Ethical Considerations in Nursing: Micro, Meso, and Macro Perspectives
Ethical Considerations in Nursing
Micro Ethics: The Individual Patient
Micro ethics focuses on the individual patient and the network of human relationships involved in their care. Clinical decisions are made in collaboration with the patient, their family, and healthcare professionals. This approach emphasizes the specific context of each case and the immediate impact of decisions on the patient’s health and well-being.
Meso Ethics: Healthcare Organizations
Meso ethics addresses the ethical considerations within healthcare organizations. It involves discerning values to guide management decisions that affect patient care. This level of ethics examines the structure and functioning of organizations and their influence on ethical conflicts. It emphasizes the importance of considering patients, professionals, and their families as integral parts of the healthcare organization. Meso ethics focuses on the corporate and structural aspects, including procedures, protocols, and processes. It takes a more normative and preventive approach compared to case-by-case analysis, representing a step towards a collective view of ethics.
Macro Ethics: Societal Healthcare
Macro ethics guides and coordinates the provision of healthcare to society as a whole, considering the nation or state level. It addresses the right to health and healthcare, taking into account issues of equity in relation to finance, access, and scope of healthcare services.
The Primary Nurse Model
The primary nurse model is a method of providing nursing services characterized by a strong and continuous relationship between a designated nurse and the patient. This nurse is responsible for planning, managing, and coordinating the patient’s nursing care throughout their illness.
Organization of Primary Nursing
- Operates within a specific unit.
- Responsible for 5-6 patients.
- Has an associated team of nurses.
- Involves administrative tasks.
Responsibilities of the Primary Nurse
- Responsible for the entire patient process from admission to discharge.
- Manages patient care, including needs assessment, care planning, monitoring, and evaluation.
- Ensures the patient and family know who their responsible nurse is.
Company Culture in Healthcare
The concept of company culture emerged to describe the unwritten rules and practices within an organization. It encompasses traditions, customs, and spontaneous coordination between departments. Company culture can significantly impact the functioning of a healthcare organization.
Applying Management Theories in Nursing: A Critical Analysis
Frederick Taylor’s Scientific Management
Frederick Taylor’s scientific management model aims to rationalize production by separating organizers and performers. It prioritizes efficiency by reducing time and maximizing movement. Work is viewed as mechanical, with the worker as a cog in a machine. This model is generally not suitable for nursing, except in specific emergency situations where a rapid, standardized response is crucial (e.g., cardiac arrest).
Taylor’s emphasis on selecting the most skilled worker for a specific task can be beneficial in emergencies. However, his disregard for worker autonomy and emphasis on mechanical execution conflicts with the need for critical thinking and ethical decision-making in nursing.
Max Weber’s Bureaucratic Model
Max Weber’s bureaucratic model emphasizes rules and regulations as the foundation of an organization. Everything must be planned and executed according to procedures. While adherence to protocols is important in nursing, Weber’s model can be problematic when applied rigidly. Ethical considerations and professional judgment are paramount in nursing practice.
Weber’s emphasis on organizational assessment to identify weaknesses is valuable in healthcare. Nurses should understand the rationale behind protocols and techniques, rather than blindly following procedures. Critical thinking and ethical reflection are essential components of quality nursing care.
Conclusion
While elements of Taylorism and Weber’s bureaucracy may be applicable in specific situations, a holistic approach that prioritizes patient well-being, ethical considerations, and professional autonomy is essential in nursing practice.