Taking a Stand

Answer

Introduction

            The provision of proper care is key to any nursing profession or institution. Nonetheless, as a leader in the field, it is more critical to understand the ethical, moral and legal concepts related to the provision of care in order to guide other nurses towards the provision of proper care. It is also clear that during the practice, a nurse may conflict with a patient or the institution may ignore certain needs of its staff and patients leading to conflicts within the institution and poor practices in some cases. This paper evaluates the role of a leader in solving critical situations in the nursing practice. Based on a real case, the paper gives an analysis of how I could be able to take a stand that could help solve a dilemma in my institution. Having taken the Keirsley Temperament Sorter test, my report indicates that I am a Guardian. In this regard, I will further describe how this trait could influence the decisions made towards solving the ethical dilemma in my institution.

Ethical Dilemma at the Work Place

            Ethical issues in the provision of care are increasingly rising with the increased diversity among the patients who visit hospitals in order to receive different forms of care (Jie, 2015). Although nursing bodies like the American Nursing Association and the International Council of Nurses provide guidelines in terms of code of ethics to guide the conduct of nurses in various situations, there are emerging factors that pose a major threat to the provision of care by nurses. One such issue is the provision of care to the Islamic patients. During my time as a nurse leader in a national hospital with over 500 bed capacity, I witnessed a case where the patient, a female Arabic woman refused to be attended to by male doctors on call. Her main concern was not on the quality of service but the risk of going against her personal (Islamic) ethics by letting the male doctor attend to her. At that point, the patient was complaining of a sharp pain along her chest area. According to the patient, this pain was sharpest whenever she took deep breaths or coughed. Evidently, this was a critical condition that would require emergency diagnosis since it may have been a heart condition. Despite this, she could not allow any male doctor or nurse to attend to her.

            According to Booth and Joseph (2013), Islamic women are prohibited from exposing their awrah or body parts to anyone except their rightfully wedded husbands. Dressed in a Hijab and covering her entire body except for the eyes, it was clear that this patient was a staunch Islam who would not be willing to go against her believes. On the other hand, Atkinson (2015) states that despite the fact that a woman may be attended by a male doctor not related to them by blood or marriage or simply, a non-maharam male, the two should not be in a room alone since this in Islamic law increases the chances of adultery. According to Islam, both adultery and "proximity" to the act are considered illegal (Adamczyk & Hayes, 2012). This therefore posed a major challenge to the nurses and doctors on call and thus the need for the management's intervention. The nurse manager, was immediately informed and was able to recall a female doctor who had just completed her shift and was just about to leave. Although this helped to solve the problem, the nurse manager's move was very risky since if the female doctor had left, it would take a while before identifying another or calling another who may have left earlier. The patient would therefore have suffered or her condition may have worsened with time.

            As a nurse manager or leader, I could request the woman to accept that the current male doctor on call to attend to her in the presence of another female nurse or even nurses if she preferred. In my opinion, this would allow  the patient to receive immediate care towards identifying whether she was suffering from a life threatening heart condition or gastroesophageal reflux disease (GERD). Since a non-maharam male is also not allowed to touch the patient, I could request that the male doctor attends to the patient with his gloves on to ensure there is no direct body contact and thus the patient's ethics could be respected. Perhaps convincing the woman to accept these options could be difficult since she already had her own believes, however, I would stick to the decision that she allows the current available doctors attend to her since her condition is equally critical. If the condition would be a regular check up, I could consider calling in a female doctor to attend to her. The dilemma presented in this case therefore presents aspects of ethics, legality and morals. According to Badzecka et al (2013),legal aspects have to do with the set laws that govern various forms of interactions, morals are concerned with the aspects of "good" and "bad" where as ethics has to the with the acceptable norms shared by people with mutual beliefs. Consequently, by emphasizing that the doctor on call attends to the patient, I will be abiding to the hospital's legal requirements on job allocation and roles distribution. Although I may have gone against the patient's ethics, the presence of another nurse during the treatment of the patient helps to reach a common ground with the patient since her condition is critical and needs immediate attention. The option to have the doctor attend to her with gloves help to ensure respect for her ethics and good morals.

Impact of the Guardian Role to the Dilemma

            The Keirsley self-assessment test is an effective tool that helps in the decision making process for all generations of people based on the different stages in life. As a Guardian leader, the Keirsley report notes that I am interested in the smooth running of social institutions, keen on following procedures, serious in duties, practical, humble, respect traditions and able to sustain fun relations with colleagues to create dependable relations. Due to the belief in the rule of law and order, I would definitely emphasize on abiding to procedures while attending to the dilemma and thus the choice to have the doctor on call attend to the patient. Nonetheless, I would be keen to respect the Islamic beliefs (customs) of the patient and thus have a male doctor and another nurse within the room as the doctor attends to the patient. Similarly, I would  request the doctor to touch her with gloves as a way of respecting her beliefs too. Due to the patient's possible critical condition, it is only practical to have her attended to immediately by the available doctor despite their gender. Waiting for another female doctor to come from her home would be impractical and thus the need to be practical would guide the decision to have the available doctor attend to the patient. Lastly, the need build trustworthy relationships would lead to the decision to utilize the available team and for all these reasons, the Guardian role would influence the proposed decision positively. It would inspire me to observe the legal, moral and ethical standards related to the issue.

ns