Running header: ETHICS NURSING PAPER

Ethics Nursing Paper

Adrian Ann Lambert
James Madison University School of Nursing

ETHICS NURSING PAPER

Introduction
Discrimination of individuals in the healthcare field by professionals is a distraction to the
quality of patient care. Many studies have recognized a relationship between discrimination and
negative health outcomes. The studies found that discrimination was directly correlated with high
incidences of depression, anxiety, and low quality of care (Bostwick, Boyd, Hughes, & West,
2014). Whether the discrimination be about sexual orientation, race, culture, religion, etc., it
begins to eat away at the strings that keep society tied together. Giancola (2014) stated that
sexual orientation should only be contemplated if it is absolutely necessary to articulate the
appropriate plan of care.
Background
The situation I encountered during my clinical experience was quite disappointing because it
happened during my womens health rotation while I was in the nursery, which is my favorite
aspect of nursing. I had received many hours at this particular hospital before coming into the
nursing program so I thought I knew what to expect because when I came before, all the nurses
on all aspects of the Family Birthplace unit were remarkable. All individuals involved were
respectful and welcoming. I expected nothing less as I walked on the unit early one morning to
meet my nurse in the nursery. To my surprise she was not happy she was paired with a student
and was not afraid to voice that opinion to myself and my proctor. I was still left to learn with her
because she was the only seasoned nurse there. However, my view of the nursery suddenly
changed when I encountered a woman who went through in-vitro fertilization with her partner.
One of the mothers wanted to know how the baby was doing so I gave a little follow up and
asked the nurse if she would come out and speak with the mom. She responded, Well if she
doesnt have an armband there isnt much I can do for her. Did you even check? I said, Yes she

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has an armband and I think she would just appreciate one of the nurses who has been caring for
the baby to come talk with her because she is excited. She then precedes to go out and speak
with the mother of the baby. She comes in and makes the following remark in a sarcastic tone, I
am trying so hard not to be judgmental but some things just should not be. She was referring to
the female partners who underwent in-vitro to have a child together.
In my opinion, this was moral distress because I knew what the ethically correct action to
take was but I felt belittled by the nurse so I did not confront her about the comment she made to
me, and more importantly, about the couple and their infant. Since I am a nursing student who
does not work on the unit, I did not feel as though it was my place to confront the nurse. So one
potential alternate response to this situation would have been to go speak with my professor
about the situation to determine what the next steps would be.
Method
The method I used to analyze and evaluate the situation is called The JMU Eight Key Questions.
They include outcomes, liberty, authority, fairness, responsibility, rights, empathy, and character.
According to the Madison Collaborative (The Madison Collaborative, n.d.), these eight questions
reflect some of the best examples of ethical reasoning. The Madison Collaborative selected these
specific questions to be the center of decision making for students to use now and throughout life
as they encounter situations that call for ethical attention. They are specific to human values that
are essential when making ethically troubling decisions.
Findings
While I keep my situation in mind, I am going to answer the 8 Key Questions to make my
situation more ethically clear. Firstly, I will address fairness. To act out of fairness means I need

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to think about all parties involved and the feelings associated with each to give everyone an
equal opportunity. With rights I need to be aware that the individuals involved in the situation
had a legal right to not be discriminated against due to sexual orientation. Every person deserves
to have equal rights without personal judgment from the healthcare team. With authority, I need
to remember what my clinical professor would expect of me as a student. I acted respectably to
the situation but I should have asked for help with the situation from my professor. If this were
my family being discriminated against because of their sexual orientation and family pattern
choices I would empathize with them. Empathy allows the person needing to make the decision
relate to the pain the individual(s) is feeling. Liberty is compromised in this situation because the
respect for freedom and personal autonomy are diminished when the nurse judges the family
based upon their sexual orientation and decision to do in-vitro to start a family. The nurse was
making it uncomfortable for the same sex couple to show their love and affection by starting a
family with in-vitro. With character, I need to make sure that the action I choose best reflects
who I am as a person. I feel like I acted in an appropriate manner but should have taken the
situation to a higher power. The aspect of responsibilities pertains to all the parties involved in
this situation. It is the individual providing care who is responsible for the well-being of the
patient and accepting them for who they are. Not what they are expected to be. It is my
responsibility as a student nurse to acknowledge this conflicting subject as morally distressing
and bring it to the attention of someone who can help me work through this issue, such as my
professor. The best outcomes are also a vital component to the care of patients. When health care
professionals begin to discriminate clients based upon their race, gender, ethnicity, or sexual
orientation they begin to group them as negative or bad. I believe when this happens the
patient begins to suffer the consequences with poor outcomes (ANA, 2011).

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Provision 1 from the American Nurses Association states that the nurse, in all
professional relationships, practices with compassion and respect for the inherent dignity, worth,
and uniqueness of every individual, unrestricted by considerations of social or economic status,
personal attributes, or the nature of health problems (ANA, 2011). This provision stands true to
the situation I encountered because it clearly acknowledges the fact that all individuals, no matter
their background, deserve the same amount of compassion and respect as any other individual.
This guides action because it confirms my knowledge that what I experienced was not acceptable
and the next time this situation occurs I can confidently discuss it with the nurse or someone with
higher authority to acknowledge its unacceptable nature.
Conclusion
With regards to the situation I encountered, I believe I would not have said anything differently
but I would have said more. I could have pulled the nurse aside and asked her about her feelings
towards same-sex partners and why it bothers her. Also, instead of acting like it did not happen, I
could have told her that I did not feel appropriate speaking about such a sensitive topic in a
negative manner. If a similar situation such as this one occurs again in the future, which it will, I
am going to address it directly and stomp the prejudice feelings out. I know it will be hard to
stand up to an experienced nurse who has been there longer than myself but I do not feel like
sexual orientation slurs should be part of conversation in a professional setting.
My analysis increased my understanding of the general topic to great degrees. I always
knew that discrimination was active in the workplace but until I personally experienced this type
of situation I did not realize the impact it has on the care of the patient and family (ANA, 2011).

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References
American Nurses Association. (2011). Code of Ethics. Retrieved from
http://www.nursingworld.org/Mobile/Code-of-Ethics.
Bostwick, W., Boyd, C., Hughes, T., & West, B. (2014). Discrimination and Mental Health
Among Lesbian, Gay, and Bisexual Adults in the United States. Europe PubMed Central.
Retrieved from http://europepmc.org/articles/pmc4144327.
Giancola, J. (2014). Achieving Cultural Competency with Lesbian, Gay, Bisexual, and
Transgender (LGBT) Patients through Applications of Carpers Fundamental Patterns of
Knowing in Nursing [Research Paper]. Retrieved from
https://www.nursinglibrary.org/vhl/bitstream/10755/324241/6/LGBT%20Cultural
%20Competency.pdf.
James Madison University (n.d.). The Madison Collaborative: Ethical Reasoning in Action.
Retrieved from https://www.jmu.edu/mc/8-key-questions.shtml.