Question

Provision 5: “The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth.”

Imagine you are nurse who is six months pregnant (guys, stretch that imagination). You arrive to the hospital and check your patient assignment. One patient in your assignment is receiving high-dose chemotherapy medication, which, in this case, is contraindicated for pregnant women to administer. You ask the charge nurse to change the assignment, and he refuses based on the acuity of the patient. He notes that other nurses on staff tonight are too new to care for such a sick patient.

2. Who is ethically right: the charge nurse trying to ensure a high-acuity patient has appropriate nursing care or you the nurse? Build an argument for your opinion.

Answer 1

It is a well-known fact that administering chemotherapy is a health hazard for cancer clinic nurses, due to the potent toxicity of these drugs. The chemo drugs are known to have fetotoxicity and high-dose chemotherapy medication is contraindicated for a pregnant nurse to administer. There is enough evidence to prove that occupational exposure to chemo is somehow related to miscarriages or children with birth defects. A nurse who is six months pregnant should give much importance to her health and safety along with the safety of the fetus. Much more than any other nurse she owes the same duties to self as to others, including the responsibility to preserve integrity and safety while maintaining competence and continuing her personal/professional growth. She has the right to politely refuse or request a change in the assignment if she is assigned a patient receiving high-dose chemo. If no other staff is as experienced as her, the charge nurse can always make an alternate arrangement by extending another experienced staff’s duty time etc. Even though PPEs are there for the nurses to administer the chemo, it is always better to avoid such a situation rather than taking the risk of miscarriage or birth defect with inefficient PPEs. Thus the pregnant nurse is more ethically right than the charge nurse. The Pregnancy Discrimination Act is there to aid the pregnant nurses struggling with their duties.