Ethics

Ethics are the moral principles that govern a person or group’s behavior. Many people go by these rules of conduct that are recognized in respect to a particular class of human actions or cultures. An ethical dilemma is where people have a moral choice between equally undesirable alternatives or conflicts in moral codes on a specific issue or action, where any choice will violate some aspects of the code. Nurses have a responsibility to their patient’s. They take a moral oath to protect, treat and be an advocate for their patients. Nurses deal with narcotics everyday and some of them abandon their own moral and ethical code and start using said narcotics. They have resulted in taking these drugs from their patient’s. Nurses who divert narcotics pose very significant threats to their patients safety. They also become a liability to the health care organization and the nursing department where the diversion occurred. Nurses are highly respected as professionals but their are many negative aspects to their profession. Due to the demanding and stressful nature of the job, many nurses have fallen victim to substance abuse. It is estimated that 10 to 15 percent of all nurses in the US are addicted to some type of narcotic. There are several reasons for this addiction. The long hours and stress related to caring for the sick or dying is a main reason. Nurses who work in ICU, ER, OR, or anesthesia have the highest prevalence of substance abuse because these areas are considered very high stress. Nurses have easy access to medications. A workaholic personality tends to lead to other addictions. Nurses are known to take care of others first and then themselves. This leads to addiction to hide the personal needs of the nurse. Narcotic diversion occurs in all clinical areas, including: falsification of medication administration documentation, replacement of a vial of a controlled drug ex: morphine with saline, excessive wastage, shorting doses of patient medications, substitution of non-controlled drugs, discrepancies between actual vs. system medication counts and intentional miscounts. No hospital is immune to narcotic diversion. However, hospitals are coming up with ways to prevent diverting from occurring. The American Nurses Association has established Standards of Professional Performance that the nurse must incorporate into nursing practice and use as a guide to their nursing care. Included in these standards is ethics, which must be integrated in all areas of nursing practice. The American Nurses Association has also developed a Code of Ethics, which is a specific guide for carrying out nursing responsibilities that provide patients with quality nursing care and provides ethical obligations of the profession. The Code of Ethics includes advocacy, responsibility, accountability, and confidentiality, not to mention autonomy, beneficence, nonmaleficence, justice, and fidelity, which are all basic health ethics that nurses should practice by. If a nurse participates in behavior such as the improper administration or handling of patient medications, the nurse does not abide by the Standards of Professional Performance or the Code of Ethics. This not only has an impact on patient safety but also has an impact on the nurse’s employment and their licensure. All health care providers should be aware of how to detect the behaviors or nurses participating in this behavior and how to properly report the behavior. There are two aspects to narcotic diversion: First the direct and indirect impact of patients care if the patient does not receive the medications that his or her physician intended, and then there is the impact on the health care worker who develops a pattern of narcotic diversion. Hospitals want to keep their patients safe and eliminate the opportunities for employees to divert medications and potentially jeopardize their jobs. Health care organizations also want to keep