Ethics in Nursing Leadership

Ethics in Nursing Leadership

Case Study 2 relates to the application of ethical principles of nursing and nursing leadership in neonatal care.

Ethical Principles That Should be Considered When Providing Care to Patients

Despite progress made in health technology and neonatology, the survival rates of extremely preterm babies remain low. Research findings based on data compiled between 2013 and 2018 in the United States focused on the survival rates of extremely preterm infants showed that less than 11 percent of infants born at 22 weeks survived to discharge (Bell et al., 2022). Hire our assignment writing services in case your assignment is devastating you.

In this case, the patient in the ward with preterm labor at 22 weeks wants their child to be resuscitated and provided the best care. However, the care providers know that the chances of survival are low, and if the child survives, they will have many developmental and medical issues. This presents a challenging ethical situation for the nurses. The decisions made need to consider the ethical principles that guide nursing decisions. These principles include; nonmaleficence, beneficence, autonomy, and justice.

Based on the research data proving lowered survival rates of extremely preterm infants (Bell et al., 2022), and the increased risk of morbidities in case of survival of preterm infants (Cheong et al., 2018), the nurses in neonatal care, in this case, should consider the principles of beneficence, autonomy, and nonmaleficence in making decisions and managing the case. The beneficence principle will help the nurses make beneficial decisions for the patient. The autonomy principle will allow the patient to make independent decisions about their preterm infant. At the same time, the nonmaleficence principle will guide the nurses to do their best to support the survival of the infant.

Advice to the Nurse in Providing Care to This Patient in this Case Study

The nurse’s moral distress and concern for resuscitating the extremely preterm infant are based on their professional evaluation of the chances of survival and the medical risks upon the survival of the baby. Caring for extremely premature infants lowers the parents’ quality of life and leads to social and financial difficulties for the families (Petty et al., 2022). They are also required to respect the autonomy of the parents in deciding on the next course of care. At the same time, as care advocates, they should protect the best interest of the preterm infant against the interest of the family. This is ethically challenging. Despite their evaluation of the case and distress, they are still bound ethically and legally to provide care and support to the patient. Based on the ethical principles of beneficence and nonmaleficence, they are expected to attend to the patient and provide essential care to their extremely preterm infant, including resuscitation, to minimize the risk of the infant’s death despite the uncertainty of survival. The nurse should attempt by all means necessary to ensure the child survives, including providing life support systems such as incubators. The nurse should apply their knowledge, in this case, to reduce and prevent the risk of infections after birth, and understand and alleviate the patient’s stress.

Fostering More of a Cooperative, Team Environment in the Labor and Delivery Unit

The success of the operations in the Labor and Delivery unit in neonatal intensive care is dependent on the level of cooperation and teamwork within the unit. Ethical dilemmas and interprofessional and parent disagreements regarding the care for preterm babies are common in neonatal care. As a result, this undermines cooperation and teamwork within the unit and risks unwanted outcomes. The nurse manager in this unit is expected to ensure strong teamwork and cooperation. The nurse can employ strategies that improve the communication skills of all of the professional care providers and the patients to achieve desirable team cooperation.

Accordingly, research has identified that sensitive communication in neonatal intensive care units leads to the development of culturally sensitive family-practitioner interactions and the development of family-centered care (Davis et al., 2022). Therefore, sensitive communication can improve the interprofessional relationships within the unit and support the understanding of the patient’s stress. It can motivate the nurses and the patients to get involved in decisions regarding the preterm child. The nurse manager can ensure a more cooperative and teamwork environment and support the nurse-patient relationships by promoting frequent sensitive communication between the unit’s health care staff and the patients.

Effective Type of Leadership/Management Style in This Situation

The Delivery and Labor unit situation requires constant communication, teamwork and cooperation, motivation, exploring options despite uncertainties, and the application of holistic approaches to ensure positive outcomes. In this situation, the leader and nurse manager must be a good motivator, a good communicator, adaptable to changes, empathetic, able to work with diverse team members, inspirational, be able to see beyond uncertainties, be courageous and confident, and lead by an example. Therefore, a transformational leadership style would be the most effective in the situation.

Transformational leadership utilizes a framework of vision, inspiration, and intellectual stimulation to motivate people toward achieving desired goals and change (Yin et al., 2020). Transformational leadership in nursing promotes effective communication and positive attitudes, creating a healthy work environment for all healthcare employees and staff (Robbins & Davidhizar, 2020). Previous research has identified that applying the transformational leadership style in intensive and critical care settings improved the quality of nursing care in such care units (Kiwanuka et al., 2021).

References

Bell, E. F., Hintz, S. R., Hansen, N. I., Bann, C. M., Wyckoff, M. H., DeMauro, S. B., Walsh, M. C., Vohr, B. R., Stoll, B. J., Carlo, W. A., Meurs, K. P. van, Rysavy, M. A., Patel, R. M., Merhar, S. L., Sánchez, P. J., Laptook, A. R., Hibbs, A. M., Cotten, C. M., D’Angio, C. T., Sood, B. G. (2022). Mortality, In-Hospital Morbidity, Care Practices, and 2-Year Outcomes for Extremely Preterm Infants in the US, 2013-2018. JAMA, 327(3), 248–263. https://doi.org/10.1001/JAMA.2021.23580

Cheong, J. L. Y., Lee, K. J., Boland, R. A., Spittle, A. J., Opie, G. F., Burnett, A. C., Hickey, L. M., Roberts, G., Anderson, P. J., Doyle, L. W., Anderson, C., Bear, M., Callanan, C., Carse, E., Charlton, M. P., Courtot, J., Davis, N., Duff, J., Haikerwal, A., Williamson, A. (2018). Changes in long-term prognosis with increasing postnatal survival and the occurrence of postnatal morbidities in extremely preterm infants offered intensive care: a prospective observational study. The Lancet Child & Adolescent Health, 2(12), 872–879. https://doi.org/10.1016/S2352-4642(18)30287-6

Davis, B., Baggett, K. M., Patterson, A. L., Feil, E. G., Landry, S. H., & Leve, C. (2022). Power and Efficacy of Maternal Voice in Neonatal Intensive Care Units: Implicit Bias and Family-Centered Care. Maternal and Child Health Journal, 26(4), 905–912. https://doi.org/10.1007/S10995-021-03199-Z/TABLES/4

Kiwanuka, F., Nanyonga, R. C., Sak-Dankosky, N., Muwanguzi, P. A., & Kvist, T. (2021). Nursing leadership styles and their impact on intensive care unit quality measures: An integrative review. Journal of Nursing Management, 29(2), 133–142. https://doi.org/10.1111/JONM.13151

Petty, J., Whiting, L., Green, J., & Fowler, C. (2022). Parents’ views on preparation to care for extremely premature infants at home. Nursing Children and Young People, 34(3), 22–27. https://doi.org/10.7748/NCYP.2018.E1084

Robbins, B., & Davidhizar, R. (2020). Transformational Leadership in Health Care Today. The Health Care Manager, 39(3), 117–121. https://doi.org/10.1097/HCM.0000000000000296

Yin, J., Ma, Z., Yu, H., Jia, M., & Liao, G. (2020). Transformational leadership and employee knowledge sharing: explore the mediating roles of psychological safety and team efficacy. Journal of Knowledge Management, 24(2), 150–171. https://doi.org/10.1108/JKM-12-2018-0776/FULL/XML

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Nurse managers and leaders are faced with situations every day that provide them with moral, ethical, and legal challenges. While many of these situations don’t have one right answer, the process of working through them to find a solution requires careful thought and deliberation, utilizing ethical principles, to come to a workable solution.

Ethics in Nursing Leadership

It is with these principles in mind that we ask you to look at the attached situations and work through the way that you would handle them if you were placed in these situations as a manager.
Directions: Please choose one of the situations provided in the assignment and answer the questions that follow it. Please incorporate at least two additional scholarly sources (aside from your text) from the literature/websites when providing your responses. Please be sure that the paper is formatted in APA format with a title page and a reference page.