An Ethical Dilemma Involving an Intoxicated and Lacerated Patient
Leadership management in nursing contributes to the quality of nursing care provided to the patient, their mortality rate, and their satisfaction, and improves the well-being of the staff. With effective leadership skills, a nurse is empowered with abilities during nursing care provision. It also ensures the quality of care provided to the patient is improved, translating to positive health outcomes. During nursing practice, ethical principles act as guidance. These principles give one skill during decision-making. They act as guidance during tough times. This essay will talk about the moral dilemma involving an intoxicated and lacerated patient. An explanation of the ethical situation will be provided, and a side will be chosen with a description of the reason for choosing the side. Towards the end, personal values exhibited by the nurse involved in decision-making will be discussed.
Ethical situations arise daily in a medical setup (Rainer et al., 2018). In my research, I identified a moral problem involving patient J, a 35-year-old man. The patient was involved in a fight or violence, sustaining a large laceration on the center of his forehead. He comes to the emergency department when well-oriented and alert and has no significant other findings except for the cut that is about 10 centimeters. On verbal scores, he has slurred speech and admits to having taken ten bottles of beer in the last few hours. Since the department is busy administering care to other urgent cases, patient J grows impatient at the waiting bay. So he wishes to leave the hospital, and the staff urges him to wait a little longer since he shouldn’t drive while drunk. However, he finds it hard to convince himself to stay longer and says he will go home.
The ethical dilemma, in this case, is between the staff’s (nurses’) concern for the safety of others and patient J’s wellbeing and exercising the patient’s right, which is the right to self-determination and autonomy. Patient J is an adult, and from a legal standpoint, he can make his own decisions. He has the right to decide whether he will accept or deny treatment after the doctrine of giving informed consent. This allows patient J to exercise his right to autonomy. However, the medical staff is worried about the safety of others and the patient’s wellbeing. This is because the patient wants to drive himself home under the influence of alcohol, having admitted to taking about ten beers a few hours before the fight. Since the nurse’s first duty is to patient J, it is impossible to detain him against his will, as this will prompt justification of the nurse’s actions.
As a nurse, I let the patient exercise his right to self-determination and autonomy (Haddad & Geiger, 2018). On applying strict standards to determine the capabilities of a patient to make decisions, patient J is legally cleared. This decision is based on the patient being an adult who understands the information that is very relevant to the decision at hand. In addition, he can communicate with the medical staff and have a good interaction despite the slurred speech. Based on my chosen action above, I would let the patient walk out of the emergency department after conceding to no medical management despite the necessity to suture his laceration. After leaving, the patient’s vehicle registration will be given to the police with documentation that he was asked not to drive while intoxicated but denied. When the scenario was evaluated using the R.O.L.E acronym framework, it was noted that the patient’s right to autonomy and self-determination still overrules (“Course Case Studies – Course #37073: Ethical Decision Making – NetCE”, n.d.). Firstly, R stands for risk of medical treatment. The treatment, suturing the wound, has minimum risks to patient J. A few people report fewer life-threatening conditions and fewer complications from lacerations of these sizes (Ozturk et al., 2013). Secondly, O stands for the patient’s opinion. It evaluates the patient’s understanding of the benefits and risks of the medical treatment and his ability to make decisions in an intoxicated state. From the strict standards, the patient can make decisions. Thirdly, L stands for the quality of life. This seeks to evaluate the effects of the unsutured wound on the quality of life of the patient. Lastly, E stands for the external factors, which involve the safety of other travelers as the patient drives himself home. This is handled by making a report to the police.
There are personal values that act as a bedrock and guidance in making decisions when faced with an ethical dilemma. These unique values help in prioritizing the life demands of a patient (Al-Banna., 2017). The first exceptional value that helps with decision-making is concern for others. If patient J drives himself home after taking ten beers, he is likely to get into an accident or get into another fight with other road users. This would threaten those traveling along the same path with him and himself. So, the police had to be involved in minimizing the chances of further violence occurring or accidents due to intoxication. The second personal value is law-abiding. Even though patient J’s well-being was of concern, his right to autonomy and self-determination had to be respected. As a nurse, I must abide by ethical principles and, more so, my duty to the patient. This includes serving patient J’s interests first by accepting his refusal of medical treatment. For every medical staff, it is important to have personal values to aid during ethical dilemmas.
References
Al-Banna, D. A. (2017). Core professional and personal values of nurses about nursing in Erbil City hospitals: a profession, not just career. Nurse Care Open Acces J, 2(6), 169-173.
Course Case Studies – Course #37073: Ethical Decision Making – NetCE. Retrieved 18 June 2021, from https://www.netce.com/casestudies.php?courseid=1939
Haddad, L. M., & Geiger, R. A. (2018). Nursing ethical considerations. https://europepmc.org/article/nbk/nbk526054
Ozturk, D., Sonmez, B. M., Altinbilek, E., Kavalci, C., Arslan, E. D., & Akay, S. (2013). A retrospective observational study comparing hair apposition technique, suturing, and stapling for scalp lacerations. World Journal of Emergency Surgery, 8(1), 1-6. https://doi.org/10.1186/1749-7922-8-27
Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An integrative review. Journal of Clinical Nursing, 27(19-20), 3446-3461. https://doi.org/10.1111/jocn.14542
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Question 
An Ethical Dilemma Involving an Intoxicated and Lacerated Patient
There will be many instances where an ethical decision needs to be made during your career. Because this topic poses so many different arguments, you must search your values first, as this provides the foundation of how you make or come to an ethical decision. Your challenge this week is to write a 2-3 page paper about an ethical situation you were involved in, one you have seen in the news, or one you have found in your research. In this paper, I want you to state both sides of the decision being decided upon. What side would you be on and why?
Use two professional references to support your ethical decision-making. Include one paragraph within your paper on your values that help you make a moral decision. Please include a title sheet and a reference page.