Assignment: Apply Guido’s MORAL model

Assignment: Apply Guido’s MORAL model

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Assignment: Apply Guido’s MORAL model

Apply Guido’s MORAL model to resolve the dilemma presented in the case study described in EXERCISE 4–3 (Guido textbook)
Apply Guido’s MORAL model to resolve the dilemma presented in the case study described in EXERCISE 4–3 (Guido textbook). How might the nurses in this scenario respond to the physician’s request? How would this scenario begin to cause moral distress among the nursing staff, and what are the positive actions that the nurses might begin to take to prevent moral distress?

MORAL DISTRESS Nurses experience stress in clinical practice settings as they are confronted with situations involving ethical dilemmas. Moral stress most often occurs when faced with situations in which two ethical principles compete, such as when the nurse is balancing the patient’s autonomy issues with attempting to do what the nurse knows is in the patient’s best interest. Though the dilemmas are stressful, nurses can and do make decisions and implement those decisions. Moral distress, first described within the discipline of nursing by Jameton (1984), is a negative state of painful psychological imbalance seen when nurses make moral decisions, but are unable to implement these decisions because of real or perceived institutional constraints. This author acknowledged that there are three categories in this phenomenon: moral uncertainty, moral dilemma, and moral distress.

Moral uncertainty is characterized by an uneasy feeling wherein the individual questions the right course of action. Generally, this uncertainty is short-lived. A moral dilemma, according to Jameton (1984), is characterized by conflicting but morally justifiable courses of action. In such a dilemma, the individual is uncertain about which course of action should be enacted. Moral distress involves the individual knowing the ethical course of action to take, but the individual cannot implement the action because of institutional obstacles. Seen as a major issue in nursing today, moral distress is experienced when nurses are unable to provide what they perceive to be best for a given patient. Examples of moral distress include constraints caused by financial pressures, limited patient care resources, disagreements among family members regarding appropriate patient interventions, and/or limitations imposed by primary health care providers. Moral distress may also be experienced when actions nurses perform violate their personal beliefs. A study by Zuzelo (2007) concluded that the primary sources of moral distress included the following: • Resenting physician reluctance to address death and dying • Feeling frustrated in a subordinate role • Confronting physicians • Ignoring patients’ wishes • Feeling frustrated with family members • Treating patients as experiments • Working with staff members perceived as inadequate (pp. 353 – 356). These themes were present in nurses practicing in multiple care settings who work with various populations of patients across the lifespan. A later study by Pauly and colleagues (2009) concluded that high levels of moral distress for nurses in clinical settings involved “nurses’ own feelings of competency and their confidence in the competence of registered nurses” (p. 569).

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

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