Introduction
When specifying a personal nursing doctrine, the single nurse must non merely reexamine his or her ain scheme of values and beliefs, but must besides confirm their ain personal assurance in their value system. By taking into consideration the models of theoreticians, such as Kohlberg ( 1981 ) and Gilligan ( 1982 ) , nurses will better understand their ain personal values every bit good as the values of the profession ( Burkhardt & A ; Nathaniel, 2008 ) . Theorists of the recent yesteryear must be viewed with a professional regard in order to guarantee that a nurse coming into an progressively hard wellness attention environment has a nucleus sense of their ain personal and professional values and is besides flexible plenty to react to single obstructions, which they may meet over the class of their nursing calling.
Aim
The intent of this paper is to depict an event in which two or more personal values were demonstrated and depict how these values influenced the professional determinations that were made. It will further measure the degree of development of these values. Personal values will be differentiated from those of the establishment and in will be discussed where these values are compatible and where they result in struggle. Finally, it will depict how these values align with the specific dogmas of the American Nurses Association Code of Ethics.
Description of Event
Nurses have one patient and one event that stay with them throughout their calling. It is the patient that they ne’er forget, the interaction that will act upon all hereafter interactions, and the event that leads to their self-awareness.
I encountered this really patient, the 1 who forced me to accommodate my values with those I pledged to care for, early in my calling on the intermediate unit. His diagnosing was pneumonic fibrosis. My challenge was to keep his O impregnation. His attention consumed the bulk of my clip, as I had him on both a rhinal cannula and nonrebreather mask to keep equal oxygenation. I assisted him in his all self-care activities in order to conserve his energy and monitored him to all his trials that displacement. Throughout the twenty-four hours, I learned he was a widowman, had two girls, and was an devouring dance hall terpsichorean.
When I returned to the unit the following twenty-four hours, he was once more assigned to me. As I was acquiring study, the ward secretary advised me his O impregnation had dropped to 70 % . I went to look into on him and found him really dying, and fighting to take a breath. I knew I had to set up his codification position and began to inquire him why he was so dying. His response was his girls would get from out of town in a few hours and he knew he did non hold that long. At that clip I began to discourse whether he wanted intubated and the deductions of such a heroic attempt, explicating that he would more than probably ne’er survive extubation. He begged me to make what was necessary for his girls to see him one more clip.
I called his doctor, received an order for Ativan, and was advised to hold the house officer see the patient. The house officer arrived in the room and understanding his hapless forecast, advised me to merely go on comfort steps. However, since I had discussed this at great length with the patient and was aware of his wants, I felt compelled to move more sharply. I once more called his doctor and explained to him the conversation I had with the patient. He gave me the order to name anaesthesia and have the patient intubated and transferred to the Coronary Care Unit.
Once the patient was intubated, I accompanied him to the Coronary Care Unit and advised them his girls would be geting shortly. Shortly after returning to the unit, I was paged to the phone. Coronary Care wanted to talk with me. The patient ‘s nurse advised me that he had expired proceedingss prior to his girls making the infirmary. They were bespeaking to talk to me, as I was the last individual to speak to their male parent.
Throughout this experience, I maintained my personal values of household, compassion for others, unity, and honestness. Although I knew as a nurse, cannulating this patient was ineffectual, I had to honour his wants. However, I was besides obligated to do certain he was good informed of his forecast and the effects of cannulation.
Personal Values ‘ Influence on the Ethical Dimension of Decision Making
Personal values are alone single beliefs, attitudes, criterions, and ideals that guide behaviour, life experience, and determination devising. These values are arranged in a hierarchy based on the degree of importance the single topographic points on each value. Therefore it is imperative that nurses acknowledge that another ‘s personal value system flat differ from their ain. Identifying one ‘s ain value system through self-contemplation and self-reflection is the first measure in ethical determination devising ( Bandman & A ; Bandman, 1995 ) . The 2nd measure is understanding the value system of others, and admiting and esteeming them as every bit valid as one ‘s ain system ( Yeo & A ; Morehouse, 1996 ) .
In this state of affairs, I knew cannulating the patient was non set uping his forecast, but his strong household values compelled me to recommend for the fulfilment of his wants. Through our honest interaction, I was comfy that the patient was good informed that this was a agency to protract the inevitable. I understood he was trying to give his girls closure. Of all the nursing actions over the two yearss I cared for this patient, the most meaningful to me was the clip I spent speaking with this patient. I was able to associate to his girls and truly relay his last conversations, conveying how of import household was to him. More significantly, I recognized his household values and why he was bespeaking cannulation.
Degree of Development of Valuess
Psychologist Lawrence Kohlberg modified and expanded upon Jean Piaget ‘s ( 1963 ) work to organize a theory that explained the development of moral logical thinking. Kohlberg ‘s ( 1981 ) theory of moral development outlined six phases within three different degrees. Kohlberg extended Piaget ‘s ( 1963 ) theory, suggesting that moral development is a continual procedure that occurs throughout the lifetime. Through an apprehension of Kohlberg ‘s ( 1981 ) theory, nurses better understand their values and how they relate to the ethical determinations they make ( Burkhardt & A ; Nathaniel, 2008 ) .
The post-conventional degree, besides known as the principled degree, consists of phases five and six of moral development ( Kohlberg, 1981 ) . There is a turning realisation that persons are separate entities from society, and that the person ‘s ain position may take precedency over society ‘s position ; they may disobey regulations inconsistent with their ain rules. Post-conventional morality positions regulations as utile but mutable mechanisms-ideally regulations can keep the general societal order and protect human rights ( Kohlberg, 1981 ) .
In Stage Five ( societal contract driven ) , the universe is viewed as keeping different sentiments, rights and values. Such positions should be reciprocally respected as alone to each individual or community. Rules that do non advance the general public assistance should be changed when necessary to run into “ the greatest good for the greatest figure of people ” ( Kohlberg, 1981 ) . This is achieved through via media. My degree of value development falls into this degree, as I was able to esteem the values of my patient and base my attention on his values.
Personal Values Versus Institutional Values
Several congruencies exist between my personal values and the establishment ‘s values. The words in the mission statement that are emphasized are patient-centered healing, quality attention, and balanced precedences related to patient attention, community committedness, fiscal wellness and doctor and employee wellbeing. My personal values include a strong sense of compassion for people and a passion for excellence.
However, incongruencies exist when single committedness is non plenty to maintain patients safe and their attention effectual. There is a direct correlativity between staff coaction and patient results. Duty for furthering an environment of teamwork remainders on the shoulders of leading, which is presently falling short of including the best involvement of the patients and all members of the health care squad in their determination devising. This is a clip for alteration within the organisation, as we have late been bought by a for-profit organisation. I foresee these incongruencies as impermanent.
Valuess Alignment With ANA Code of Ethical motives
My values are in alliance with the ANA Code of Ethics ( 2001 ) dogma 1.4, which states that the nurse respects the patient ‘s right to self-government or liberty ( Burkhardt & A ; Nathaniel, 2008 ) . It farther provinces that the nurse is obligated to supply accurate, complete and appropriate information that will ease the patient in the decision-making procedure. I personally did non back up my patient ‘s determination, but respected his rights and was comfy that he had accurate information to do his determination.
Decision
Harmonizing to Burkhardt and Nathaniel ( 2008 ) , ethical relationships are grounded in a self-awareness of one ‘s ain values and the assurance to portion these values with others. We must be committed to the of all time germinating procedure of value development and esteem the values of others. These constructs are the foundation for ethical determination devising and ease the nurse in struggle declaration when personal, professional and institutional values are non in alliance.