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Nursing practice is a complex phenomenon and usually takes shape in several dimension. Nurses can develop a better idea of how to practice, the effects of the practice, and how to respond to challenging situations, by reflection of this practice and especially reflection of critical events. Autonomic dysreflexia is a medical emergency that occurs after a spinal cord injury due to disruption of normal autonomic response stimuli below the level of spinal cord injury. Even though it can cause cardiac arrest, convulsions, stroke, and death, health professionals are generally unaware of this condition and often misdiagnosed (Wihlborg et al. 2018).
I observed that workers were confused and sometimes refused regular medication with aggressive patients. Staff members crushed the tablets and brought them to the patient's food. The patient was, the person who is old and confused, he is, they rely on the nursing staff to help them with all the activities of the day. It is difficult to communicate with them and not get their real permission or consent. However, medications are needed to maintain good health, deal with mental illness, and prevent anxiety from chronic conditions (such as high blood pressure). I also support this practice by asking questions about nurses but the answer is somewhat defensive. It seems that the only way to administer these drugs is for faith and for the health of the patient (Asghar & Rowe, 2017).
At first, I felt the need for such a statement because it was considered an ethical challenge. I also acknowledge the need to confirm whether the patient has taken the drug, a fact that has earned prior consent and respect for the patient’s rights and dignity. Nurses have one more requirement to act in the best interests of the patient and in this case, it is easy to see that they need medication and can take care of their personal well-being. However, I will ask more about the improvement of this condition because due to cognitive weakness the patient may not be able to understand the difference between the thematic steps to feel better (Palesy & Levett-Jones, 2020).
Nurses with autonomic dysreflexia play a role in physical and mental challenges. Nurses who choose to work in this field should be dedicated and enthusiastic about the general care provided for physically dependent individuals. Therefore, the knowledge of care need and outcome is more important because the nurse is helped this patient to commence the rest of his life with a body that works contrarily at present. The goals must be to assist that person, and his family, have confidence for tomorrow and to understand that they can still live productive life, full-independent in the limit of his disability.
Therefore, it can be seen that the activity of nurses by secretly preserving drugs in patients’ diets is too much and may be motivated by experience and comfort rather than patient interest. With an unwavering focus on ensuring patient safety through patient care centers and the highest quality of patient care, Rennó, Ramos & Brito (2018) point out that activities that result from prior thinking may put patients at greater risk. The nurse may have such an idea in such a situation but it still does not matter but this step can create a risk for the patient. If there is another person who asked him and asked if the patient has to take the drug (more obvious at that time) the patient will not tell, because he does not know if it should happen. Thus, patients can use it because a second dose may be given.
The ethical considerations raised from this particular situation are not equivalent to law, although there is an overlapping field and a combination of both opinions. Aggressive and confused patients may be at risk of self-harm and appropriate treatment may be considered appropriate in this context, but it is questionable whether medication should be denied. It will respect autonomy and mean that the care provided is not just tied to a home-based routine, and means a patient-centered approach (Kelly et al. 2016).
There seems to be a fine line between moral practice and rude behavior, so it is important to understand why this step was taken and to be fair. If this helps, nurses may be able to overcome their own prejudices and prejudices about a particular patient through critical testing and reflection. It will help me to develop critical thinking. The nurse can then critique and change the type of activity, if possible alternative methods are not used, such as providing a variety of medications in other forms, which is more appropriate for the patient. Although it is not easy to determine the right course of action in this situation, it is easier to assess the motivation of the activity and understand the policy implications if the nurse adheres to the client's practice-oriented principles. But it is also important to discuss the theory of this practice and the practices that take special care of those nurses who are able to understand the ethical issues and ethics that arise from such a situation (Kelly et al. 2016).
As part of this reflection, I will now attempt to combine the decision of the overall assessment of the conditions described and discussed above. Drawing this situation makes it clear to me that there is much to learn from the situation. First, it speaks to the complexity of general nursing duties, especially when dealing with ethical issues. The key ethical issues in this scenario are related to autonomy and efficiency and the motivation of patients in the actions of the nurses involved. Autonomy is a core ethical principle, and respects the rights and individuality of patients as a professional nursing practice. Patient-centered practice is the norm, but it should be a basic principle and can be considered for evaluating patient-centered care in such national situations as effective for analyzing nursing practice.
In the acute stage, care and nursing staff should consider diagnosing autonomic dysreflexia in patients based on the symptoms and their appropriate actions. Therapy Medication is rarely required – interventions, like bladder and bowel management are generally effective. Moreover, there is no sensation about the choice of medication. Antihypertensives with short-term and rapid activity may be present, such as nitrate, nifedipine, and sildenafil, while care should be exercised to avoid severe hypotension. From the personal experience, paramedics may be reluctant to use it because they do not have a license to use it. With this in mind, it is important to educate patients and empower them to administer medication independently (Bagheri et al. 2019).
In this scenario, I argue that nurses should spend more time with these patients and think about ways to safely dispense medication without challenging autonomy. This is clear that deception is a practice and concept that does not fit the basic principles related to healthcare and nursing. I knows from this that concealed actions are not acceptable and if this situation reappears, I will have the power to challenge and restore focus to take action to the rights of patient. This is also important to maintain a balance between the best causes for the patient. Ongoing discussions will continue, when the patient is disabled, but if the nurse adheres to ethical principles, they will provide the patient with concentrated care (Jansson & Ene, 2016).
This process of reflection is an important learning journey for me as it enhances my understanding and insight into the ethical challenges I faces in my daily practice and work. The reflections, guided by constructive models, have helped me to evaluate and analyze this situation and to apply ethical and philosophical parameters. I also discovered that managing these reflections not only increased my understanding of the situation and the complexity of the ethical question raised by it, but also strengthen my critical thinking skills.
Ethical decisions seem very difficult to make in nursing, because ethical questions often create some confusion about right and wrong. There are cases like this, but I know that there is literature to help nurses understand more clearly the rights and flaws of moral dilemmas, and that using that information can help to understand and improve future practices.
Specialist nurses for those who are experiencing dysreflexia. Caring for those who are suffering from dysreflexia must be the focus of the patient. Nursing staff plays an important role in the multidisciplinary. Moreover, effective communication between nurses, patients, their families and multi-departmental teams is essential. Nurses should be aware of the potential sensitivity of dysreflexia patients.
Asghar, M., & Rowe, N. (2017). Reciprocity and critical reflection as the key to social justice in service learning: A case study. Innovations in Education and Teaching International, 54(2), 117-125.
Bagheri, M., Taleghani, F., Abazari, P., & Yousefy, A. (2019). Triggers for reflection in undergraduate clinical nursing education: A qualitative descriptive study. Nurse education today, 75, 35-40.
Jansson, I., & Ene, K. W. (2016). Nursing students’ evaluation of quality indicators during learning in clinical practice. Nurse education in practice, 20, 17-22.
Kelly, M. A., Berragan, E., Husebø, S. E., & Orr, F. (2016). Simulation in nursing education—International perspectives and contemporary scope of practice. Journal of Nursing Scholarship, 48(3), 312-321.
Palesy, D., & Levett-Jones, T. (2020). Reflection revisited: Educational interventions for advancing the professional disposition of postgraduate nursing students. In Enriching Higher Education Students' Learning through Post-work Placement Interventions (pp. 229-246). Springer, Cham.
Rennó, H. M. S., Ramos, F. R. S., & Brito, M. J. M. (2018). Moral distress of nursing undergraduates: Myth or reality?. Nursing ethics, 25(3), 304-312.
Wihlborg, M., Friberg, E. E., Rose, K. M., & Eastham, L. (2018). Facilitating learning through an international virtual collaborative practice: A case study. Nurse education today, 61, 3-8.
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