Nurses generally have a responsibility to identify and address ethical issues that may arise in their line of work. To deal with these issues, they have to employ solutions both professionally and morally, showing sympathy when necessary; putting in mind the effect of the issue on their patients and the institution. In the case that a nurse is deeply connected with the patient, confronting the issue poses an even greater challenge, like in the case of Mr. Newcomb. By applying a nurse’s ethical principles, I would help Mr. Newcomb see his mistress for the last time while ensuring that his wife’s feelings are not hurt in the process, as discussed.
To begin with, I would apply the principle of beneficence to serve the needs of the patient before anything (Varkey, 2020). Owing to the fact that the patient is approaching death, I would give him the chance to have a last request as a way of acting for the benefit of my patient. Mr. Newcomb had, for a long time, been taking medication, and the realization that he was about to die influenced his request. Although helping him is morally wrong to the wife, the fact that it was his only and last request means that his mistress must have been special to him, and denying them the right to see each other for the last time or to say goodbye would be wrong.
Secondly, I would use the principle of autonomy which gives the patient a lease to make moral and rational choices out of his own free will (Varkey, 2020). By this principle, I would let Mr. Newcomb make the decision to see his mistress if any form of persuasion fails. Autonomy also gives a patient the right to confidentiality. Therefore, if he needs to see someone privately, I have to accept and do my best to offer favorable conditions. Refusing his request is equivalent to denying him autonomy.
Thirdly, non-maleficence gives a nurse the obligation to keep the patient out of harm’s way (Varkey, 2020). Based on my judgment of Mr. Newcomb’s condition, helping him see his mistress would cause more good than bad. My first obligation is to my patient, and giving him a last request seems like a good way of keeping him out of harm’s way. This principle advises against depriving a patient of a good life. If seeing his mistress assures his happiness, then I would help him. To keep both Mr. and Mrs. Newcomb out of harm, I would ensure that the meeting goes smoothly.
Fourthly, the principle of justice requires that every patient and visitor get fair treatment, including the time of visitation for the visitors (Varkey, 2020). This rule, therefore, also applies to the mistress. She is also allowed just as much time with the patient. Since Mr. Newcomb’s life is reaching an end, it would be fair to give his mistress time to see him. Helping Mr. Newcomb or creating conducive conditions will help avoid unnecessary drama during her visit. Although this act is unjust to Mrs. Newcomb, who was always there to support her husband, making sure she does not find out presents a win-win situation for both parties and is, therefore, a crucial part.
Finally, in making this conflicting decision as a nurse, I have to ignore some personal beliefs and values while altering others based on empathy. It is arguably true that the wife was always there to support him, and helping with seeing his mistress presents a betrayal to his wife. I particularly value loyalty in marriage. I have to re-consider based on Mr. Newcomb’s condition in this situation. Our close relationship also would not let me deny him the last request. Non-maleficence allows me to advise against the decision, but if he insists, then I would formulate a way for him to see his mistress. I would also make sure the wife remains in the dark about the matter to save her from unnecessary pain. This will give me a clearer mind, and it feels like the right thing to do for my patient and friend.
To conclude is a description of some strategies that might help me as a nurse. Asking for help in difficult situations like the one with Mr. Newcomb goes a long way in diversifying my decision. Maintaining positive friendships and nurturing interpersonal connections as a nurse helps keep mental health in check (Wei et al., 2020). Developing a positive attitude even in conflicting situations contributes to effective decision-making and working.
Varkey, B. (2020). Principles of clinical ethics and their application to practice. Medical Principles And Practice. https://doi.org/10.1159/000509119
Wei, H., Kifner, H., Dawes, M., Wei, T., & Boyd, J. (2020). Self-care Strategies to Combat Burnout Among Pediatric Critical Care Nurses and Physicians. Critical Care Nurse, 40(2), 44-53. https://doi.org/10.4037/ccn2020621