Nurses experience many situations that lead to ethical dilemmas.These dilemmas vary widely in the concepts involved and the nature ofdecisions involved. Personally, I have experienced several situationsthat cause ethical dilemmas. Uustal’s (1990) nine-step model is oneof the decision making tools designed to assist nurses to navigatesuch situations. Below is a brief explanation of my application ofthe model in a unique situation.
The situation involved an elderly patient who had suffered a brokenleg. The patient had spent several weeks bedridden with no visitorsat all. He had grown lonely and was desperate to leave the ward andstretch his body. During my shift he had pleaded and begged me to lethim walk around facility. I was worried putting weight on his leg wastoo early. Furthermore, a week ago, he had survived a scare a afterhe slipped in the bathroom. With this in mind, I found it hard tomake a decision on whether to risk his health to please him or todeny him his wishes and watch him continue to lie on the bed indesperation and loneliness. To make a good deceion I sought to employUustal’s decision making model.
Accordingly, I assessed the objectives I needed in the givensituation as the first and foremost step. My objectives in this casewere protecting the patient from harm and at the same timemaintaining respect for a patient’s autonomy in freedom of choice(Slate, 2013). The second step involved doing a preliminary survey ofmy options. Besides the option of refusing or granting him permissionto walk around, I also considered other options such as I walk himwith my support or to move him a round in a wheelchair.
The third step involved identifying implicated values on my part andthat of the patient. For the patient, the core value at stake wasdignity while on my part it was professionalism (Slate, 2013). Thefourth step pertained to assessing the significance of the decisionproposed and the implications beneath it. The implications includedvalues and resources such as time and money. For instance, Iconsidered the wheelchair would save time, enable the patient to moveabout and keep him from harm such as falling or further injuring hisleg.
The fifth step was considering the amount of time and energy inmaking the decision. For me, the wheelchair option was the mostsuitable. The sixth step involved making a strategic planneddecision. In this case, my strategy involved settling for the optionthat was acceptable to my busy schedule, ensured patient safety andalso one that the patient would easily agree to. The seventh strategyinvolved considering other possible options. I considered taking thepatient for a walk after my shift if he would agree to it.
Step eight involved further evaluation of options. For betterinsight, I sought the advice on a fellow nurse on the situation.According to her input, I needed to choose either moving the manaround in a wheelchair or walking him around after the shift. Theninth and final step was the making the final decision. I settleddown for walking him with my support around after my shift.
The exercise therefore captures the importance of Uustal’s decisionmaking model and how easily it can be applied by nurses who faceethical dilemma in various situations
Slate, MK 2013.Ethics for the Professional Nurse. Retrieved from
Uustal, DB. 1990.Enhancing your ethical reasoning. Crit Care Nurs Clin North Am.