Nursing Ethics and Ethical Decision-Making in Patient Care
This paper examines nursing ethics and the ethical dilemmas that arise when nurses are overwhelmed by excessive patient loads and staffing shortages. Through a fictional but realistic case study, the paper traces a nurse's experience managing competing patient needs during a single shift, resulting in delayed care, patient harm, and a critical charting omission. Drawing on utilitarian principles, the American Nurses Association Code for Nurses, and scholarly literature on moral distress, the paper evaluates possible courses of action, the nurse manager's disciplinary decision, and the broader systemic factors that compromise ethical nursing practice. The paper concludes by emphasizing the need for collaborative, supportive healthcare environments that enable nurses to make sound ethical decisions.
- Introduction: Nursing ethics amid staffing shortages and competing demands
- Data Collection and Assessment: Case scenario: nurse manages competing emergencies on understaffed shift
- Problem Identification: Charting omission and delayed IV care as core ethical failure
- Consideration of Possible Actions: Utilitarian and Code for Nurses analysis of the nurse's options
- Decision and Selection of Course of Action: Nurse manager chooses not to pursue disciplinary action
- Reflection on Decision: Moral distress, systemic factors, and lessons for future practice
- Conclusion: Supportive environments needed to uphold nursing ethics
✍️ How to write this paper — guide, tools & examples ▾
What makes this paper effective
- Uses a concrete fictional case study to ground abstract ethical principles in realistic clinical detail, making the argument accessible and persuasive.
- Integrates relevant scholarly citations (Chinn, Erlen, Gastmans, Smith and Godfrey) to support each stage of the ethical analysis rather than relying on assertion alone.
- Applies a recognizable ethical framework — the ANA Code for Nurses and utilitarian reasoning — systematically across the case, showing how principles translate into practice decisions.
Key academic technique demonstrated
The paper demonstrates applied ethical analysis: it moves from general principles (nursing ethics, moral distress, the Code for Nurses) to a specific scenario, then works back outward to systemic conclusions. This structure — principle → case → evaluation → reflection — is a standard method in professional ethics writing and nursing case studies.
Structure breakdown
The paper follows a seven-part structure mirroring a clinical problem-solving model. The introduction frames the nursing ethics landscape. The data collection section presents the case scenario. Problem identification names the core ethical failure. Consideration of possible actions weighs utilitarian and deontological perspectives. The decision section narrates the nurse manager's resolution. The reflection section draws broader lessons. The conclusion offers systemic recommendations. Each section builds directly on the previous one, giving the paper a clear logical progression.
Introduction
Nurses are required to make many immediate decisions in the course of their assigned duties. Unfortunately, in recent years, patient care has often been compromised as a nursing shortage crisis has escalated to epidemic proportions. Increased patient loads have resulted in hasty nursing decisions as responsibilities and hours worked have both grown. Although precious time must be spread thin to accommodate higher numbers of patients, nurses must exercise their morals through consistency in ethical behavior. According to Peggy Chinn (1), "Many ethical issues, such as end-of-life decision making, have increased in complexity. Other issues, such as advocacy and choice, have changed in certain respects but are more clearly centrally situated within nursing's ethical domain."
As a result, nurses are held accountable for a variety of decisions in nursing practice, and in many instances a patient's life depends on those decisions. Gastmans (496) states that "Generally, the goal of nursing activity is described as the promotion of the well-being of the patient by providing good care in the wider meaning of the word (i.e., the physical as well as the psychological, relational, social, moral, and spiritual levels). Nurses participate in an ethical practice. In each particular situation, they have to make personal choices and decisions based on the good that nursing practice sets as a goal. The ethical practice becomes concrete through the personal relationship between the nurse and the patient. The quality of nursing care must always be seen in the light of the relationship between a unique nurse and a unique patient. The patient cannot be considered as a passive object to which a core strategy is to be applied."
The following discussion examines nursing ethics and the situations that often lead to a compromise of quality patient care and difficult ethical decision-making processes in nursing practice. Conclusions are drawn regarding the ways in which ethical dilemmas can be resolved.
Create your account
Always verify citation format against your institution’s current style guide requirements.