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The ethical lives of nurses and medical caregivers are developing in multifaceted nature owing to the quick changes that are the consequence of logical advances, a developing business ethos, and innovative procedures planned for institutionalizing patient care. On occasion, medical attendants accept that they cannot react sufficiently to the moral issues that they experience due to their immensity and nurses’ obligation to keep on thinking about patients regardless of hindrances. Through Betty’s case presented herein, it is apparent that advocacy outside work regarding social justice within nursing and health policy is an ethical issue that every professional nurse should consider in their day-to-day undertakings as professionals.
Betty Carson, RN, was working at Exodus Recovery in Downtown LA in March 2018. She did much as a primary caregiver for geriatric patients who had mental health issues. One of her obligations was to make follow up visits to patients’ homes and to ensure that all the patients under her care received continued care and that they all followed their treatment regimes. Jose Gonzalez, 72, was one of Betty’s patients and came from Gladys Avenue in Downtown LA. It was during her first visit to Mr. Gonzalez’s home that Betty encountered a scene that turned her into a nurse advocate, something she had no interest in before. Gonzalez was under the care of Carlota, 20, his granddaughter. Apart from Gonzalez, Miss Carlota was also responsible for Emiliano Vargas, her cousin, who had suffered multiple burns in an accident. The three were in Rodrigo Gonzalez’s – Carlota’s father and Jose’s son – house. Betty’s consternation was the fact that Vargas’ prescriptions for antibiotics and painkillers had run out. Vargas is an undocumented immigrant, and Jose is equally uninsured. In the entire house, only Rodrigo and his wife Camilla have health insurance under the ACA. Their incomes make it hard to afford insurance and to process Vargas’ documents.
In Betty’s assessment, two things stood in the way of this family’s access to healthcare: their low-income status and their ethnicity. Rodrigo worked at Central Processing while Camilla worked at Ellis. Carlota was planning to join college in the Fall of 2018. Jose and Rodrigo moved to the US in 2004, and Rodrigo’s two brothers also left Mexico for San Diego, all in pursuit of jobs and better lives. In 2009, Jose went down with multiple sclerosis. What irked Betty was the fact that the members of this family lived less dignified lives and lacked access to healthcare due to their immigrant and socioeconomic status. When she went home, she decided it was time to get involved in civil rights action. She started by volunteering at the Los Angeles Community Action Network to lobby for low-income persons, homeless individuals, and undocumented people.
In the ANA Code of Ethics advocacy is an ethical provision for professional nurses. Under Provision 3 of the ANA Code of Ethics, “The nurse promotes, advocates for, and protects the rights, health, and safety of the patient” (American Nurses Association, 2015, p. 9). Moreover, Provision 9 – subparts iii and iv – addresses nursing advocacy outside work regarding issues of “principles of social justice in nursing and health policy” (American Nurses Association, 2015, p. 35). Under these two provisions, Betty, as a registered nurse, manifests ethical nursing practice. Nurse advocacy can come with substantial power; when professionals speak, people listen. Having had a firsthand experience of the situation at her patient’s home, Betty had acquired the charisma and propulsion she required to advocate for the healthcare rights of less advantaged groups such as the poor and immigrants.
The British philosopher Thomas Hobbes contended that if left solely to themselves, human beings would be in constant war, and to counteract that possibility for their survival, human beings require strong leadership and an agreed-on social contract to guide human conduct (Epstein & Turner, 2015). Once a person becomes a nurse, they enter into a social contract with society, and part of that contract is to advocate beyond the daily care of patients. For a considerable length of time, nurse researchers have investigated and established how the setting of social insurance and healthcare can compel medical attendants’ ethical reactions, prompting moral distress (Peter, 2018). Haddad and Geiger (2019) stress on the essentiality of ethical values for any healthcare service provider. Nurses encounter ethical issues daily, and they should make ethical practice the foundation of their nursing practice, like Betty did. After learning about nursing ethics in this course, there is nothing I would do differently from what Betty did, in practice. I concur with Haddad and Geiger (2019), advocating for patient care, advocating for patients’ rights, and upholding ethical standards are essential parts of nursing practice.
As a nurse leader, I would guide my staff in a situation similar to Betty’s in multiple ways. For instance, I can help my staff to create an independent action group to advocate for a more specific concern, such as the cost of prescription drugs or the health rights of undocumented persons. Advising the group members to make their action group work in collaboration with other established groups advocating for similar issues is equally productive. I would also ensure that the group’s activities remain initially localized to areas where their advocacy issues are a primary concern. The staff and I would also support local representatives and candidates who support the issue we care about. I would equally caution my staff not to expect to see the direct result of advocacy in the short run; the results may be hazy and may take a long time to realize.
References
American Nurses Association. (2015). Code of ethics with interpretative statements. Web.
Epstein, B., & Turner, M. (2015). The Nursing Code of Ethics: Its value, its history.OJIN: The Online Journal of Issues in Nursing, 20(2). Web.
Haddad L.M., & Geiger, R.A. (2019). Nursing ethical considerations. Web.
Peter, E. (2018). Overview and summary: Ethics in healthcare: Nurses respond.OJIN: The Online Journal of Issues in Nursing, 23(1). Web.
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