Facing Nurses With Ethical Dilemmas

An ethical dilemma is a situation where an individual is compelled to make a difficult decision as a result of two or more conflicting choices. The choices in consideration in such circumstances can be justified as uncertain, equally bad, or equally good (Butts & Rich, 2016). As registered nurses, we are faced with various situations in which we have to make decisions that affect an individual’s well-being. The choices we make under such circumstances may differ depending on the nurse. The consequences of the on-duty-bound choices we make can affect a person’s well-being. In the nurse’s opinion, the action taken based on the decision may be justifiable. However, the appropriateness of the decision may be uncertain. Ultimately, a choice has to be made when nurses are faced with dilemmas; however, the person making a choice is responsible for the consequences.

The statement “what may be an ethical dilemma for one registered nurse may not be an ethical dilemma for another registered nurse” means that every person has their guiding principles in decision making. Hence what may be an ethical issue for one nurse may not hold for another nurse. On one occasion in my career, I started my night shift when I was informed that a patient had been restrained on 4-point restraints because he was getting off the bed and wandering without a physician’s order. The intention of the restrain in the previous shift was made to prevent the patient from falling. However, it was not ethical to restrain a patient without an order from a physician. I took action to report the issue to my supervisor, who filed an incident report, and the patient’s family was notified.

As registered nurses, we often face ethical dilemmas that call for justifiable decisions. Making appropriate decisions requires individuals to have a better understanding of themselves and their responsibilities, ask good questions, challenge the status quo, and be continuous learners (Butts & Rich, 2016). Application of the Five R’s in the nursing profession can help one achieve justifiable ethical decisions. According to Butts and Rich (2016), the Five R’s are read, reflect, recognize, resolve, and respond. Values in nursing are fundamental in the practice of nursing. They are the guiding standards for actions, providing a behavior evaluation framework, and influencing decisions for practice. As a nurse, I find it wise to reflect on my personal beliefs and values, other people’s values and beliefs, and then align myself with other people’s situations to make decisions. In my nursing practice, the personal values I appreciate are respect, honesty, integrity, compassion, kindness, and loyalty. I uphold these values because I have the responsibility of promoting patients’ dignity and care.

My society has a positive perception of values such as honesty, respect, responsibility, justice. In my practice, I make evidence-based decisions when faced with dilemmas. Nam et al. (2017) propose that nurses’ decisions should be evidence-based considering personal clinical understanding, research evidence, and patient preferences. Although my decisions are evidence-based, they match most of my values. In my society, giving back to the community and justice are the most useful attributes since they promote equity. My duties as a nurse limit most of my personal choices, and my choices in healthcare are controlled by the government and healthcare organizations. In my view, limiting choices is essential in regulating actions in healthcare to avoid personal values overriding professional obligations. On many occasions, I have not limited my patient’s choices as long as they are aware of all options available. I believe that some people’s choices should be limited by the government or health care organization through rules and regulations as long as they affect resources equity and individual well-being.


Butts, J. B., & Rich, K. L. (2019). Nursing ethics. Jones & Bartlett Learning.

Nam, A., Lee, E., Park, J., Ki, E., Nam, S., & Park, M. (2017). Effects of an Evidence-based practice (EBP) education program on EBP practice readiness and EBP decision making in clinical nurses. Journal of Korean Academy of Nursing Administration, 23(3), 239.

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