Nurses Educator

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Introduction

In nursing education, teaching students to navigate legal and ethical dilemmas is crucial to preparing them for the real-world challenges they will face in their professional careers. One effective method for addressing these dilemmas is through the “Right Thing to Do” strategy. This approach encourages students to reflect on hypothetical and real-world cases by asking, “What is the right thing to do?” It fosters critical thinking, ethical decision-making, and professional judgment, all of which are essential qualities for nurses.

This article will explore the implementation of the “Right Thing to Do” strategy, providing case examples and discussing the outcomes of this approach in nursing education. Strategy for Legal and Ethical Issues

What Is “The Right Thing to Do” in Nursing Education?

The “Right Thing to Do” strategy is a teaching method used to introduce and discuss legal and ethical issues in nursing. It presents students with hypothetical or real-world scenarios that reflect common dilemmas nurses may encounter in their careers. By asking the question, “What is the right thing to do?” students are encouraged to think critically and apply ethical principles, professional standards, and legal considerations to arrive at a solution.

This strategy is especially useful in helping beginning nurses and students socialize into the profession, giving them a framework to address complex situations. Nursing educators often integrate it into lessons on patient rights, autonomy, informed consent, confidentiality, and other ethical issues relevant to healthcare.

For example, in a lesson about the rights of patients participating in research, nursing educators might present scenarios regarding informed consent, justice, and risks versus benefits. After discussing the context, they pose the question: “What is the right thing to do?” This question engages the entire class, prompting individual students to share their perspectives, which fosters a deeper understanding of ethical nursing practice.

Implementation of “The Right Thing to Do” Strategy in Nursing Education

To effectively implement the “Right Thing to Do” strategy in nursing education, instructors can follow a legal and ethical decision-making framework. This involves presenting students with specific case studies, encouraging them to think critically, and asking, “What is the right thing to do?” Here are several case scenarios that illustrate how this strategy can be implemented in the classroom:

Scenario 1: The Confidentiality Dilemma

A 20-year-old male patient admits to being a prostitute for four years, having engaged in both heterosexual and homosexual relationships. He is undergoing diagnostic tests for respiratory and gastrointestinal infections. He asks the nurse not to disclose this information to anyone. What is the right thing to do?

Scenario 2: The Post-Surgery Complication

An 18-year-old female patient receives general anesthesia for fractures in her tibia and fibula. Upon waking, the nurse discharges her with instructions, which the patient doesn’t fully comprehend due to her post-anesthetic state. Three days later, she is readmitted with severe complications, leading to a below-the-knee amputation. What is the right thing to do?

Scenario 3: Restraints and Patient Autonomy

A 76-year-old woman from a nursing home is admitted with acute dehydration and disoriented behavior. Restraints are applied to prevent her from pulling out her IV. Her daughter, upset, asks for the restraints to be removed, arguing that her mother’s nursing home is restraint-free. What is the right thing to do?

Scenario 4: Delegation and Patient Safety

As a supervising nurse, you delegate tasks to a nursing assistant who leaves a patient unattended in the bathroom. The patient falls and hits her head. What is the right thing to do?

Scenario 5: The Placebo Prescription

A 45-year-old man with a history of drug abuse arrives at a clinic in pain. The physician prescribes a placebo, suspecting the patient is not in real pain. What is the right thing to do?

Scenario 6: The Teen Pregnancy and Abuse Case

A 16-year-old girl, who already has one child and has had two abortions, comes to a clinic fearing she is pregnant. Her pregnancy test is negative, but she confesses that her brother’s friends have been forcing her into sexual relations. What is the right thing to do?

These scenarios provide students with real-life situations that challenge their ethical and legal understanding. By encouraging students to reflect on each case and apply their knowledge of nursing principles, they can learn to make informed, ethical decisions.

Outcomes of Using the “Right Thing to Do” Strategy in Nursing Education

The outcomes of using the “Right Thing to Do” strategy in nursing education are multifaceted. This teaching method encourages students to:

  1. Enhance Critical Thinking and Problem-Solving Skills: By analyzing legal and ethical dilemmas, students learn to approach complex situations logically and ethically. They are encouraged to move beyond rote learning and think critically about the implications of their decisions.
  2. Develop Professional Judgment: Asking “What is the right thing to do?” helps students practice making decisions that align with professional nursing standards and values. This strategy helps students transition from theoretical knowledge to practical application in real-world situations.
  3. Improve Ethical Decision-Making: Legal and ethical dilemmas often require nurses to make decisions that balance the needs of patients, families, and healthcare providers. The “Right Thing to Do” strategy encourages students to consider all aspects of a situation before making a decision, promoting thoughtful and ethical nursing practice.
  4. Foster Empathy and Compassion: The strategy encourages students to put themselves in the shoes of both patients and colleagues. By understanding different perspectives, students can develop a deeper sense of empathy, which is essential in nursing.
  5. Prepare for Real-World Challenges: Nursing is a profession filled with difficult decisions and ethical dilemmas. This strategy prepares students for the real-world challenges they will face as nurses, ensuring they are ready to act responsibly and ethically in complex situations.

Bowles’ “Find the Error” Game

As part of the “Right Thing to Do” strategy, Bowles proposed a game called “Find the Error.” In this game, instructors provide statements that contain errors related to ethical or legal nursing practices. Students are then tasked with identifying and correcting the errors, using critical thinking and problem-solving skills.

For example, an incorrect statement might read, “It is acceptable to share a patient’s medical information with a family member without the patient’s consent.” Students would then correct the statement based on their knowledge of confidentiality and privacy laws. This exercise not only reinforces critical thinking but also helps students practice applying ethical principles to real-life scenarios.

Encouraging Discussion and Multiple Perspectives

The “Right Thing to Do” strategy fosters open dialogue and encourages students to explore multiple perspectives. In clinical settings, nursing students often feel torn between patient care priorities, institutional policies, and ethical standards. This strategy provides a structured way for students to consider different approaches and come to a well-reasoned conclusion about what is right.

For instance, when students encounter practices that differ from what they have been taught, they may struggle to determine the “right” course of action. The strategy allows students to discuss the pros and cons of various methods, helping them see that there can be more than one valid approach to solving a problem.

Emphasizing Fundamental Nursing Principles

At its core, the “Right Thing to Do” strategy emphasizes fundamental nursing principles such as asepsis, patient safety, and respect for patient autonomy. It teaches students that while there may be multiple ways to approach a situation, these basic principles must always be upheld. By reinforcing these principles, nursing educators can help students feel more confident in their decision-making and better prepared to handle ethical challenges.

Conclusion

The “Right Thing to Do” strategy is an effective tool for teaching nursing students how to navigate the legal and ethical dilemmas they will face in their professional careers. By presenting real-world scenarios and asking, “What is the right thing to do?” educators can help students develop critical thinking, ethical decision-making, and professional judgment. This strategy also encourages empathy, discussion, and the exploration of multiple perspectives, all of which are essential skills for nursing practice.

By integrating this approach into nursing education, educators can better prepare students for the complex, ever-changing world of healthcare, ensuring they are ready to make thoughtful, ethical decisions in their future roles as nurses.