Ethical Dilemma with Pain Control in Pediatric Nursing
Dilemma Description
The boy name AC, 7 years old, and came in with broken leg. He is suffering great pain, but his parents are refusing to get pain medication such as opioids because they think any types of medication will cause liver damage. AC’s parents want to treat his broken leg without medication due to their strong belief that any type of medicine will damage the liver. And they want his son to overcome his pain by his own.
Identify the Principle(s) from the ANA Code of Ethics
Advocacy in nursing is the act of pleading for support or recommendation for patients.
Beneficence means that taking good actions which help others. By taking good actions, harms can be prevented or removed or the situation will be improved to give a benefit to others (nursing world, n.d.).
Veracity means telling the truth. It is an essential component of building a relationship with patient and family, but it is also a duty to disclose (nursing world, n.d.).
Relate Principles from ANA Code of Ethics to the Dilemma
AC’s parents refuse to give any pain medicine to him due to their belief that pain medicine will damage the liver, and the 7-year-old patient is only responsible for the pain. For the patient, a nurse acts behalf of the patient to receive treatment for the pain. Explain to parents that the patient might not be able to overcome the pain and it can cause severe stress that affecting his normal function of daily life.
In this case, the nurse needs to explain how it will benefit AC by taking pain medicine. According to the Code of Ethics, beneficence is benefitting others by taking good action which prevents harm and provides a more safe condition to others (American Nurses Association, 2015) Explain thoroughly what and how it benefits AC, and how less of hassle in pain that AC is going through. It needs to be addressed that extended pain with a high intensity can be harmful to the neural system (Lundeberg, 2015).
Telling the truth about adverse effects of treatment is important. Explain to AC’s parent that there is also a chance to increase the risk of damaging liver by taking pain medicine, but that is the case when patient overdose or taking the medicine in a long period of the time. Information on other possible adverse effects of the opioid medication such as hypotension, bradycardia, sedation, nausea, vomiting, constipation, and respiratory depression are also provided (Lilley, Collins, & Snyder, 2017).
Discuss the Outcome of the Dilemma
Although the parents’ concern regarding medication which can cause liver damage seems highly affecting client’s pain management following injury, the outcome of treating AC’s pain with medication was successful that the parents agree with the treatment and AC can be relieved from the pain.
Identify the Resources at the Clinical Agency to Assist Dealing with Ethical Dilemmas
Ethical principles from American Nursing Associate code of ethics helps to deal with this dilemma. An ANA provides the ethical obligation and duties that act for patients. In this case, it helps for the nurse to understand the parents’ concern with medication treatment for pain, and the principle of the code of ethics make nurses to provide information regarding medication which can be beneficial for the patient. Not only provide good information for the patient, also the nurse informs them there is a chance to have undesired harmful effects resulting from the medication. The parents already aware of some adverse effects. But it is important to disclose them that there can be another adverse effect beside the one they already know. All of the information provided by the nurse is from reliable resources such as journal article and textbook. These resources are evidence-based and currently used by the healthcare system. By telling them the truth about the medication, not only educate the parent but also build a rapport with them which helps to result in an optimum outcome in patient care.
References
Code of ethics for nurses with interpretive statements. (2015). Silver Spring, MD: ANA,American Nurses Association.
(n.d.). Retrieved June 11, 2017, from http://www.nursingworld.org/
Lilley, L., Collins, S., Snyder, J. (2017). Pharmacology and the Nursing Process, 8th Edition. [Bookshelf Online]. Retrieved from https://online.vitalsource.com/#/books/9780323358286/
Lundeberg, S. (2015). Pain in children - are we accomplishing the optimal pain treatment?. Pediatric Anesthesia, 25(1), 83-92. doi:10.1111/pan.12539
Potter, P. A., RN, MSN, PhD, FAAN, Perry, A. G., RN, EdD, FAAN, Stockert, P., RN, BS. (2017). Fundamentals of Nursing, 9th Edition. [Bookshelf Online]. Retrieved from https://online.vitalsource.com/#/books/9780323327404/