DNP 815 Describe a recent or current ethical issue you have faced in nursing practice, or which has attained national attention

Answer 2 for DNP 815 Describe a recent or current ethical issue you have faced in nursing practice, or which has attained national attention

According to Jorgensen & Kollerup (2021, p 486) nursing documentation “is a written or electronically generated record that reflects the activities of nursing care and can range from nurse’s assessment of subjective and objective data, analysis of the situation, care planning, implementation and evaluation.” The ethical issues arises when there is a lack of awareness of ethical dilemmas in nursing documentation that may present or heighten harm and risk to patients. Documentation is crucial for pinpointing the nursing interventions done for the patient and hence highlighting progression of care, safety issues, and legal shielding for nurses. However, due to increased workload nurses struggle to document efficiently and effectively (Jorgensen & Kollerup, 2021) especially in this era of COVID 19. In addition, nurses may relay pertinent information about the patient at the bedside handoff but forgets or by choice did not enter same in the electronic health record or the details may not be passed on orally or documented. Jorgensen & Kollerup (2021) suggested that the choice of documenting specific data is dependent on the attitude, opinions and viewpoint of the nurse.

The ethical dilemma arises when the choice of stance taken by the nurse such as omission by nurse’s choice or patient’s request, partial or in complete documentation or inappropriately worded notes can have consequences to the patient and continuation of care.  Nursing documentation addresses needs of patients and if not appropriately address may result in neglect in providing care to patients. In addition, the lack of ethical awareness can lead to nurses set in their routine which can be harmful to the patient if not done according to orders. For example the nurse has the patient for her tour of duty for a few days and she has been providing care in a specific manner but there was a change or modification in the patient’s order but routinely providing care and lack of checking current changes can result in harm to patient which may not be captured in documentation.  Avoiding harm to patients by documenting accurately is essential. Also, patient expressing autonomy such as right to refuse or requesting clarification to make informed choices is sometimes not captured in the nurses’ documentation. In addition, fairness in documentation is essential in documenting patients’ right to refuse treatment or care (Varkey, 2021).

Documentation in the electronic health records of patients’ results and treatment is crucial in this scholar DNP project as failure to document would mean that the patient was not screened for Methicillin-Resistant Staphylococcus Aureus (MRSA) or the patient was tested but the result was not entered or followed up. This may be risky or harmful to the patient and others as treatment may be delayed and proper isolation technique would not be commenced on time. The infection control nurse and this scholar will be auditing the patients who are admitted records to ensure that the patients’ charts are updated with their documentation of screening that was done and date and time and the unit policy manual for admission will reflect the change. Overall documentation is an issue that nurse educators and nurse manager will constantly need to address so that the progression of care for the patient may be sequential and less harm will be meted out to the patient, due to delayed documentation or omissions.

References                 

Jorgensen, L., & Kollerup, M. G. (2021). Ethical dilemmas in nursing documentation. Nursing Ethics. https://doi-org.lopes.idm.oclc.org/10.1177/09697330211046654

Varkey, B. (2021). Principles of Clinical Ethics and Their Application to Practice. Medical Principles and Practice, 30(1), 17-28. https://lopes.idm.oclc.org/login?url=https://www.proquest.com/scholarly-journals/principles-clinical-ethics-their-application/docview/2501298059/se-2