In the nursing field, ethics are a set of rules or moral
principles that governs the actions and decisions made by nurses in the
workplace. Throughout our course of study and clinical attachments in nursing,
we will definitely face situations which puts us in a dilemma, and we would
have to count on our ethical decision-making skills to overcome the problem.
As nurses, I believe its our duty to provide care for our
patients and ensure their wellbeing throughout their visit in the hospital. In this
scenario, I was faced with a dilemma if I should confront SEN Sng again and
report to a superior or keep quiet and do nothing about the situation. If I were
to confront SEN Sng and make a report to the superior, I would get her into trouble
and she would dislike me throughout the 2 weeks and may even make my attachment
an unpleasant one by trying to find fault with me. Im afraid that she might
scold me as well. On the other hand, if I do nothing about the situation, the
patient might suffer from air embolism.
Air embolism occurs when air bubbles enter a blood vessel and
block the blood flow. Air embolism might cause stroke, heart attack or respiratory failure if the
embolism or air bubbles travel to the brain, heart or lungs respectively (Healthline,
2018). A single small air bubble will not cause much problems, but larger
or multiple air bubbles should be removed (theNursePath, 2016). According to a
study done by Pant, Deepanjali, the minimum amount of air which will cause
patient to show symptoms of air embolism is 20ml if air per second and 70 – 150
ml of air per second can be fatal to the patient. The maximum safe amount of
air is still unknown (Pant, Narani & Sood, 2018).
The mortality rate of venous air embolism ranges from 23% to 50% (Balakrishnan,
Noor & Curran, 2016). The true incidence of venous air embolism is
not known due to the difficulty in documenting the diagnosis (Natal & Doty,
2018). I would also question SEN Sng on the reason why she is annoyed by
my comments, and her reason for not wanting to take action regarding the air bubbles.
Maybe she was in a rush?
scenario, SEN Sng has breached nonmaleficence. As nurses, one of our goals is
to ensure we protect the patient’s safety and prevent injury. By not taking
action regarding the air bubbles despite being prompted to, SEN Sng’s actions poses
a potential danger or harm to the patient. Running normal saline for the patient
provides a benefit for the patient, however, the IV drip contains air bubbles
in it which may cause venous air embolism to the patient. In this situation, the
risks outweigh the benefit. She did not take actions despite being confronted
by me, in fact, she got annoyed at my comments instead. SEN Sng has also displayed
negligence. Her duty was to administer normal saline safely, she realised there
was a mistake, but she did not want to immediately act upon it. There was a
breach in duty when she did not take actions even when she was aware of the air
bubbles in the IV drip, which poses a potential danger to the patient. In order
to prevent causation and damages, it is therefore my responsibility to
intervene. SEN Sng did not have integrity as she realises her mistake but did
not do anything about it. She also displayed an unprofessional misconduct.
the normal saline for the patient as soon as possible, SEN Sng displayed beneficence.
beneficence, paternalism and justice by confronting SEN Sng a second time and
letting her know that the bubbles should be removed twice, as I am protecting
be displaying beneficence and paternalism again if I decide to report the
incident to a higher authority to take action and change the IV drip set, as I am
making a decision that is best for my patient. In addition, I would also be
displaying the principal of veracity. However, veracity would also be breached
if I decide to not take any actions against SEN Sng.
scenario, SEN Sng should confess to her mistakes and act appropriately, which
is to change the IV drip set. However, after being reminded by me that the air
bubbles should be removed, she still did not take any actions. I have the right
to make the decision and intervene immediately or else the patient might be
harmed. I also have the right to make the decision, as by doing so, I would be
abiding to the principal of ethics, against SEN Sng’s actions which breached
several principals, codes of ethics, professional conduct and nursing negligence.