A successful nurse practitioner (NP) is one who always provides responsible care to each of their patients. According to the American Nurses Association’s Code of Ethics for Nurses, there are 9 provisions for nurses to follow. They call for prioritizing patient safety while holding accountability for the nursing practice. While the Code of Ethics is clearly outlined, it’s not always so simple to put these ethics into practice. Working as an NP often involves serving many patients, some of whom may raise ethical questions that challenge the ability to provide optimal care. These scenarios can lead to ethical dilemmas for NPs, making it essential to find ways to balance patient care with ethical standards. For NPs struggling with these challenges, here are two common situations you might encounter and guidance on navigating them.
Informed Consent
As stated in “Informed Consent: Ethical and Legal Considerations for Advanced Practice Nurses,” informed consent goes beyond simply obtaining the patient’s signature. To ensure this obligation is fulfilled, NPs must share all available information about the treatment process with the patient and any possible outcomes. However, some obstacles may arise in this process, leading to ethical dilemmas for NPs.
Medical terminology isn’t as accessible to understand for the everyday patient. Patients may rely on their medical provider to know what’s best for treatment and may accept it without question despite not fully understanding what it may entail. In some cases, a patient’s native language may be different from their NP’s, creating an additional barrier to interpreting their medical information.
In cases where NPs must be sure to obtain informed consent, NPs can provide patients with documentation that clearly defines all relevant treatment information in language that is easily accessible. Documentation can also include a FAQ section for patients to reference outside of their appointments. For patients with a possible language barrier, strive to have documentation in their native language, or work with a translator to ensure messages are shared correctly. Most importantly, NPs must foster a culture of openness and compassion. When a patient feels comfortable in your practice, they are more likely to come to you with questions or concerns about their treatment.
Vaccination Refusals
As social media platforms have given way to misinformation surrounding vaccines, NPs can expect to meet with patients and/or parents of child patients who refuse vaccines. Although parents can refuse vaccinations based on specific types of exemptions, the case still comes at a struggle. The NP may feel conflicted knowing the vaccine will be beneficial for the patient and will prevent them from contracting dangerous diseases, especially if the patient is a child. However, NP must also respect each patient’s autonomy. In situations where NPs experience this conflict, here are three steps to ensure patients are fully informed of all potential outcomes while respecting their autonomy:
- Educate and Inform: Provide clear, evidence-based information about the benefits and risks of vaccines, addressing any misconceptions and offering to answer questions to help the patient or parent make an informed decision.
- Respect Patient Autonomy: Acknowledge and respect the patient’s or parent’s decision while documenting the discussion and the patient’s decision thoroughly, even if it conflicts with your professional recommendation.
- Collaborate and Compromise: Explore possible compromises, such as a delayed vaccination schedule or focusing on essential vaccines, to find a solution that respects the patient’s concerns while still offering some level of protection.
The Bottom Line
Navigating ethical challenges is an essential aspect of an NP’s role, requiring a delicate balance between professional responsibilities and patient autonomy. Ethical dilemmas for NPs often arise in these situations, demanding thoughtful approaches to maintain ethical standards. By providing thorough education, respecting patient choices, and seeking collaborative solutions, NPs can uphold their ethical standards while delivering compassionate and effective care. Ultimately, the goal is to ensure that patients are fully informed and feel respected in their healthcare decisions.
