Lecture fifteen: Clinical reasoning and ethical decision making Flashcards
What ethical decision making?
Ethical decision making involves trying to distinguish right from wrong in situations without clear guidelines.
What is an ethical dilemma?
An ethical dilemma exists when moral claims conflict with one another. It can be defined as follows:
A difficult problem that seems to have no satisfactory solution
A choice between equally unsatisfactory alternatives (Stuart, 2013)
Why is clinical reasoning important?
Learning to think like a nurse requires deliberate practice and a structured approach to working through clinical problems.
sets the foundation for all other levels of inquiry associated with the production and utilisation of nursing knowledge
Does not happen by accident, nor does
it occur by simply observing expert registered nurses (RNs)
Why is ethics in nursing so tricky?
We nurse in a complex and technical era
Communication Barriers (missing patient cues due to not enough time, busy environment, etc.)
Various legislations underpinning nursing practice
The need to be evidenced-based and person-centred in the practice routine
Lack of experience (“I have never dealt with this before.”)
Our very own moral beliefs/ principles that may be different to others
How Do We Develop Moral Reasoning?
- It starts with self-awareness
- Develop good communication skills
- Know local policies e.g. resuscitation / advance directives / DNR orders, asking about EPOA etc
- Be willing to SEE and INTERPRET refusal cues
- Develop excellent clinical reasoning skills
- Grow an awareness of relevant legislation e.g., end of life choice act (2019)
- Have a model to guide ethical decision making
What are the eight steps to Levett-Jones’ Clinical Reasoning Cycle?
1) Consider the patient situation
2) Collect Information
3) Process information
4) Identify the problem(s)
5) Set goal(s)
6) Take action
7) Evaluate
8) Reflection
