Criteria
Thoughtfully addresses topic and builds on depth of discussion by including application of course content and critical analysis.
Effectively integrates scholarly literature (2 references within last 5 years).
APA 7th Edition.
See grading rubric for full grading criteria.
Focus:
Demonstrate an understanding of common ethical issues in the ICU, and related nursing considerations, by picking one of the following ethical issues and discussing.
-The potential personal impact (psychological, physical or spiritual) of working in critical care on nurses
-Providing care for patients with substance misuse disorder who also suffer from chronic pain.
Here are 2 sample papers to emulate:
1.
Providing care for patients with substance misuse disorder who also suffer from chronic pain
The shame attached to substance abuse disorders is one of the ethical problems we face in healthcare and as a society (Adams & Volkow, 2020). Instead of acknowledging addiction as a chronic medical disease, society often places blame or moral failure on those who struggle with addiction. As a nurse, I treat these patients with decency and care while attending to their medical requirements. Chronic pain can significantly impact a patient’s quality of life, necessitating careful management of drug usage to prevent disease aggravation or addiction relapse (Dydyk & Conermann, 2024). Working collaboratively with the medical team, which includes addiction counsellors and pain experts, is crucial to creating a complete pain management strategy that minimizes the risk of drug abuse while balancing appropriate pain treatment.
Therapeutic communication should be used to ensure patients are aware of their options, risks, and available therapies (Ernstmeyer et al., 2022). To respect their autonomy, they should also be encouraged to participate in decision-making while considering their capacity for informed decision-making. Furthermore, treating patients’ psychological and social needs in addition to their physical health is a crucial part of holistic treatment for those with chronic pain and drug abuse issues (Fenske et al., 2021). This might include arranging support groups, providing counselling, or putting patients in touch with neighbourhood resources for continued treatment and recovery.
It is necessary to manage complicated ethical issues while providing long-term pain management for patients in the intensive care unit who simultaneously have drug abuse disorders. To handle ethical issues like this, I aim to respect the values of beneficence, non-maleficence, fairness, and patient autonomy in all aspects of patient care and ensure every patient receives the best treatment possible while adhering to ethical norms by encouraging a caring and nonjudgmental approach, working with interdisciplinary teams, and providing patient-centred care.
Reference
Adams, V. J. M., & Volkow, N. D. (2020). Ethical Imperatives to Overcome Stigma Against People With Substance Use Disorders. AMA Journal of Ethics, 22(8), E702-708. https://doi.org/10.1001/amajethics.2020.702
Dydyk, A. M., & Conermann, T. (2024, May 6). Chronic Pain. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK553030/
Fenske, J. N., Berland, D. W., Chandran, S., Van Harrison, R., Schneiderhan, J., Hilliard, P. E., Bialik, K. C., Clauw, D. J., Lowe, D. A., Mehari, K. S., Smith, M. A., Urba, S. G., Van Harrison, R., Proudlock, A. L., & Rew, K. T. (2021, January 1). Pain Management. NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK572296/
Open Resources for Nursing (Open RN); Ernstmeyer K, Christman E, editors. Nursing: Mental Health and Community Concepts [Internet]. Eau Claire (WI): Chippewa Valley Technical College; 2022. Chapter 2 Therapeutic Communication and the Nurse-Client Relationship. Available from: https://www.ncbi.nlm.nih.gov/books/NBK590036/
2.
Psychological Distress Impacts in Critical Care Nursing
Critical care nurses experience high rates of psychological distress resulting from several factors surrounding ethical dilemmas in ICU care, especially in death and dying (Gagnon and Kunyk, 2022; Pestana et al., 2024). In addition to well-known risk factors contributing to distress such as high workloads, patient acuity, and staffing shortages, nurses in critical care settings have reported severe psychological impacts from role constraints, where they have information relating to prognosis and are unable to share, and underprioritizing patient dignity in dying in a “what can be done should be done” mentality, often posing possible medical futility (Gagnon and Kunyk, 2022). Several studies have demonstrated the long-term mental health effects psychological distress imposes on nurses leaving some unable or unwilling to return to their profession (Gagnon and Kunyk, 2022; Helmers et al., 2020). While contributing to further staffing crises in an already-burdened healthcare system, leaving remaining nurses at even higher risk of the same demise, this undoubtedly impacts the nurses’ ability to provide for their families while damaging their perceptions of self-worth. Strategies proposed to mitigate risk rely heavily on organizational culture and management influence of establishing supportive environments with open communication and a culture of safety in self-expression (Helmers et al., 2020; Pestana et al., 2024). Of recent development in understanding prevention and proactive management of the impacts of psychological distress, is capacity building of moral resilience where nurses engage in self-care, self-compassion, and use reflective processes to develop understanding and acceptance of outcomes (Helmers et al., 2020).
References
Gagnon, M., & Kunyk, D. (2022). Beyond technology, drips, and machines: Moral distress in PICU nurses caring for end‐of‐life patients. Nursing Inquiry, 29(2), e12437-n/a. https://doi.org/10.1111/nin.12437
Helmers, A., Palmer, K. D., & Greenberg, R. A. (2020). Moral distress: Developing strategies from experience. Nursing Ethics, 27(4), 1147–1156. https://doi.org/10.1177/0969733020906593
Pestana, D., Moura, K., Moura, C., Mouliakis, T., D’Aragon, F., Tsang, J. L. Y., & Binnie, A. (2024). The impact of COVID-19 workload on psychological distress amongst Canadian intensive care unit healthcare workers during the 1st wave of the COVID-19 pandemic: A longitudinal cohort study. PloS One, 19(3), e0290749–e0290749. https://doi.org/10.1371/journal.pone.0290749
