Moral Dilemmas and Ethical Decisions Nursing Essay

Moral Dilemmas and Ethical Decisions

Health Care Policies and Protocols

An ethical dilemma is bound to set in whenever more than one patient arrives at the hospital with emergency needs. The nurses have to ensure that they are keen in executing tasks quickly so as to weigh priorities in terms of which patient to give treatment first. The nurses must make a decision because usually, the hospital may not have all the resources to handle the patients at the same time. This process is called Triage. In the case of Jeffers and Damascus, many ethical considerations will have to be applied, and the nurses might even have to refer to Emergency Nurses Association Code of Ethics which provides them with a good reference point useful in making the most appropriate decision (Parahoo, 2014). 

Nurses are guided by various policies when handling patients in the emergency room. First, the nurses must maintain high degree of competence. They should also offer sound judgment that protects the lives and privacy of the patients as much as possible. This principle gives the patients equal rights to receive quality healthcare and right of protection. Even though the nurses have to make a decision in favor of one of the above people (Jeffers and Damascus), the decision has to be as sound as possible and the hospital should not neglect any of the patients but should strive to save the lives of both (Sun et al., 2013). Jeffers and Damascus share the right of treatment because, at the emergency department, the nurses should focus on offering healthcare to all people regardless of the background or status of that person.

The nurses must also consider the Principle of Nonmaleficence. This policy directs that the nurses must give quality care to the patients and not do them any harm through negligence or discrimination. The nurses, especially those at the emergency department, should provide care to the patients based on their judgment and ability. The nurses should in no circumstance neglect the patient unless such patient proves impossible to recover or is at the point of death. This principle means that Damascus deserves the right of treatment despite his background which entails criminal history and complicated medical history as well. If Jeffers is given the first priority, it should not be because he has a family and comes from a relatively stable background, but because he meets the health regulation of having a medical cover (Sun et al., 2013).

The nurses would also consider the principle of Beneficence. This law requires that the nurses contribute to the wellbeing of the patient. It may involve any affirmative action which targets at improving the condition and status of the patients without discrimination. There are many positive actions which could be undertaken by the nurses to help the two patients. Damascus, for instance, needed help to keep up with the medical requirements like having an insurance cover that he did not have. But since this could not be possible at the emergency unit, it could be insisted if such patient survived. The nurses may also apply the policy of respect for autonomy at the emergency department in dealing with the ethical dilemma arising.

How Health Care Disparities Impact Treatment Decisions

The emergency room is often full of anxiety and mostly there is no enough time to execute tasks because prolonged procedures risk the lives of the patients. In that case, the nurses must be quick in making decisions and those decisions must be sound. This leads to many disparities. For example, if the triage nurses do not know person’s medical history, it may result in the patient not receiving the necessary type of care (Huber, 2013). 

The emergency department is complex and so the invasive interventions may not give the patient or surrogates an opportunity to say anything. This disparity is mostly due to reduced cognitive ability of the patient and urgency of the healthcare. A disparity can, therefore, occur between Damascus and Jeffers whereby one is treated unfairly because of the purported reckless behavior. The nurses would give priority to Jeffers on the ground that he has medical cover and that his accident resulted from an unavoidable cause.  

Available Health Care Policies That Direct Care for Uninsured Patients

Healthcare insurance is crucial for everyone. It gives patients the right of accessing healthcare. Having a health cover, therefore, allows the patient to access quick and quality healthcare. However, when a patient is involved in an emergency which requires urgent medical care, such a person is entitled to healthcare in any hospital. This is according to Emergency Medical Treatment and Active Labor Act (EMTALA) which provides that a patient who is in a critical condition can receive healthcare in any hospital until he/she stabilizes (Burkhardt, & Nathaniel, 2013).  This requirement includes patients without insurance cover. Also, the hospital has a moral obligation to refer the patient to another hospital in case it does not have an emergency unit or if the patient requires more specialized treatment.

Moral and Ethical Challenges Nurses Can Face When Following Hospital Policies and Protocols

The nurses at the emergency unit might face many ethical challenges especially as far as Jeffers and Damascus’ cases are concerned. First of all, Damascus does not have medical cover. He also comes from a background that proves him as a careless person who might not be able to pay the bills after treatment. The nurses have to consider this challenge because Jeffers, on the other hand, has all the rights to receive the healthcare based on his history. The nurses here will have to overcome the challenge of discrimination since they should not judge a patient based on their background in the case of an emergency, but since a decision has to be made, Jeffers ought to be given the first priority. The United States Healthcare policy states that failure to have a health cover can affect the way a person receives health care, and this is the case with Damascus.

Evidence-Based Strategies for Managing Uninsured and Indigent Population

One of the suggested and evidence-based strategies for managing the uninsured patients is bettering the whole process and improving facilities in the emergency department. This approach would allow more people to be served and this would minimize the ethical dilemmas by allowing the uninsured people to get healthcare services with the hope that they will comply with the hospital terms. A zero percent turn-away policy has helped many hospitals to maintain their profitability and reputation. The uninsured and indigent patients can be identified and possibly isolated so as to give room for searching their family members and other identities. Their database can be recorded separately to avoid any mix-up of the information. The department must also have a taskforce specializing in gathering information about the patients and making quick decisions.