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As any other sphere of occupation, healthcare has its own conceptual framework of ethics and moral standards. The well-known principle of doing no harm, medical confidentiality, the responsibility for life and health of patients, problems of relationships with patients and their relatives are all included in it. In general, it can be perceived as a teaching about the proper behavior of healthcare workers to create the most favorable conditions for recovery of the patients. In addition, it also includes ethical, moral, and legal standards concerning euthanasia, as well as the inevitable death of the patient (Butts & Rich, 2015). This conceptual framework is meant to guide healthcare professionals, including nurses, in their daily work, namely in case they encounter particular problems or dilemmas. However, it alone is not enough to address these issues successfully, primary due to its generalized nature. In the end, the outcome of any issue depends on nurse’s approach to it. Therefore, the following research is dedicated to study the role of the nurse’s temperament and leadership styles in the process of resolving dilemmas that may arise in her practices.
As any occupation related to dealing with people, nursing often makes its representatives face various ethical, moral, and legal dilemmas. However, on the contrary to majority of the other professions, dilemmas in nursing must be addressed with the utmost efficiency, as the well-being or even life of a patient is often at stake. In this regard, it is possible to provide the following example of moral dilemma faced by the nurse. A 67-year-old woman was receiving the long-term medical treatment at the clinic after being diagnosed with a small cell lung cancer. The disease was likely connected to the fact that she was an avid smoker, and used beta carotene supplements (Roth, Cox, & Hong, 2011). The nature of cancer has defined the primary method of her treatment – chemotherapy. However, in about a year, the disease has entered its fourth stage, decreasing the efficiency of the active treatment drastically. As a result, the patient was informant of the futility of further treatment. It should be noted that she has accepted the news calmly, expressing the desire to be moved to hospice for the palliative treatment. However, her family had an opposite opinion on the matter, urging the patient to continue receiving active treatment. As a result, the moral dilemma has been formed as a result of clash of the two opposing opinions. The first of them was the patient’s desire to spend her last months of life in peace. The second was the desire of her family to continue the painful treatment driven by the fear of the loss of a loved person. At the same time, the nurse must act in accordance with her professional ethics (the principle of doing no harm), which exacerbates the problem (Butts & Rich, 2015).
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The ethical implications of the described dilemma emerge from nursing ethics, namely from the mentioned principle of doing no harm. In case the nurse takes the side of the patient’s relatives, there is a possibility that the treatment by the means of chemotherapy will be continued. It often causes anemia, weakness, as well as nausea and vomiting, which, on the background of the infeasibility of the treatment, may contradict the principles of nursing ethics (Butts & Rich, 2015).
The moral implications of the dilemma lie in the fact that it has no satisfactory outcome for the patient’s relatives. As a result, their desires and opinions are unlikely to be taken into account, resulting in them being left out of the process of treating the person they love (Butts & Rich, 2015).
The primary legal implications of the described dilemma are connected with the concept of human rights, that is enshrined in the U.S. Constitution. In particular, it is clearly stated that each person has an undeniable right to life. Therefore, the patient’s relatives may interpret the actions of healthcare professionals as an attempt to rob her of this right and file a corresponding lawsuit against them (Butts & Rich, 2015).
In this case, the role of the nurse is that of an advocate that must act in the best interests of the patient, while maintaining productive relationship with her relatives. In particular, she must convince them that the patient has the undeniable right not only to life, but also to an opportunity live it decently. It means that the suffering she has to experience must be minimal, which cannot be achieved in case an active treatment will be continued. At the same time, the switch to palliative care will allow the patient to spend her last months of life peacefully, with her family being able to support her (Roth et al., 2011).
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The outcome of the dilemma largely depends on the leadership style used by a nurse, which, in turn, is dictated by her temperament. There are many ways to determine it, with the Keirsey Temperament Sorter being the most popular one. According to it, the nurse demonstrating extraverted feeling, in combination with introverted sensing (i.e. the caregiver type) will have such personal traits as adherence to the norms and rules, as well as respect to the opinion of other people (Joyce, 2010). As a result, she is likely to use the democratic leadership style (Kelly, 2012).
On the one hand, such nurse may use her developed ability to sense and judge to gather the detailed information about the sides of the conflict and turn it into supportive judgments that may help to resolve the dilemma. Moreover, she is good at reading others, which makes it easy for her to understanding their point of view. Due to the strong desire to be liked, the nurse of the caregiver type is highly supportive of other people. These two traits allow her finding the common ground between the patient and her relatives, which allows resolving the moral dilemma (Joyce, 2010).
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