Case Study Reflection on Ethics of Nursing

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Case Study Reflection Paper
Jo Channing

Case Study Reflection Paper
The case study about John and Mary and their children illustrated cultural, legal, and ethical issues that can arise in the healthcare setting. Having worked in the Neonatal Intensive Care Unit for the last decade of my nursing career has exposed me to several situations that were also complicate by these same issues. As nurses, we often encounter patients and family members whose beliefs differ from our own. This case study was an excellent tool to help me reflect upon these differences and how we must overcome them to give a standard of nursing care that is not compromised by the barriers of contrasting cultural and ethical beliefs. We must also be aware of the legal implications of our care regarding these situations. Many parents and families from various cultural and religious backgrounds constitute the people that I interact with in the NICU where I work. How we as medical staff interact with these families can impact the extent to which our care is perceived in addition to the extent to which we can openly communicate with and teach our families. The cultural relevance of John and Mary’s situation in the case study involved actions that were driven by the family’s religious beliefs. Whether cultural or religious, the individual beliefs of a family may be unfamiliar to and difficult to understand to those of us in the health care profession. Whether or not we agree with the many beliefs of the populations to which we provide care is not where importance should be placed, rather how we choose to give care that is not only culturally appropriate but as standard as the care provided to anyone else. Because we become so accustomed to providing care in a way that is not typically challenged by cultural differences, it takes some creative thinking to understand what par our patient’s cultural and religious beliefs play in their decision making process. Trying to understand the differences may help us to find solutions to some of the problems that can arise from these differences. This creative thinking process was challenged within myself as I reflected on John and Mary’s situation. Although I did not agree with their decision not to immunize their children, placing blame would serve no purpose in my role as a nurse. Efforts to keep the parents receptive to learning would be dependent on how they are treated. The actions of the nurse could have an impact on the futures of their children. Another example of how cultural issues are relevant in my personal nursing practice came to mind when discussing the cultural implications of the case study. I took care of a premature twin whose mother had delivered at home with the help of a midwife from her church. Members of her church believed in prayer to treat illness rather than medical intervention. One twin did not survive and the surviving twin was taken into the custody of Social Services after the dad placed a phone call to 911 inquiring how to obtain a death certificate for the deceased baby. Emergency medical personnel arrived on scene, only to the deceased infant and a mother who refused medical care for her and her infant. A court order was obtained to treat the surviving infant who was in respiratory distress. Prior to my shift, the day nurse presented these parents as “negligent monsters”. To my surprise, these parents were kind and gentle and felt like what had happened was “God’s will”. As a nurse, my role was not to judge these parents, but to provide care for their preterm infant just as I would for any other family. Despite their beliefs, these parents are the ones who will take the infant home to raise. The best thing that I can do as a nurse is to provide them with the tools necessary to do this in a way that it will be received and understood. Along with the cultural implications that were presented in John & Mary’s case study were...
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