Ethics and Healthcare Reform: Nursing Viewpoint

Introduction

Nurses’ competent performance of assigned tasks is a key to quality healthcare services and, as a result, patient-positive outcomes. However, there are situations when the process of care delivery is complicated by conflicts caused by various reasons. The ethical misunderstanding that occurs during interaction among nurses and patients is a significant challenge since many stakeholders are involved, and new approaches should be found to maintain a positive working environment.

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One of the factors affecting the emergence of conflicts is healthcare reforms, and the recent Affordable Care Act (ACA, or Obamacare) adopted with the aim of facilitating access to the services of health employees is the reason for some disagreement. Based on the provisions of this law, nursing duties are expanded, which, in turn, complicates the process of work and affects the staff satisfaction with the new regime. Ethical conflicts that are complicated by reform need to be avoided to improve the quality of work with the population, and relevant practices and methodologies can be useful for solving this problem.

Ethical Conflicts Caused by the Healthcare Reform

The terms of the ACA provide for freer access to medical help through the expansion of insurance services, which is designed to increase the possibilities of consultations with medical specialists for people with low income. However, with the expansion of these capabilities, more tasks appear among nurses, and some ethical nuances are inevitable. According to Lathrop and Hodnicki (2014), conflicts are frequent among the highest category of nurses, in particular, with doctoral education since they have the highest degree of responsibility. However, different representatives of the healthcare sector are involved in the misunderstanding that may have a distinctive nature and consequences.

The misunderstanding that arises among participants in the care process is often based on disagreements caused by different views on the same situation. As Jimenez-Herrera and Axelsson (2015) note, the opinions of patients and nurses regarding the conditions of care may vary considerably. The increase in the number of people who want to receive freer access to medical services complicates the decision-making process.

The medical staff is forced to experience heavy workloads caused by high labor commitments. These and other stressors interfere with focusing on end goals, and although employees do not have to respond to external irritants, the human factor is still present. Another cause of conflict is the lack of information on how to implement immediate responsibilities under the new legislation properly. Jimenez-Herrera and Axelsson (2015) remark that “nurses can find tools for caring when they combine their practical knowledge with an ethical approach” (p. 549). However, if the management does not convey to employees the main provisions of the reform, no approaches can be applied. The aforementioned conflicts may be avoided by resorting to appropriate methods and practices.

Nurses’ Techniques of Negotiating Ethical Conflicts

As a way of combating those ethical conflicts that are caused by the adoption of a new law on affordable health insurance, it is possible to use current relevant methods. In particular, Johnstone (2015) considers educational practices for nurses as an effective way of dealing with stressors. Psychological tiredness under the influence of a large number of patients is natural, and it is essential to take timely measures to eliminate its negative impact on the care delivery process. Training with experienced psychologists and teamwork can help nurses to avoid fatigue and take a more neutral approach to work responsibilities.

Another potentially successful technique for overcoming ethical conflicts is the competent policy of time management. According to Johnstone (2015), if the nursing staff does much work, the schedule should be designed so that all responsibilities could be distributed among specialists evenly. Excessive fatigue, in turn, is fraught with interpersonal conflicts among the employees of healthcare institutions. Therefore, the leadership of medical settings should address the task of distributing working time responsibly so that all caregivers could have equal labor conditions.

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Finally, the study of the methods of working with the population should be encouraged at the individual level. As Johnstone (2015) argues, the nursing profession is the continuous process of learning and self-education. Accordingly, the higher the personnel awareness of the peculiarities of working with low-income citizens is, the higher the chances are for mutual understanding. This practice may be implemented through consultations with senior colleagues, studying the problems of certain communities, and other approaches aimed at improving professional literacy in a particular field.

Conclusion

Practices and techniques aimed at overcoming those ethical conflicts that are caused by the adoption of the ACA are the crucial components of nurses’ work. In particular, psychological training, collective sessions, and competent time management policies are the topical ways of solving this issue. Also, self-education allows specialists to gain valuable experience regarding the characteristics of providing care to different categories of the population, which is particularly important in the context of increasing access to health insurance. The participation of different stakeholders is necessary in order to achieve mutual understanding and eliminate potential disagreements concerning different views on the care delivery process.

References

Jimenez-Herrera, M. F., & Axelsson, C. (2015). Some ethical conflicts in emergency care. Nursing Ethics, 22(5), 548-560. Web.

Johnstone, M. J. (2015). Bioethics: A nursing perspective (6th ed.). Melbourne, Australia: Elsevier.

Lathrop, B., & Hodnicki, D. (2014). The Affordable Care Act: Primary care and the doctor of nursing practice nurse. Online Journal of Issues in Nursing, 19(2). Web.

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