Simulation vs Real Practice in Nursing Training - Coursework Example

Nursing Training: Simulation V Real Practice of Your Contents Introduction 3 Justice 3 Patient Autonomy 5 Beneficence V Non-Maleficence 5 Professional-Patient Relationships 7 Synthesis 8 Conclusion 9 Bibliography 10 Introduction Nursing is defined as a profession that involves the provision of care and healthcare in order to ensure healthy living and improve the quality of life of people in society (Meleis, 2011). Therefore, nursing is a technical profession that requires specific competencies. In order to ensure that nurses gain the right competencies and capabilities, they will need to learn and understand important things about their field. And being a profession that deals with human beings, there is a question of how nurses claim. There is a moral dilemma of whether student nurses should be trained with real patients at the hospital or whether they should learn theoretical aspects of medicine in practice in laboratories and on mannequins and other dummies in simulated conditions. This ethical dilemma is complicated because if student nurses practice on real human beings, it will mean putting people at risk due to the need for these student nurses to learn. However if they never practice on real-human beings, how can they gain competency? One can counter that student nurses can acquire skills through practice in laboratory circumstances. But this is not really at the same level as actual practice. This paper will examine this ethical conflict and provide information about the two contrasting views in five contexts of ethical principles including autonomy, non-malfeasance, beneficence, justice, professional-patient relationships amongst others. Justice This is the quest towards providing fair and reasonably fair services to all members of the society (Cavaliere & Nathaniel, 2010). This is because everyone in the United States and every part of the world today has some fundamental rights that entitle him or her to fair and appropriate treatment as a human being. And in cases these rights are not fulfilled, a person can petition a court of appropriate jurisdiction to seek justice (Hall, Brinchmann, & Aagaard, 2012). The fundamental right guaranteed by the constitution of the United States implies that healthcare facilities are banned and prevented from taking any actions that will jeopardize the health and wellbeing of patients. Clearly, using student nurses to treat patients is tantamount to using these patients as experiments. This is because the student nurses are persons who know about the facts of the way treatment must be carried out, but they are typically persons with no experience. Hence, it will not be fair or just to allow any patient to be treated by these student nurses. However, in reality, there is the need for a reasonable supply of nurses to occur in the society. This is because if all patients today are not going to allow anyone but experienced and qualified nurses to treat them, it means they will not have an appropriate supply of nurses in the future to treat them. Therefore, there is the need for some mechanism to be put in place to ensure that nurses of today are treated well. This is steeped in the fact that healthcare facilities have a duty and obligation to ensure they have a reasonable supply of nurses. In the event where they fail to do so, sections of the society that gets affected by this lapse can sue them as well. Therefore, the only reasonable step that medical facilities need to take is to ensure that they use some important methods and important approaches to train nurses. The only logical way and process of doing this is to blend laboratory and simulated sessions with the practice of treating real people. However, this ought to be done in a well structured system and process in order to provide an efficient timetable and process for student nurses to proceed from practicing in laboratory settings to real-life practice as a part of their training. Patient Autonomy The concept of patient autonomy relates to the fact that patients have a right guaranteed by the law to determine who treats them and who touches them in order to provide healthcare (Burkhardt & Nathaniel, 1998). The right of a patient to determine who treats them implies that patients can question or reasonably expect that a hospital or clinic will only authorize nurses who are skilled and experienced enough to cover their case. Hence, the healthcare facility will have to do everything possible to ensure that they have the right caliber of nurses who have enough experience. This ethic of patient autonomy is stepped in the fact that in the case of a hospital of clinic providing services to the public, it impliedly asserts and assures the public that it will provide a service with professionals who are of an appreciable level of education and experience. Hence, the patients impliedly expect that level of care and precision in the service provided in the healthcare facility. Therefore, the facilities will have to prevent the use of unqualified and inexperienced nurses because in cases where there are complications or issues, a patient may sue and take legal action against the facility because their right to autonomy was not respected. The right thing to do in rare circumstances where student nurses with no experience are used is to inform the patient of the risks. If they consent to it and disregard their autonomy and ask the student nurse to treat them, then the medical facility will bear a much less harsh obligation for the situation and any issue that comes up afterwards. Beneficence V Non-Maleficence Beneficence is an action that is done with the view of benefiting another persons and this include the situation where a person is in a difficult and challenging situation and needs help (Monagle & Thomasma, 2012). There is a general medical requirement that before any treatment is done, there is the need for a healthcare professional to weigh the implications and possible aftermath of the treatment (Sneesby, 2008). Medical practitioners are expected to refrain from causing harm. And this is a default position and ethicists require that physicians and other medical professionals like nurses should stay away from situations in which they will put patients in a state that was worse than their previous state if they treat them. However, there is an obligation for medical practitioners to distinguish between obligatory and ideal beneficence. In a situation where patients will suffer when they are not attended to, it is obligatory for the healthcare professional to provide some kind of attention that will ease a patient’s pain. Therefore, in a situation where patients are in serious pain and hardship, there might be an obligation for anyone with any kind of solution to act to ease the pain and challenges of persons in these harsh and difficult circumstances. In that case, a student nurse might be permitted to use her limited skills to treat a patient to ease her pain. This is because the situation will be exceptional and a patient might be allowed to carry out her practice on a patient. The non-maleficence principle on the other hand shows that healthcare professionals must not harm others in their practice (Sales & Folkman, 2000; Borry, 2006). Therefore, in the case of learning how to practice, it is apparent that any institution or facility that allows student nurses to practice on real patients will be guilty of breaching this ethic. This is because in a situation where theoretically oriented student nurses are allowed to treat patients, it will imply that the ethic of non-maleficence will be breached. This is because the ethic requires facilities and professionals to take care and avoid situations where patients are put in a situation where they will be harmed by the input of professionals. Therefore, in simple terms, the principle of non-maleficence prevents the use of student nurses in the treatment of patients to learn and understand how treatment is carried out. Putting all together, it is apparent that the theory of beneficence and non-maleficence renders the use of student nurses in actual practice as unethical. However, in situations where there is the pressing need to save life, they could be called upon. Professional-Patient Relationships There are professional rules and professionals standards that guide the conduct of nurses in practice. This includes confidentiality, due care and diligence amongst other things that are essential and primary in guiding the conduct of nurses in their professional operations (Beech, 2007). These professional codes are important and central because they are regulated by the nursing professional association that a nurse belongs to. They are mainly utilized to prevent nurses from doing things that might be wrong and negative. Once a nurse becomes a professional and she is qualified and admitted into a professional body or given a license, the nurse is expected to be measured by the standards and the regulations that come with the ethical standards. However, until a nurse can be licensed, she will not be bound by the same standards and same rules. A student nurse cannot be held to the same standard of care and the same professional duties as a qualified and experienced nurse. Hence, allowing a student nurse to practice on real people will imply that they cannot be held to the same degree of accountability as real nurses. This means they will be given responsibility without accountability. This is a dangerous situation that could create major problems and issues for the healthcare or medical facility that employs them. This is because in a case where a healthcare facility employs patients who are not of a reasonably high level and cannot be held accountable on the professional level, the healthcare facility will be held accountable for vicarious liabilities (Ngwenya & Chadwick, 2013). Vicarious liability implies that an employer or healthcare facility will have to take responsibility for maintaining professional standards and professional requirements for employees. This implies that nurses in the real situation and the real context will not one that student nurses can be held accountable for. This therefore means that student nurses might be problematic in such real-time situations and in cases where there are is the option to use simulations and laboratory situations, it could be argued that this must be preferred to the use of real-life situations and real-life contexts to give student nurses practical exposure and experience. Synthesis From the research it is apparent that using real-human beings to practice amongst student nurses is something that can potentially bring legal and other ethical problems for healthcare facilities. However, as identified in the section on justice, there is an obligation on healthcare organizations that require them to ensure the consistent supply of healthcare professionals and nurses. Therefore, there is the need and the merit for student nurses to get some kind of exposure in handling patients in real-life circumstances. Like most ethical dilemmas, there is the need to draw a balance between the two extremes. Leaving a student nurse to practice in the laboratory environment only will create nurses who only have theoretical knowledge. Thus, there is the need for some kind of checks and balances to be put in place to ensure that student nurses get some kind of exposure in practical affairs. The best way to do this is to allow student nurses to practice on real human beings under regulated circumstances. In other words, student nurses must be allowed to carry out real-life practice on people only when they are given some professional ethical guidance. Also, there is the need for close supervision to be carried out in situations where student nurses practice on real patients. Conclusion The study identifies that healthcare practice of nurses on real patients has issues relating to justice, patient autonomy and beneficence. Therefore, therefore it is not right for patients to practice with real patients. Rather, it is also not appropriate to keep nurses practicing in laboratory conditions only. This is because patients might lack exposure and this will equally contravene the same ethical standards when the nurses begin to practice. In order to ensure an appropriate solution, there is the need for student nurses to practice on real patients, but in a highly regulated environment. This will ensure that ethics are followed and the right procedures are applied in all situations to avoid liability. Bibliography Beech, M. (2007). Confidentiality in Health Care: Conflicting Legal and Ethical Issues. Nursing Standard , 42-46. Borry, P. (2006). Empirical research in bioethical journals. A quantitative analysis. Journal of Medical Ethics , 240-245. Burkhardt, M. A., & Nathaniel, A. K. (1998). Ethics and Issues in Contemporary Nursing. New York: Delmar Publishing. Cavaliere, T. A., & Nathaniel, A. K. (2010). Moral Distress in Neonatal Intensive Care Unit RNs. Advances in Neonatal Care , 145-156. Hall, E. O., Brinchmann, B. S., & Aagaard, H. (2012). The Challenge of Integrating Justice and Care in Neonatal Nursing. Nursing Ethics , 80-90. Meleis, A. I. (2011). Theoretical Nursing: Development and Progress. Amsterdam: Wolters Kluwer. Monagle, J. E., & Thomasma, D. C. (2012). Healthcare Ethics. New York: Jones and Bartlett. Ngwenya, C., & Chadwick, R. (2013). Confidentiality and Nursing Practice. Nursing Ethics , 136-150. Sales, B. D., & Folkman, S. (2000). Ethics in Research with Human Participants. Washington, DC: APA Publishing. Sneesby, L. (2008). An Ethical Dilemma: Mine, Yours or Ours? Journal of Medicine and Biomedical Sciences , 114-147. Read More