Australian references in academic writing

Nurses and Ethics of Code

Regardless of what institution or department a person is in, there would be violation of the laws in the workplace. Healthy workplaces basically contribute to the job satisfaction of all the people who are working there. Let alone job satisfaction, it leads to and actually affects patient safety. (Browne, 2009) Now many scholars and experts are looking into the ethics of a workplace and how they go onto affect the workers and the patients. If we examine this in the simplest terms, we see that patient safety is the major goal that every hospital is aiming for. It is true that job satisfaction is required, but if a nurse or a doctor is not satisfied with his job, his work output will not be as good as it can be. This will eventually harm the patient and contribute towards a poor prognosis. Thus, the ethics of a workplace are very important and they contribute to the eventual outcome of that place. (Browne, 2009) The major issue here is that how can an organization make an environment healing and therapeutic for the patients and their families, when the same organization is proving to be harmful for the health staff that is present there. (Jackson & Daly, 2010)

The International Council of Nurses Code of Ethics states that all the nurses have an important responsibility to take appropriate action to protect patients when their care is being hindered by either a co-worker or any other person. Other international and local nursing codes of ethics and other standards that are place also tell the nurses to take action against a person if they putting a person at risk. If we look at this, then a patient's life can be put at risk by illegal, unethical or incompetent acts of a person. There is no hesitation in stating that these acts can be committed by other nurses or even doctors and surgeons.

A code of ethics is basically established on principles of beneficence, non-maleficence, veracity, justice, honesty, autonomy and respect. These codes are made when looking in to all the aspects of the health care system. The people making the code know that guidelines that they are setting and why these rules would be required. The Australian Association of Occupational Therapists code of conduct (2001) stated that a person should be loyal to their organization and he or she should show a decent amount of respect and dignity. In this excerpt, it was strictly stated that a person's responsibility as a member of the society on moral and legal grounds overrides their loyalty to the organization at all times. This means that if the therapist is ever in doubt of the action or the function of their colleague, they can report it to the National Office of OT Australia or the territory Member Association.

Even though, it appears like the moral thing to do and it appears like an easy task, it really isn't. Taking an action at your workplace with conscious knowledge or providing harm to your own colleague or even someone at a senior position than you takes a lot of guts. According to literature, when nurses go on to take a moral step to secure the safety of the patient and the quality of care, it can hurt the nurses to quite an extent. (Ahern & McDonald, 2002)

As it was stated earlier, when there is a violation of a law, the nurses are told to report to an authority. Now many a times, the authority fails to take an action or fails to even respond to the reporting, this therefore leaves the nurses in doubt in the first place. (Johnstone, 1999) Thus, here the nurses are left with the choice of either to stay silent, leave the job where they are working or the last step which is whistle blowing.

We are considering look at that what factors actually cause a person to address instances of criminal behavior. In various North American studies on peer reporting of co-working violations, it has been suggested that most of the nurses are reluctant to report. (Lawton&Parker, 2002) However, Johnstone (2002) stated that when nurses are pushed beyond a certain limit, it is then that they decide to act and take an action towards whatever wrong that is happening.

Therefore, they are many factors that would influence a nurse's decision to report the risks or wrong doings. First and foremost, the individual characteristics of a person play a pivotal role. These characteristics are basically the professional and the personal ethics a person has. These would be discussed in more detail below. The situational factors also play a great role in determining whether someone will report a violation or not. For instance, if a nurse is merely trying to create an issue, he can go on to report the minutest negligence. However, most of the nurses would over look small mess ups. Most of the time, the intentions of the wrongdoer and the secret of the wrongdoing are so malicious, and then one is left with no choice but to report. Last but not the least, the organizational issues also come into play. If the corporation that will be reported about actions will actually go onto do something.

The term non-Maleficence in Latin means 'above all, do no harm.' This basically obliges the person to not harm or injure anyone. This goes on to prevent people from wrongfully harming a patient or prescribing them the wrong drugs. This principle is different than the principle of beneficence which means to do well. Both these principles can be applied to this situation, because health care works main moral duty is to help the person and not harm them in any way possible. (Johnstone, 1999) Beauchamp and Childress (1994) state that the obligations of non-maleficence actually go on to override the obligations of beneficence. If these two terms are applied in terms of the nursing context, then non-maleficence basically makes it alright for a person to speak against any action that causes a person that could be have been avoided. (Johnstone, 1999) It is true that the nurses themselves shouldn't do any harm to the patient. However, most of the nurses are directly supervising a patient or are there to note any sort of wrong behavior or negligence that is taking place. Thus, under the principle of non-maleficence, they should go on to report it so it doesn't happen in the future.

Beneficence in Latin means 'above all, do good.' This goes on to oblige the health care personnel into acting and working just to benefit the others. Feelings like empathy, sympathy, care, compassion kindness are all actions of beneficence. (Johnstone, 1999) There is however another aspect to this principle that limits its effectives. Even though a person should do good and speak up for what is right, but he is not obliged to do so if acting good will ultimately go on to harm that same person. In other words, if our own moral interests are being harmed or compromised in a way, then we do not have to do well. (Johnstone, 1999) There is however an obligatory beneficence that creates controversy in a matter. There are times, when a person's moral and social obligations make it vital for that person to do good and go for the good cause.

To incorporate this matter into nursing care, Johnstone (1999) puts out a simple case. Suppose there is a patient who is in the late stages of her disease and it is known that she will die soon. A specific wish of hers is to not get transfused by blood. Regardless of what grounds or basis the patient stated this wish, but the fact that she stated it should have some importance. The doctor comes in and rushes to order a pack of blood. It is known that this blood is not required and will not help the patient but the doctor still orders it. Here the nurse refuses to administer the blood and tells the doctor to do so. In this instance, it was seen that the nurse objected to do something she was told. She portrayed beneficence and was nice to the patient's wishes and her demands. If the person was going to lose her life and then that are required.

When talking about reporting a violation at workplace, the issues of confidentiality and loyalty also come up. As of now, due to federal regulations, medical personnel should keep information to themselves that is not therapeutically needed and would otherwise destroy the trust of the patient. (Ashley, Deblois, & O'Rourke, 2006) Therefore, the nurses cannot just go onto discuss certain matters that are not important. This not only falls under the confidentiality of the patient but also under hospital and doctor confidentiality. In cases where a nurse has to report a violation of conduct, she should make sure that she only tells information that is needed for the case. The major things that should be mentioned are the ethics that should have been followed and how they weren't followed. Going in excessive details would not only be violating confidentiality law but will create further complications for the nurse.

It is true that loyalty is an important characteristic regardless of where a person works. Even though Loyalty is something nurses should feel for their senior doctors and for the hospitals, morality over rides loyalty. If a doctor or a hospital functions in a way that they cause excessive harm to a person's life, there is no point in staying loyal to such a hospital. Sometimes mistakes and negligence occurs that can be fixed, other times these mistakes go on to take a person's life. Nurses should look at how many future accidents they go on to prevent only if they report the wrongdoing at the hospital.

The Australian Nursing Federation states that the Nurses, midwives and the entire nursing assistant have a right to refuse to certain procedures. Their refusal can be based on ethical, religious or moral grounds. This basically stats that a nurse can refuse to her seniors or the doctors if she feels that some unethical or immoral action is being carried out. The case discussed earlier is also an example of conscientious objection when the nurse did not go with the blood transfusion due to the wishes that the patient had. There is however an exception to this rule that the nurses are supposed to carry out what they are told if the procedure is urgent and failing to do so will increase the risk of fatality in the patient.

The Case of Corrine Warthen, who was a registered nurse, refused to dialyze a critically and terminally ill unconscious patient. Her choice to do was based on conscientious grounds such that she believed that this procedure only caused him more harm and did not benefit him at all. (Johnstone, 1999) There are cases when refusing to do something has gotten nurses fired from the profession or has had their licensing revoked. Due to this reason, there are many instances where nurses do go ahead and participate in procedures just because of the fear of being fired. It is also unfortunate that many of the employers or the policy makers do not look into this issue.

A person's conscience is what basically tells the person that something is wrong or right. It is the basically the recognition of the moral quality of a person's action. There has been emphasis laid on the moral reasons and the moral feelings of the nurse. Surely, if there is a violation of ethics or any other medical personnel does workplace violence, the nurse has the right to object to him. There are nurses who have refused to work with certain personnel only because they do not want to feel guilty and do not want blow the whistle on such persons.