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Ethics Game Reflective Journal Essay Nursing has evolved throughout the years. Gone are the days that the existence of nursing geared towards following the orders of senior members on the profession and initiation of routine procedures. In today’s nursing, nurses are valued and needed for their reasoning as well as intellectual skills. The changes in nursing require the desire to be more responsible and contributory to the wellbeing of those that needed care. These changes led to more complex ethical dilemmas that nurses’ encounter. This paper aims to provide a reflection on the Ethical Dilemmas presented on the Ethics Game Simulation, the decision-making steps taken to address the ethical issues, how the ethical concepts influenced the decisions made, and the application of the ethical concepts to a medical-surgical unit. The Case of the Troubled Teen This case illustrates Rachel Banks a 16 year-old teenager who got pregnant out of wedlock and currently on her tenth hour of labor on the OB/GYN unit at Seva Medical Center. She’s accompanied by her parents. Rachel’s parents are instructing the staff nurses to withhold the pain medication as punishment for getting pregnant before getting married. Since Rachel Banks is a minor, legally, the parents can decide for her. The nurses are concerned due to the possible detrimental health effects that the situation can cause to Rachel and her unborn baby, Lily. The nurses also became aware that the parents may not be fully educated on the consequences of their decision. In order to make an ethical decision on this case, I used the Baird Decision Model which provided five frameworks: Step 1: Be attentive, Step 2: Be Intelligent, Step 3: Be Reasonable, Step 4: Be Responsible, and Step 5: Be Reflective (University of Phoenix, 2013). The main issue in this case is how to ensure that Rachel and the baby get appropriate and timely medical care. I reviewed the e-mails and communications gathered in order to get a picture of the situation and see that the best possible solution arise. Upon understanding the main issue of this case, I’ve identified that the primary stakeholders includes; Rachel Banks, her parents, her unborn child, the staff nurse, and the primary nurse because they will be impacted on the decisions made in this situation. After identifying the main issue and the primary stakeholders, using the rights/responsibilities lens I was able to identify that my obligations and duties includes providing the best possible care to Rachel Banks and her unborn child, not to accommodate parents who are harming their child, and also support my staff’s professional improvement. On the results lens, I was able to recognize what would create the greatest good for the greatest number of stakeholders which was to involve the nurses and the parents in assessing need for medication intervention and also provide information for aftercare support and education. I believe that the decision made on this scenario benefits both the patient and her family. By involving the parents in the assessment of Rachel’s medical needs, conflict is alleviated and thus, creates a positive outcome. The Case of the Policies and Politics This case is about Alain Trottier, a patient brought in the emergency room by his domestic partner, Yves. Alain was admitted to the ICU unit and has been unconscious. The day- shift supervisor, Carlotta Baldwin is preventing Yves from seeing the patient and refuses provide information regarding the patient because he is not an actual family member. However, according to the hospital policy, domestic partners are to be treated as married couples for the purposes of access and, most importantly, when it must be determined who can make medical decisions for a patient unable to give their own consent. My duty as the nurse taking care of Alain is to identify the critical issue in this situation which is the equal treatment and access of gay partners at Seva Medical Center as equal to those of straight couples. Upon identifying this as the main issue, it is easier to analyze the problem. Again, the following stakeholders were identified: Alain Trottier (patient), Yves (domestic partner), C arlotta Baldwin, RN (shift supervisor), Amelia Flinch (Director of Nursing), the shareholders of the hospital, and lastly, I the staff nurse taking care of Alain. This scenario has led to the identification of relationship lens. The relationship lens focuses on the community. The main concern of this lens is to provide basic liberties to all people (University of Phoenix, 2013). The three rights represented in this case were: right to participate in decision-making for an unconscious family member, right to have hospital policy regarding participation by family members implemented, and right to be informed that your interpretation of hospital policy is inaccurate. I believe that these rights are the major component of this lens because it focuses on the patient, family, and healthcare providers. Upon understanding the basic rights related to this situation, the following actions such as educating all employees with hospital policies, establishing a taskforce to make sure that the policies are put into practice and conducting yearly audits to make sure that the policies are implemented. These actions will ensure that the patient will benefit greatly on the policies placed on the facility. Lastly, the reputation lens discusses the virtues important for leadership; core competencies such as managing diversity, problem-solving, self-knowledge, decision quality and fairness. These values are important because of the overall positive effect that it can bring to the patient and the facility. My final decision in this case is to note on Alains chart that Yves is to be given access and treated as family. Speak to Carlotta about my decision and let my supervisor know. I believe that this decision has no risk. This decision has demonstrated that I am fully knowledgeable on the hospital policies and also implementing what I know for the benefit of my patient. By assuring equal access will likely improve the hospital’s status in the community. Lastly, by informing Carlotta Baldwin and the supervisor know of the decision can be a message that further education is needed for all employees to be more aware and knowledgeable of the hospital policies. Ethical Dilemma at a Medical-Surgical Unit I’ve been working as a RN at a medical-surgical unit for almost a year now. I still consider myself as a novice nurse and I feel that I haven’t been exposed to a lot of ethical dilemmas. However, I believe that pain management or providing pain relief can be an ethical dilemma for any nurse. The ethical issue is this: can we as nurses undertreat a patient’s pain because we are concerned about the repercussions or because we know that the patient is addicted to the medication. I believe when challenging situations like this arise, I need to be conscious of my own biases and make evidence-based decisions that can provide optimal treatment to the patient. By not being judgmental, I can fully assess what would benefit my patient greatly and include him/her on the treatment plan- giving autonomy. By including the patient I can also decrease the harm because I will have a better understanding of what will work best for my patient, and lastly, by hindering my biases I will be able to treat my patient’s pain in a non-discriminating way possible. As nurses continues to encounter complex ethical dilemmas as the profession and society gears forward, we must still go back on the foundation of nursing in accordance to the mission of Florence Nightingale; nurses are missioners of health dedicated to the advancement of human welfare. References: University of Phoenix. (2013). Ethics Game Simulation [Multimedia]. Retrieved from University of Phoenix, HCS478 website.