes to nursing knowledge by examining ethics and ethical challenges in the nursing profession. It will also serve as a reminder to nurses about ethical code of conduct and its importance in the nursing profession.
Nurse leaders may utilize the data to enhance their practices, and organizations can use the data to develop and and educate nurses under them about the ethics of the nursing profession and likely challenges to be encountered.
Finally, this study will serve as an additional material for further research and future reference.
SCOPE OF THE STUDY
This study is focused on the relationship between ethical challenges and professional nursing practice. Specifically, this study is focused on determining the extent of nurses knowledge on nursing ethics, determining whether ethical challenges affects professional nursing practice, examining the different types of ethical issues encountered by nurses and recommending ways ethical challenges in the nursing profession can be prevented.
Lecturers and nursing students of School of Nursing, University of Calabar Teaching Hospital, Cross River State will serve as respondents for this study.
LIMITATIONS OF THE STUDY
This study is limited to the relationship between ethical challenges and professional nursing practice. Specifically, this study is limited to determining the extent of nurses knowledge on nursing ethics, determining whether ethical challenges affects professional nursing practice, examining the different types of ethical issues encountered by nurses and recommending ways ethical challenges in the nursing profession can be prevented.
Lecturers and nursing students of School of Nursing, University of Calabar Teaching Hospital, Cross River State will serve as respondents for this study, thus this serves as a delimitation to this study as additional and adequate research is needed if this work is to be used anywhere else.
DEFINITION OF TERMS
Ethics: Ethics involves determining what is good, right and fair.
Ethical challenges: Problems encountered when trying to do what is good, right and fair.
Nursing: Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. They also take on vital roles of education, assessing situations, as support.