NCLEX-PN

Nurses' ability to identify ethical issues affecting both staff and clients, provide information on ethics, and intervene appropriately to promote ethical practice will be evaluated during the NCLEX Exam. Additionally, you'll be expected to review the outcomes of your interventions to uphold ethical standards in nursing care. Embracing these ethical principles will help you excel in making ethical decisions and ensuring the well-being of your clients and the integrity of the nursing profession. Ethical Decision Making Ethical decision-making is an essential aspect of nursing practice. Nurses must be able to weigh the ethical implications of their actions and make decisions that are in the best interests of their clients, even when faced with difficult dilemmas. Nurses can use a variety of frameworks to help them make ethical decisions. One common framework, Participative Ethical Decision-Making (PEDM), was developed in 1997 by Mary Calabro, NP (Nurse Practitioner).

Applying the PEDM Model:

Case Study: A 3-year-old girl with sleep apnea, enlarged tonsils, and repeated sore throats is brought to the doctor by her mother. The mother has missed previous appointments with a specialist and refused to have her daughter's tonsils removed, as advised by the ENT. The girl now has another sore throat; however, the mother is adamantly against the surgery.

Step 1: Is there a problem with no solution that is completely satisfactory to all parties?

Yes, the mother’s unwillingness to agree to surgery and the NP’s professional ethics, which require consideration of the surgical necessity and the possible impact of overruling the mother in an arbitrary or threatening manner.

Step 2: Who is involved, what is the issue or problem, and when does a decision need to be made?

Mother, child, and possibly the community are involved. The conflict is essentially one of who has the right to make decisions for a minor child. Time is of the essence due to the child’s sleep apnea.

Step 3: What professional standards or codes of conduct are involved?

The NP is ethically obligated to provide the safest care possible for all children. The NP has extensive knowledge and experience, and understands the dangers of sleep apnea ( beneficence , maleficence ). Advocacy is another important ethical principle, especially when caring for a minor who cannot advocate for themselves. However, the NP also wants to maintain the child's family unit and support system. The NP may believe that the mother has a responsibility to follow the ENT's recommendation for surgery.

Step 4: What are the client's principles and values related to the dilemma?

The mother is scared of surgery because her mother told her not to let her daughter have surgery until she is five years old. The mother trusts her mother's advice and support. The mother and grandmother

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