Ethical dilemmas abound in nursing practice. Consider these commonplace scenarios:
* An angry patient threatens to leave the hospital against medical advice. Should you hold him against his will?
* A cancer patient fears chemotherapy. Should you give less detailed information about the effects of anticancer drugs?
* An obese home care patient with pressure ulcers refuses to cooperate in turning. Should you turn her anyway?
Such conflicts between the patient’s wishes and the nurse’s perception of the patient’s best interests occur regularly. That doesn’t make these ethical dilemmas any easier to resolve, but how nurses approach them can significantly affect clinical outcomes. Taking the time to listen to patients—and to integrate relationship skills with principles of ethical practice—can help nurses achieve solutions that are both ethical and appropriate for individual patients.
That’s from the February issue of AJN, in which nurse–ethicist Doug Olsen (who has in the past written for this blog on ethical issues related to mandated H1N1 vaccinations for nurses) offers a thoughtful discussion that may resonate for all nurses who’ve ever faced a situation like those in the above examples. It may seem obvious or cliched to say that listening to patients can help solve apparently intractable problems—but just because listening as a skill is hard to measure doesn’t mean that it’s not sometimes effective where more rigid tactics would fail.