Nurses are part of the larger healthcare community that comprises other professionals like physicians, therapists, pharmacists, dieticians, and researchers among other professionals. The primary role of nurses is to ensure that they discharge healthcare services to promote the health of patients. As members of community healthcare, nurses operate in an interactive environment where they face professional, legal, as well as ethical issues, besides the challenges that are derived from within their profession (Nemie, 2009). Most of the legal-ethical issues that are experienced in the nursing profession revolve around conflicting forces between the standards under which nurses have to operate and the real situation in most healthcare environments in which nurses operate. This paper explores the conflicts that prevail between ethics and legal issues in the nursing profession.
Conflicts between ethics and law in the nursing field
In most cases, nurses are involved with caring for the lives of individuals who often do not share similar worldviews with the nurses. Therefore, this is one of the sources of conflicts where nurses struggle to balance between offering the appropriate level of healthcare for patients and providing periphery needs to patients. These needs lay outside the duties of the nurses, yet the needs are vital in meeting the medical needs of patients. In most cases, the law stipulates the duties of nurses as enshrined under the Employment Act. Just like other professions, the roles and responsibilities of nurses in most countries are clearly stipulated in the law. However, most of the healthcare environments in which nurses discharge their duties as provided for by the law present situations that go far beyond the laid down responsibilities of nurses. In most cases, nurses are left to confront the situation where they have to attend to the non-medical needs of patients. Although these are not part of their responsibilities, the needs are critical in the achievement of the nursing role of ensuring the well-being of patients. It would be hard for nurses to lead patients to recovery if they were to strictly stick to their roles of providing healthcare services. In some cases, nurses take the role of caregivers and therapists to help steer patients toward recovery.
According to the Nursing and Midwifery Council (2008), nurses often work under physicians who give them directions on how to attend to patients depending on the healthcare needs of the patients. Under medical law, nurses are supposed to adhere to the orders of physicians, who are considered specialists when it comes to attending to the medical needs of patients. However, physicians are sometimes bound to make mistakes when providing medical care to patients. Nurses often understand the medical care needs of patients and are bound to discover the mistakes that are made by physicians given that nurses are closer to patients than physicians.
Since nurses are supposed to follow the orders of the physicians, a dilemma between law and ethics presents itself where the nurse can still choose to follow the wrong prescription for a patient because the chief responsibility is with the physician who gave the prescription. However, the nurse also has a choice to correct the mistake and help eliminate the dangers on the patient and the burden of responsibility on the side of the physician concerning the mistake. For the sake of the dignity of their professions, nurses find themselves correcting such mistakes as they align more with the lives and health of patients instead of the legal issues that surround their profession. Therefore, there is no clear alignment to the provisions of the law in life care pathways, which makes it hard for nurses to align with the provisions of the life care support laws (Allmark & Tod, 2009).
Healthcare support and life care pathways
Different issues keep coming up in the healthcare field, thus confronting the existing states and laws. With the emergence of different scenarios in the medical field, different laws are developed to guide responses to such cases. One of the critical areas in the nursing field that present ethical and legal dilemmas is end-of-life care. Under the law, it is provided that all sets of actions in healthcare are supposed to be guided by the urge to promote the best interest of the patient by paying attention to the legal and ethical principles available. However, the definition of best interest as aligned to the law is not standard. This implies that nurses are caught between the push for withdrawing healthcare services and the need to ensure that the healthcare needs of patients are fully attended to. The question of intention also arises when it comes to most cases in life care pathways (Nursing and Midwifery Council, 2008). Under the same law, nurses are allowed to offer healthcare services that can shorten the life of a person. However, there are restricted circumstances under which such kind of care should be offered by the nurses (Allmark & Tod, 2009).
It is apparent that nurses are often caught up in situations where they are pushed to withdraw a number of healthcare services as a way of reducing the probability of certain patients to live. This often comes out of the request of close associates of the patients owing to the healthcare state of the patients. There are some cases, especially for patients with chronic illnesses, where the ability of nurses to improve the heath state of the patient is stretched to the limit. Examples are cases of patients with conditions that are not treatable and where nurses cannot prevent patients from feeling pain. In such cases, there are options for nurses under the law to take healthcare decisions that are largely considered to be illegal, yet in the best interest of patients. However, all this boils down to one issue, which is the fact that life is sacred and should be protected at all costs. Taking such a decision means failing to protect and embrace life. Therefore, nurses have had to stick to the principle of protecting life, which informs the ethical basis of their work. Nurses often resist attempts and forces to offer certain services, even though they have to so within legal justifications (Allmark & Tod, 2009).
The other ethical dilemma in the nursing field concerns the legal grounds on which nurses can solve labor relations issues. However, many people are of the opinion that nurses should not go on strike due to the fact that they provide essential public services. Nurse strikes have been witnessed in different states in the United States, like California, as well as other countries across the world. Nurse strikes result in an increase in the number of people who succumb to their heath states due to lack of medical care. More deaths and worsening of heath conditions of people are experienced whenever nurses down their tools in demand for better terms of remuneration. Therefore, the overarching concern is whether nurses should not go on strike even when their needs are not addressed by the concerned bodies. The duty of the nurse is to provide care for patients. However, failure to meet the needs of nurses implies lack of care for them, which can easily spill over and affect their duties (Kemp, 2013).
According to Ulrich et al. (2007), ethical concerns for nurses keep rising. However, nurses manage to battle the ethical concerns by embracing a number of things. One of the things nurses focus on to pacify their work environment, irrespective of the ethical and legal standoffs, is the respect and value that they attach to their profession. To a large extent, nurses are considered by many people as supporting instruments for life; thus, there is a high level of confidence in their work from the public. As explained earlier, the will of nurses to go on with what they think is right for the majority of the people helps nurses manage the legal and ethical pressures. According to Nemie (2009), nurses ought to be allowed to team up and develop groups that are critical in exploring the challenges that they face. This is critical in debriefing nurses, thereby helping nurses maintain the right attitude in their work. This is critical in helping nurses strike a balance between their work and the ethical and legal forces in their work environment. Through this, nurses are able to maintain their ethical responsibilities.
References
Allmark, P., & Tod, A. (2009). End of life care pathways: ethical and legal principles. Nursing Standard, 24(14), 35-39.
Kemp, D. S. (2013). Can health care providers ethically go on strike? Employment Law.
Nemie, J. K. P. (2009). Challenges for the nursing profession in Malaysia: Evolving legal and ethical standards. Journal of Nursing Law, 13(2), 54-62.
Nursing and Midwifery Council (2008). The code: Standards of conduct, performance and ethics for nurses and midwives. Web.
Ulrich, C., O’Donnell, P., Taylor, C., Farrar, A., Danis, M., Grady, C. (2007). Ethical climate, ethics stress, and the job satisfaction of nurses and social workers in the United States. Soc Sci Med, 65(8), 1708-1719.