Leadership Ethics and the Disruptive Resident
My ethical dilemma occurs daily in the long term care environment (LTC). When residents behaviors are disruptive to staff and other residents in the facility, the solution is to give medications to quiet them down. Is this the right thing to do?
Ethics, as defined by Merriam Webster’s online dictionary (n.d.), is a branch of philosophy dealing with what is morally right or wrong. The Code of Ethics for Nurses with Interpretive Statements (ANA, 2001) is a guiding framework for ethical decision making. In the current LTC environment, ethical decisions often come down from the top seemingly without concern for the rights of the resident. Nurse ...view middle of the document...
Analysis of Evidence
Communication, or deliberation is the key to ethics in elderly care. A study by S. van der Dam, T. Abma, M. Kardol, & G. Widdershoven (2012) used moral case deliberation (MCD) in two nursing homes and a care home involving a total of 700 residents and 375 staff. Decisions have to be ethical and meet residents’ needs because they are living in the facility for the rest their lives. Perspectives from everyone involved in the issue, structural factors and limitations needs to be discussed and the resident and his representative need to be involved in the discussion after all the informations and options have been presented. Leaders can create a work environment where asking questions and discussing ethical issues and solutions becomes everyday practice (Dam et al., 2012; Lazaridou, & Fris, 2008).
To resolve ethical issues in long term care, the caregivers need to recognize that an ethical issue is present. When in a chaotic environment such as long term care, caregivers feel pressured to get their work done and when a resident becomes disruptive to other residents and staff, the first thought is often to give a medication instead of determining the resident’s need. In a study by E. Solum, A. Slettebø, & S. Hauge (2008) the leader is tasked to change workplace cultures that engage in, “unspoken acceptance of not taking responsibility for patient’s best interests.” When a patient is disruptive caregivers must shy away from attaching a motive, like “all she wants is attention,” and instead keep the patient’s rights in focus. This was a qualitative study approved by the Regional Research Ethics Committee for southern Norway.
The Code of Ethics for Nurse and the Patient’s Bill of Rights are our professions guidelines for ethical decision making (ANA, 2001; CCN, 2014; Lazaridou, & Fris, 2008). Provision 1.4 Right to self-determination, also known as autonomy, is the philosophical basis of informed consent. Patients have the moral and legal right to determine what will be done to their person. Patients or their representatives are to be given understandable information on benefits and risks and be allowed to make decisions (ANA, 2002). In a paper by Lazaridou & J. Fries (2008) quantum...