COLLAPSE

521 replies week 8

Discussion 1

COLLAPSE

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In the final week of this course, we ask that you describe a clinical situation in which a registered nurse may encounter moral distress. After reviewing the Four A’s from our textbook, apply the concepts to the situation you chose and then share with us the mitigation strategies recommended or applied.

Describe a clinical situation in which a registered nurse may encounter moral distress. Answer the AACN’s Four A’s found on page 84 in your Butts and Rich text to further explain the situation, and the possible mitigation strategies.

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Reply 1 Veronica

Moral distress occurs when nurses experience varying degrees of compromised moral integrity. The term moral distress can also be defined as “when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action” (Butts, 2016). Working in two emergency rooms at two different facilities, there are days in which I feel moral distress. I especially feel this way at the small community emergency room I work at because of the lack of resources that are available to this low-income community, as at times I wish I could do more. It can be extremely infuriating when you know exactly what resources you need, or what resources the patients need, but do not have them. One issue I see a lot are patients who do not have primary physicians or patients who have not been properly educated on how to control their chronic diseases by their providers. In applying the 4 AACN questions, I do ask myself if this frustration I feel is causing distress or showing signs of suffering. Next, is affirming your distress and commitment to take care of yourself and address moral distress Third is assessing sources of your moral distress to prepare for an action plan. This is trying to figure out if the moral distress is coming from within or institutional constraints, which in my case is finding ways to de-stress outside of work. Finally, acting to implement strategies for changes to preserve your integrity and authenticity. (Butts, 2015).

Reply 2 Rebecca

Moral distress is something that every nurse has had to deal with at one point or another. The AACN’s 4 A’s are ask, affirm, assess, and act. There was a situation at work just the other day where the doctors and nurses experienced moral distress. We had a patient who was so sick and was not going to make it. The family wanted everything done for him. We tried everything and in a last ditch effort an impella was placed. While he was having this procedure, he coded multiple times and was very unstable when he was brought back to us. He coded again in the room. As we were coding him, the doctor called the family and asked them to allow us to stop and they refused. It was horrible to watch and be a part of this code knowing we were just prolonging his death and causing him more pain by everything we were doing. We were able to get him back but he coded four more times that evening before he finally passed. We all felt that it was wrong to continue to code him but it was what the family wanted and therefore we continued until he could no longer be brought back.

Discussion 2

COLLAPSE

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Describe different ways that social media use can violate ethical nursing practices. How can ethical social media use be beneficial to health care professionals and their patients?

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Reply 1 Hannie

I remember many years ago when Facebook was just starting to become popular, nurses would often post about work. Today I believe that there is a higher restraint as most nurses have learned that what they post on social media can affect their jobs. One incident I remember specifically, was when living in a small community where everybody knew the other people business, a terrible trauma happened that involved a young child. One of my charge nurses posted several posts related to having a hard day at work, and to hug your loved ones, and went as far as to say that taking care of pediatric trauma patients is extremely difficult. Because this community was so small, it would have been extremely easy for most who read her posts to figure out who she was talking about, even though she never listed any information to identify the patient. Situations like these are common, but nurse must exercise caution.

Social media is a powerful way to distribute information, because of this it can be an excellent way to ensure information is spread to large volumes of people relatively cheap and extremely easy. According to Carrington College (2014), social media is used by most hospitals to reach patients and has a huge benefit in times of disaster. Personally, I have used social media to involve friends, family, and anyone who wanted to know information related to my medical volunteer trip to Houston last year during the hurricane and flooding. Additionally, this platform is a great way to raise money for medical causes such as the Houston and Puerto Rico disaster relief fund. During several at home major medical events, social media has been used to warn others of the danger or where to get help. Social media when used ethically stand to serve nurses and the healthcare system with great opportunity to reach millions of people.

Reply 2 Anna

With focus shifting to patient-centered care, social media platforms such as mobile technology and the internet are increasingly being utilized in the nursing profession. Even though patients, nurses, and other healthcare workers have benefited from the increased use of social media, it as well continues to provoke ethical dilemmas in the nursing profession (Denecke et al., 2015). There are various ways through which social media platforms can be used to violate ethical nursing practices. The greatest ethical issue that arises from social media utilization in nursing is the increase in cases of invasion of patient privacy. Often, the violation of patient privacy adversely affects the patient-nurse relationship since both their private information may be accessed by third parties online. The ethical use of social media in nursing, however, can benefit patients, nurses and other healthcare providers and, as a result, improve the quality of patient care. The practice could also lead to faster communication in healthcare facilities and improve patient outcomes.

 
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