The best course of action that I would follow is to arrange for Mr. Newcomb to see his mistress. Due to personal beliefs, I would try to avoid directly lying to his wife Mrs. Newcomb as it is unethical. However, regardless of personal beliefs, it is my responsibility to fulfill a patient’s reasonable request and provide him with the privacy and time to meet whoever he wishes. As a nurse and healthcare provider, personal belief systems should not interfere with professional duties or patient care at any level.
Nurses often care for patients whose value systems differ or even conflict with theirs. Ethics and values can both encourage as well as complicate the balancing of ethical principles of the patient with those of the healthcare profession. Commonly nurses use personal values to provide better and empathetic care, but to plan effective care, the patient values need to be identified. If any situations arise where the patient values are conflicting and unclear, a nurse can clarify through various stems in order to affirm the choice but ultimately professional duty and values are to support the patient as long as it does not violate the nursing code of ethics or regulations (Al-Banna, 2017).
Therefore, based on this reasoning, my professional values have led me to respond in the manner that I did to the scenario. My personal values are vehemently against lying and deception, including through acts of infidelity that I would consider betrayal. However, I must adhere to nursing ethics and professional practice values which lead me to respect Mr. Newcomb’s request without judgment or condemnation. The incident would not have diminished my treatment and personal connection with the patient.
Nurses should strive to adhere to the four principles of ethics: beneficence, nonmaleficence, autonomy, and justice. Examining the scenario, all of the four principles are met and not violated. Justice involves treating patients in the best interest and equal to others is applicable in that any patient could place such a request and I would meet it, Mr. Newcomb not being the only one with that privilege of visitors. Potentially an injustice is being done to Mrs. Newcomb as she is being deceived, but the primary duty still remains to the patient. The principle of beneficence emphasizes promoting good and benefits to the patient. The meeting with the mistress may be beneficial to Mr. Newcomb, improving his moral and mental health as he is dying. Similarly, nonmaleficence indicates that no harm is to be done. Refusing the last request to Mr. Newcomb can potentially cause harm and upset the patient, so abiding by it is more ethical as it once again causes good and does not harm anyone since it is just a meeting. Finally, autonomy indicates that a patient is responsible for their choices and has full control over their healthcare-associated choices (Davis, 2018). As a nurse, one recognizes the autonomy of Mr. Newcomb in choosing to see his mistress for a few hours, as a grown adult he has the understanding and capacity to make such a request.
Self-care practice is a significant topic of discussion for healthcare providers and their patients in both professional and other contexts. Although self-care is a holistic activity, there are strategies that can be undertaken to promote it. According to Wanchai & Armer (2018), nurses can assist patients to improve self-care capabilities through:
- Establishing a nurse-patient relationship – interpersonal communication to provide patients with self-care agency and support to understand their treatment regimen so that they can begin implementing it on their own;
- Nurse coaching and motivational interviewing – a client-centered, directive counseling aimed to increase motivation and coach to take charge of their growth, accountability, and self-management;
- Enhancing patient participation – patients are provided information about their health status, and have the ability to openly discuss it and be appropriately advised.
Each method should be employed when appropriate based on the individual needs of the patient and given context.
References
Al-Banna, D. A. (2017). Core professional and personal values of nurses about nursing in erbil city hospitals: A profession, not just career. Nursing & Care Open Access Journal, 2(6). Web.
Davis, C. (2018). Ethical decision making. Nursing Made Incredibly Easy!, 16(2), 4–5. Web.
Wanchai, A., & Armer, J. A. (2018). Promoting self-care capabilities of patients: Nurses’ roles. JOJ Nursing & Health Care, 7(4). Web.