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NAVIGATING ETHICAL DILEMMAS WITHIN THE SCOPE OF PRACTICE�PRESENTED BY NJERI GAITHO

DIAMOND LEISURE LODGE AND GOLF RESORT

15-17 NOVEMBER 2023

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WHAT TO DO?

  • Ethical dilemma is when one is challenged to chose between conflicting principles or values.

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  • Ethical dilemmas involve-

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  • Organizational values( code of conduct/ ethics)

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  • Nursing values( Nursing ethics)

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  • Health care provider values

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Ethical dilemma vs moral distress

  • Ethical dilemma- nurse must chose from two conflicting values

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  • No matter what choice they make , there are consequences

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  • Moral distress – right cause of action is known to the nurse

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  • However limited by forces outside their control.

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MAKING A CHOICE

  • Ethical issues that present as dilemmas in nursing are ecountered daily in the line of professional duty.

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  • Honesty vs concealing information- patients diagnosis, benefit of interventions or none.
  • Coordinate and collaborate with multidisciplinary health care team member in planning and providing patient perioperative care(2)

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  • Competence of specialist vs seeking alternative.
  • Participate in making ethical decisions regarding patient care outcomes(8)

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MAKING A CHOICE

  • Health care needs vs resource allocation
  • Contribute to specifications and quality checks to determine suitability of theatre structure, devices and supplies required for optimum services(15)
  • Advocate for quality perioperative care(16)
  • Autonomy vs beneficence
  • Participate in making ethical decisions regarding patient care outcomes(6)

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MAKING A CHOICE

  • Science vs beliefs( religious , cultural)

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  • Art 11(b)recognize role of science and indigenous technologies

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  • Participate in research in and utilize research findingsto promote quality perioperative practice(10)

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  • Confidentiality vs duty to warn
  • Promote patient safety in all perioperative phases(17)

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How do I navigate

  • Is the decision legal?

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  • Constitution, legislation, policies, rules SOP’s

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  • Does it prevail in the face of scrutiny by stakeholders?

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  • What was the motive / driving force

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  • Does it align with policies and set values?

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  • Omission ,abuse of power, supression

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How do I navigate

  • Will the decision cause more harm or good to the vulnerable person?
  • Acting beyond scope of practice

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  • Does the decision affect/ maintain the social good?

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  • Environmental impact

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Provide evidence

  • Document the process
  • All discussions
  • Assessments
  • Interventions
  • Patients decisions
  • Accurate documentation serves as evidence that the nurse has fulfilled their ethical and professional duties

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  • Acknowledgement
  • ANA
  • Constitution of kenya
  • Scope of practice for perioperative nurses in kenya

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