Verified Document

Ethics As A New Graduate Of Six Term Paper

Ethics As a new graduate of six months working night shift on a small cancer unit, I am faced with a dilemma. Mr. V has been in and out of the unit several times over the last few months. He has liver cancer and has gone through several episodes of chemotherapy. His wife has been staying with him since his admission. There are two RN's on this unit.

Mr.V recently joined the hospice program. His current admission is for pain control with orders to start a morphine drip to be regulated for pain control.

The only set parameters indicated by hospital policy are to decrease the drip when respirations are less than twelve breaths per minute. Mr. V has requested that the drip be increased several times during my shift. Even though he does not appear to be in any discomfort, I increase the drip. On my final round of the shift, Mr. V requests that the drip be increased again, stating that the pain is increasing. I note that his respirations remain stable at 12 breaths per minute.

An Ethical Question

This man is dying of liver cancer. For a while, morphine will control his severe pain. However, it may further reduce respiration. As a medical professional, I feel responsible to give this patient enough morphine to ease his suffering without causing him harm. However, I must consider the legal and ethical issues at hand.

On one hand, if I continue to increase his pain medication, I may be accused of overprescribing narcotics or hastening death. On the other hand, my patient has a right to proper pain management. For most terminally ill patients, pain can be controlled and, as a hospice worker, I am responsible to provide pain control.

In the past, many nurses did not fully understand pain control. As a result, many terminally ill patients were denied enough medication to relieve their pain because nurses were afraid of addicting patients or of killing them.

The medical industry and the public believed many untrue statements...

People were afraid that morphine would lead to problems with drug addiction and that drugs would lose their effectiveness after a long period of time.
Today, however, medical professionals know a lot more about pain control. The American Nurses Association's (ANA) Position Statement on Promotion of Comfort and Relief of Pain in Dying Patients completely supports the use of full and effective doses of pain medication for dying patients.

We now know that the pain control process involves using a "baby steps" approach. This approach uses small doses of analgesics, such as aspirin, then using stronger drugs, such as morphine, to maintain pain control. Medical standards dictate that pain medications should be given at regular intervals and in large enough doses to maintain a patient's comfort level and pain control.

Hospices and oncology services report that respiratory depression is uncommon in patients who are receiving opioids for the control of pain. Pain is itself a respiratory stimulant, and the opioid effect on the respiratory center diminishes rapidly with chronic use. If the patient is terminally ill and the dose of opioid required to produce comfort does happen to depress respiration, it is still reasonable to allow the undesired effect (respiratory depression) in order to achieve the desired effect"

In addition, according to the ANA, increasing a dying patient's dose of medication to achieve adequate symptom control is ethical, even if it causes the person to die sooner.

Goals of All Involved

Mr. V is in a hospice, where he is expected to die. The main goal of the hospice is to make the quality of the patient's life the best possible during his final days.

The main objectives of the hospice are to control pain and other symptoms caused by the disease and by the medications he is taking, and also to prevent depression if possible.

Because…

Sources used in this document:
Bibliography

Strevy, S.S. Myths & facts about pain. RN, 42-45. 1998, February.

C. Junkerman and D. Schiedermayer, Practical Ethics for Students, Interns, and Residents, 2nd Ed, Frederick, MD: University Publishing Group, 1998.

American Nurses Association. Code for Nurses With Interpretive Statements. Kansas City, MO: the Association. 1985.

Strevy, S.S. (1998, February). Myths & facts about pain. RN, 42-45.
Cite this Document:
Copy Bibliography Citation

Related Documents

New Nurses and Reality Shock
Words: 1000 Length: 3 Document Type: Research Paper

Reality Shock Nursing One of the biggest challenges for modern nursing is the challenge that newly graduated nurse's face once they leave school and enter a full-time health care facility. Colloquially known as "reality shock," this is the view that despite years of training, time in the clinical setting, and even prior experience, the stress of the new nurse is that they are unprepared for the pace, attitude, culture and expectations

Ethics Program Developing an Ethics
Words: 1667 Length: 6 Document Type: Essay

Priority of values should be identified so as to aid the organization avoid breaking laws by following the stipulated requirements of operation. The top three of four values should be reviewed to help the organization determine which values currently help it fulfill its mandate. For example, in the accounting department, the organization should identify accuracy and confidentiality as the key values to the success of the department. Values needed to

Ethics in Mechanical Engineering Ethical
Words: 1132 Length: 4 Document Type: Essay

This definition implies that organizational commitment is essentially a conscious, value-based process." From this perspective, Bob should not have any ethical conflicts with his job if he is to be considered committed to it. Yet at the same time, someone who has no moral problem with helping to produce weapons that cause such pain and mass destruction may not be of the moral character to be trusted with such a

Ethics: Assisted Suicide What Is Assisted Suicide
Words: 3182 Length: 9 Document Type: Term Paper

Ethics: Assisted Suicide What is Assisted Suicide? Recent Issues Theories: Is it Ethical? The Death with Dignity Act (DWDA) The Deontology Argument Virtue Ethics The Velma Howard Case (Assisted Suicide) Peter Williams Case Ethics: Assisted Suicide Physician-assisted suicide, is this really an ethical technique? A lot of people feel strongly on both sides of this concern. However, on April 13, 1999, the most known doctor executed an assisted suicide, Dr. Jack Kevorkian, was given a sentenced of ten to twenty-five

Ethics in Southwest Airlines an
Words: 7676 Length: 18 Document Type: Term Paper

(Southwest Airlines Corporation) The employees are always put first at Southwest Airlines, and according to the CEO Herb Kelleher, who was responsible for founding the company Southwest Airlines, the philosophy that employees come first is deeply embedded in the psyche of the company, and if the employees of the company are happy and contented and fully satisfied with their work, then they will most definitely take better care of the

Ethics and Firm's Goals Agency Problems: The
Words: 524 Length: 2 Document Type: Essay

Ethics and Firm's Goals Agency Problems: The shareholders of a corporation are its owners, and these oweners control management by electing a board (with most smaller shareholders voting "by proxy" or not really voting at all) that oversees the executive positions in the corporation, who in turn oversee the operations and management of the firm. An agency relationship exists to separate the personal liabilities of the shareholders/owners and the actions/resources of

Sign Up for Unlimited Study Help

Our semester plans gives you unlimited, unrestricted access to our entire library of resources —writing tools, guides, example essays, tutorials, class notes, and more.

Get Started Now