This discussion forum examines ethics in professional nursing.
Nurses are frequently asked to give medications with which they are not familiar or to administer a familiar drug in an excessive dose or uncustomary route of administration. Unable to quickly determine its appropriateness or safety, a nurse might trust the physician’s order and administer the drug without fully understanding the implications or might refuse to administer the drug.
Discuss what are some predictable reactions of the nurse’s coworkers, supervisors, and physicians when a nurse refuses to follow a physician’s order? What ethical decisions can be used to guide such decisions?
reply
Nurses can be easily put into precarious situations on any given shift. When using ethical principles to try and make the most ethical decision when refusing orders nonmaleficence and beneficence are to be used. Do no harm intentional or unintentional. This is always a nursing responsibility, and this means that the nurse must be knowledgeable of the medications they are administering. Beneficence is doing good for the patient (Burkhardt, 2020). As long as the nurse is keeping the patient’s best interest in mind the nurse is acting ethically. If a nurse encounter orders that they feel are unsafe, they should consult with the charge nurse and manager. They must be careful that they are following the proper guidelines for refusing to carry out orders. Unless there is a safety concern or an order that conflicts with personal or religious beliefs, failing to carry out orders can be grounds for discipline by the employer as well as the board of nursing, as it could be deemed “neglect” (Bucceri, 2022). Generally, nurses will support nurse’s refusal to carry out orders. Supervisors and physicians will most likely push back, and management prefers supporting doctors. The nurse must use all of their resources to make sure they are making correct decision. It can dicey when a nurse stands up for their ethics, but it is important to advocate always for their patient. Refusing orders is sometimes part of that advocation.

 

 

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