Which situations represent a breach of nursing ethics? (Select all that apply)

Introduction:

Clinical prioritization demands systematic assessment triage to identify life-threatening physiological instability, ensuring that high-acuity patients receive immediate nursing interventions before addressing routine tasks, stable patients, or administrative documentation requirements.

A. This choice is incorrect because while medication administration is a fundamental nursing responsibility, it does not constitute an emergency intervention, and it should be performed only after the nurse has ensured that all patients with critical or life-threatening conditions have been assessed and stabilized.

B. Addressing acute instability is the highest priority action, as sudden chest pain and dyspnea are cardinal signs of potential cardiac or respiratory compromise, such as myocardial infarction or pulmonary embolism, requiring immediate nursing assessment, rapid intervention, and physician notification to prevent severe clinical deterioration.

C. This choice is incorrect because documentation, while legally required and professionally important, is an administrative task that should never take precedence over the immediate assessment or intervention of a patient demonstrating acute signs of physiological compromise or instability.

D. This choice is incorrect because reviewing care plans or coordinating physical therapy appointments are routine, scheduled tasks that do not address urgent physiological needs, and these activities must be deferred until the nurse has completed the initial assessment of all patients to ensure safety and stability.

Introduction:

Delegation decision-making is governed by the Five Rights of delegation, which ensure that tasks are assigned appropriately to maintain safety. Evaluating the "Right Circumstance" involves assessing patient stability, the complexity of the clinical environment, and the potential for predictable outcomes during the care process.

A. Delegating a stable patient's bathing activity to a UAP is an appropriate use of the right circumstance. Bathing is a standard, routine task that requires minimal clinical judgment and is within the scope of practice for unlicensed personnel when the patient is stable and has predictable outcomes.

B. Delegating the assessment of a new patient admission to a UAP is an incorrect delegation decision. Nursing assessments require specialized clinical knowledge, critical thinking, and professional judgment that only a registered nurse possesses. Delegating this task violates professional standards and compromises the quality of patient care.

C. Delegating complex dressing changes to a volunteer is inappropriate as it involves procedures that require specific training and clinical competence. Volunteers are not trained or authorized to perform clinical tasks that affect patient safety, making this delegation a significant breach of facility and nursing practice regulations.

D. Delegating teaching about a new medication to a UAP is a violation of nursing scope of practice. Patient education regarding pharmacology, side effects, and administration requires nursing knowledge to evaluate the patient’s understanding and clinical status. This responsibility cannot be delegated and must be performed by a nurse.