Nursing can change your entire viewpoint on life. Patients with bad attitudes, heartless peers and everyday life can make this calling a burden. It takes strong morals and a good heart to survive without becoming bitter. Beginning this assignment I struggled with which ethical principle I use the most. I generally use Deontology and Principlism. I ruled out Deontology because, it’s simply duty; following the rules or responsibilities. Recalling the “Florence Nightingale Pledge”, I felt my life was no longer my own. The instructions of the assignment forced me to look beyond work and into my own life as well. How did I make decisions overall? Reviewing different scenarios, I concluded, in general my decisions, personal and work-related, utilize the Principlism method. Principlism is a newer approach to applied ethics based on a group of “non-absolute” principles. Principlism includes four principles: beneficence, nonmaleficence, respecting autonomy, and justice.
Recently I cared for a patient admitted with a diagnosis of Diabetic Ketoacidosis (DKA) and a previous history of Diabetes Mellitus type 1. Upon endorsement the patient received 500ml of fluid, with no follow up labs, no insulin drip, vomiting, and noncompliant. The patient was belligerent and refused to allow me to do an accucheck. Because of “patient rights”, I could have left him to his own devices. Instead, implementing beneficence and nonmaleficence, I spoke softly, expressed concern, and listened. I found out he’s suffered with diabetes since a teenager and was sick of being sick. Finally, he allowed me to do the assessment and draw labs.
Later in the shift, the patient’s condition worsened. I unsuccessfully attempted to contact the physician on several occasions. There were no orders for fluid therapy, antiemetic or an insulin drip. The physician finally arrived to the unit and was updated on the patient’s condition. I requested orders to begin DKA