Ethical Dilemma on Case Manager - Essay Example

? Ethical Dilemma on Case Manager Case managers tend to appear uncomfortable with the perception that they can deny services; rather, they presumably facilitate treatment (Primeaux & Pava, 2009). As the complexity of the medical cases continues to increase, case managers in nursing have to manage a team of physicians. The managers are not expected to determine the medical necessity of patients (Toren & Wagner, 2010). However, case managers are expected to raise questions about the patient treatment and care without showing any bias. The process of striking the right balance between conflicting viewpoints causes them to encounter multiple ethical dilemmas especially in case of unnecessary or duplicative services (Icheku, 2011). This process involved balancing the needs of the insurer, patients and hospital (Primeaux & Pava, 2009). The managers are expected to have the interests of the patients at heart. The process of resisting the conflict of interests and ensuring proper medical procedures are followed without affecting the morale of nurses is a tough balancing act. Nurses can easily feel offended, demoralized or ignored depending on the skills and effectiveness of a case manager (Ulrich et al, 2010). The increasing pressure in the nursing profession demands that healthcare professionals get acquainted to the growing pressure in the nursing field. Nurses are expected to act morally in difficult medical situations. Nurse Managers are faced with the dilemma of balancing patients’ care and supervisory roles. Management responsibilities and active attention on patients demands that nurses pay special care in multiple aspects within the medical field. The call to extra responsibility has proved to be a dilemma as the medical field continues to suffer from acute shortage of medical personnel (Icheku, 2011). Managing multidisciplinary teams requires specialized training (Toren & Wagner, 2010). Meeting the needs of subordinate doctors and patients is the ultimate test of passion, professionalism and commitment in the nursing field. Nurse Managers experience workplace burdens. Awareness is needed for the nurse managers in order to overcome the burdens associated with ethical issue (Primeaux & Pava, 2009). Support for other nurses is essential (Icheku, 2011). The nurses are expected to co-work with doctors while delivering patient care. Ensuring ethical issues have been fulfilled demands that a team-approach be necessitated. Case managers are answerable to multiple parties (Munhall, 2012). This makes them face multiple dilemmas. Violation of treatment and other medical services can attract legal redress (Ulrich et al, 2010). The act of balancing the needs and requirements of stakeholders in the medical profession is delicate. Nurse Managers or case managers must have the skills to determine successful outcomes in different cases (Icheku, 2011). The multiple dimensions of outcomes should be noted. This means considering the impact they have on patients, nurses, the hospital and other parties (Primeaux & Pava, 2009). Successful outcomes have different implications to different people. The process involves weighing the advisedness of health services (Toren & Wagner, 2010). The managers are expected to have the capacity to weigh the probability of each outcome. This is important in evaluation the course of action to take (Munhall, 2012). This can attract re-examination. Managers are expected to rise above medical needs to create an atmosphere that accommodates other non medical stakeholders. Practice dilemmas evoke distressing reactions from nurse managers. The dilemmas revolve around professional conflicts, inadequate resources and patient care concerns (Munhall, 2012). Moral stress is increasingly becoming common in the nursing profession. This is because of the struggle to make decisions that involve conflict multiple ethical principles. Nurse Managers are bothered by the need to balance patient autonomy to ensure the required results are achieved. Moral dilemmas in the nursing profession have caused a lot of doubt (Toren & Wagner, 2010). Many nursing decisions tend to conflict ethical principles leaving nurses with dilemmas. The context of the preferences of a patient and the belief system must always be taken into consideration (Primeaux & Pava, 2009). Morally correct decision in nurse management is limited to the nature of the workplace environment. Nurse Managers face financial pressures and limited resources from patients. The burdens and challenges of the profession tend to converge on the patient and the nurse managers (Ulrich et al, 2010). Studies show that moral distress affects the effectiveness of nurse and patience outcomes. Nurse Managers aim to achieve satisfaction, attrition and minimize distress among nurses. The nurses are bound by the professional ethics and requirements (Munhall, 2012). Ethical issues affecting nurse managers revolved around morals. This is because nursing is perceived to be a moral profession. Nursing managerial dilemmas tend to address patient protection, prevention of complications and maintenance of healing (Toren & Wagner, 2010). Internal and external contexts of nursing are directly linked to the nurses’ psychological experiences and responses. Nurse Managers are known to suffer from ager, loss of self-work and suffering as a result of nursing dilemmas (Primeaux & Pava, 2009). Nurses suffer from feelings of powerlessness, anxiety and resentment when dealing with ethical dilemmas that arise from the profession. Opposing moral responsibilities are known to be a major cause of ethical dilemmas among nurse managers (Ulrich et al, 2010). This leads to nurses having feelings their moral integrity is negatively affected or compromised. Dealing with ethical dilemmas requires a comprehensive strategy (Primeaux & Pava, 2009). The moral dilemma that is associated to workplace extremes can be deal with by having nurses in ethics management committees. In many cases, nurses fail to share their ethical concerns within the practice environments. The organizational climate is central to the effectiveness of the nursing profession (Ulrich et al, 2010). Nurse Managers are supposed to be empowered with skills and ideas that favor and empowered nurses to be better in the nursing profession (Munhall, 2012). Medical policies that cater for the needs of the nurses and patients must avoid ambiguity and presumptions. Ethical dilemmas that relate to moral distress can be perpetrated by rigid rules (Primeaux & Pava, 2009). This can affect resource utilization which affects the effectiveness of the nurses. A significant number of ethical dilemmas that relate to morality and professionalism have been caused by the passive nature of nurse leaders. Nurse Managers are accused of being self-centeredness (Ulrich et al, 2010). This has caused the nurse managers to maintain the status quo even when the moral distress is on the rise among the nurses. The ethical dilemma touching on moral distress in the line of duty can only be addressed through structured dialogue of a regular basis (Toren & Wagner, 2010). Ethics and power are closely related according to research. Nurses suffer from failure to access the platforms to raise ethical concerns that relate to the professional operations and effectiveness. The nursing organizational impediments can be addressed through dialogue (Primeaux & Pava, 2009). The quality of case managers and nurses affects the effectiveness of health sector and treatment cost (Munhall, 2012). The probability of success in a particular treatment must be counter checked against the likelihood of a successful outcome in the same procedure (Toren & Wagner, 2010). The nurse managers is expected to determine the quality and extent of care expected while pursuing a successful outcome. The ability of a patient to pay, details about the insurance cover and the expectations of the nurses or doctors play a critical role in the process of dealing with ethical dilemmas. The nurse managers are expected to fight for clients while ensuring the quality of services is not compromised. Ethical conduct is the lynchpin of case management in the nursing sector. Improving the organizational approach in the nursing professional entails a touch balancing act. The success of the healthcare sector is dependent on the mutual respect between the multiple stakeholders under the leadership of case managers. References Icheku, V. (2011). Understanding Ethics and Ethical Decision-making. Xlibris Corp. Munhall, P. L. (2012). Nursing research: A qualitative perspective. Sudbury, MA: Jones & Bartlett Learning. Primeaux, P., & Pava, M. L. (2009). Symposium on health care ethics. Bingley: Emerald Group Publishing Limited. Toren, O., & Wagner, N. (2010). Applying an ethical decision-making tool to a nurse management dilemma. Nursing Ethics, 17(3), 393-402. Ulrich, C. M., Taylor, C., Soeken, K., Danis, M., & Grady, C. (2010). Everyday ethics: ethical issues and stress in nursing practice. Journal of Advanced Nursing, 66(11), 2510-9. Read More