A nurse is a professional that deals with managing of patient’s health care. It requires sacrifice and dedication to ensure the patients get quality healthcare. However, it is a profession faced by many challenges in the course of duty (Corsaro, 2011). One ought to deal with these challenges in a professional way to ensure efficient health care is always provided to patients. Personally I work in a ward that takes care and monitors patients recovering from abdominal surgery.
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I also work in the maternity delivery department for patients who require a caesarian operation. My role as a nurse in the caesarian section is to assist in the surgery in conjunction with the medical doctor. I also give advice and emotional support to the patients during and after surgical operations. Additionally, I supervise the patient compliance on adherence to medications given to them. I also advise the patients on taking proper diet during the hospitalization period. One of the common dilemmas faced is ethical dilemma in the caesarian section during surgery. It is a common problem that I have encountered in the workplace.
A personal scenario experience of problems during delivery operations
Mary has been following her prenatal sessions strictly. Her mother and her sister always accompany her to the clinic for checkups. However, Mary has been taking cocaine secretly (partially due to depression from her marital problems) without the knowledge of her family. Her nurse suspects it, but Mary has fervently denied it. She also refused to undertake a drug test, even though, her nurse consistently explained the hazards of cocaine to her and her unborn child. Her family members are of a similar opinion with the nurse on this matter, but Mary has found it difficult to quit taking cocaine. Disappointed, the nurse reported the case to the hospital’s ethics committee. On a Friday night, Mary, 20, is rushed to the hospital going through abdominal pain.
The patient’s past delivery records show that the patient has had two subsequent C-sections. Physical examination has shown normal weight and blood pressure. The fetus is in normal position, and the pulse rate is regular. Before, Mary has been complaining of chest pains and coughs a lot. The nurse fears that Mary may have oxygen deficiencies due to her recent chest problems and may therefore not survive a vaginal delivery.
Mary and her family insisted on undergoing a vaginal delivery (VBAC). They fear that it may not be possible for her to survive another cesarean delivery. Her mother, especially, has undertaken to sue the hospital if it carries out another C-section on her daughter. The hospital’s ethics committee and the nurse find themselves at crossroads. If they respect the patient’s autonomy, there is a high risk of losing either the baby or the mother’s life. And if they were to perform another C-section the patient is likely to develop complications in the future.
Literature review on ethical dilemmas during delivery
Substantial research work has been carried out on the ethical issues that are faced during delivery. In this case, there are two conflicting sensitive issues. Whether to strictly adhere to the principle of autonomy (Miller, 2013). The principle of autonomy states the patient has a right to make a decision whether to accept the medical decision made by the doctor or not. Adhering to the principle of autonomy and carrying out normal vaginal delivery puts the life of the mother in danger. The research questions in this article are whether one can ignore the principle of autonomy in case of ethical dilemmas during delivery and which law is paramount.
The purpose of this article is to give a guideline on what situation the nurses are supposed to deal with as well as handle ethical dilemmas during delivery (Miller, 2013). The problem in this article is that it doesn’t analyze the outcomes that may appear as a result of taking the principle of autonomy as secondary. The research of this article involves both primary and secondary sources of data.
The primary sources included interviewing of both patients and experts on the view of dilemmas faced during delivery (Miller, 2013). The secondary sources involved reading from journals and other scholarly articles that discuss ethical dilemmas during delivery. The dependent variables in this study include the patient’s decisions and the outcome of the operation. They will vary from patient to patient and the patient’s condition. The independent variables include the underlying ethical principles and legal restrictions.
According to research by Charles Sonya she considers the principle of the beneficence to be paramount over that of autonomy. The principle of beneficence is based on doing well to the patient and no harm. She considers repeated vaginal deliveries dangerous and hence considers the principle of autonomy secondary. Charles takes the principle of freedom to be vague in consideration of how vaginal deliveries are critical to patients who have oxygen insufficiency. In this case, according to his research, he opts one to go against the principle of autonomy and save the patient’s life.
This differs from an article written by Thompson. According to the article, one ought to weigh between the two dilemmas.
The purpose of the research article is to explain ways to come up with solutions and make wise decisions regarding the choice between the caesarian and the normal vaginal delivery. Additionally, its purpose is to describe all possible solutions to the problems and analyze the advantages and disadvantage of each solution. In his view, both principles are paramount in the case of a caesarian section, and one ought to select the most appropriate solution according to the situation. According to his research, patient still survive the fatal vaginal delivery by use of oxygen support delivery (Miller, 2013). Additionally, ignoring the patient’s and family decision might lead to serious consequences both for health workers and hospital in case the caesarian operation turns out to be fatal (Corsaro, 2011). The sources of this article include both secondary and primary sources of information.
The primary sources mostly involved interviewing of health care workers and their view on challenges faced during delivery. It also entailed questionnaires that were given to patients who had already undergone the operation. The secondary source, of information involved the use of the internet. The internet provided previous work that had been done and investigated by different authors. The work was in the form of journals, scholarly articles and research work of various universities.
The independent variables included various ethical principles such as the principle of beneficence and autonomy. The dependent variables include the medical conditions of the patient as well decision that he/she makes before delivery operation. The problem of this article, it doesn’t give a conclusive decision but leaves the medical doctor and nurse to make a decision about it.
In both articles give a view and ways of solving the problems that face delivery. I would like further research to be carried on both articles about the consequences of ignoring the principle of autonomy and doing the best to save the patient’s life. Ignoring on the principle of autonomy and going by saving patient’s life has prior consequences. In case the patient dies during caesarian operation, the nurse and the medical doctor in charge during the process will be fully accountable.
On the other hand, following the principle of autonomy, in case a patient dies during vaginal delivery, a nurse shall feel so depressed on the issue. However, according to nursing education the principles should be followed appropriately to avoid facing adverse legal consequences.
In conclusion, more research should be carried out on various types of ethical dilemmas faced during delivery. Scholars should set up a conventional framework on how to handle such difficulties to ensure optimal patient care and human respect.
G. Miller, D. (2013). The Ethics of Hospital Regulations on Vaginal Births after Cesarean Sections. 7, 13-13.
Rita Corsaro, M. (2011). Patient Requested Induction of Labor – Examining an Ethical Dilemma. 8, 15-15.