Nonmaleficence Nursing

Nonmaleficence Nursing Examples

Non-maleficence in Nursing

Every nurse encounters ethical dilemmas in various challenging patient care scenarios throughout his/her career.

This can lead to increased stress as they try to figure out what the best course of action is in each circumstance.

Using ethical principles such as non-maleficence gives them a strong framework for making rational choices. The principle of non-maleficence entails a desire to prevent inflicting harm or injury to another person through actions of commission or omission.

Non-maleficence implies that a person really works towards a positive conclusion for those with whom they come into contact, whereas maleficence is the intentional delivery of a harmful act or consequence on another person or a group.

Non-maleficence is an ethical principle that is especially important in the context of healthcare, primarily nursing.

Nurses apply this principle by choosing actions that inflict the least amount of harm in order to accomplish a desirable output. Furthermore, the principle of non-maleficence directs nurses to prioritize the patient’s safety in all aspects of treatment.

Significance of Non-maleficence in Nursing

Non-maleficence is a significant element of nursing since it serves as a direction when making critical decisions. This is certainly relevant when opposing viewpoints, challenging environments, or conflicts of opinion complicate the decision-making process.

Nursing, like many other professions, has its own code of ethics to ensure that individuals have clear standards to follow when deciding what measures they should and should not undertake.

Non-maleficence, or doing no harm, is one of the most significant and applicable aspects of the nursing code of ethics. This nursing ethical principle can be applied to various scenarios, including:

• Choosing a course of action when there is a conflict of values. When religious beliefs about marriage and sexuality influence an individual’s response to family planning or contraception methods, a conflict of values may occur. Nurses and other medical professionals must be cautious not to let their personal opinions about beliefs influence their advocacy for the various therapeutic interventions available to patients.
• Assisting patients in making their own informed decisions. A patient may have considerable reservations about treatment, such as chemotherapy, dialysis, surgery, or specific medicines. Nurses must thoroughly explain the benefits and risks of various therapies to the patients, as well as what can happen if none are utilized.
• Making decisions for patients who are unable to make their own. Other patients are unable to make decisions for themselves, such as those who are unconscious or too young, as in the case of NICU patients. These patients may have family members or other caregivers, but they may not have anybody else to make decisions for them. Healthcare professionals are occasionally forced to make these decisions on behalf of patients.

Difference Between Beneficence and Nonmaleficence in Nursing

Some nurses are perplexed by the strong relationship between nonmaleficence and beneficence. Non-maleficence entails avoiding actual injury, whereas beneficence entails preventing or removing harm.

Avoiding purposeful injury, the danger of harm, and harm that occurs while conducting desirable actions are all aspects of the principle of non-maleficence.

In addition, healthcare professionals have long been expected to do good, which suggests the principle of beneficence, but if they are unable to do so, they must at the very least avoid harming everyone else.

Non-maleficence is the principle or rule that one should not cause evil or harm, whereas beneficence encompasses harm avoidance or removal, and promotion of good actions.

In simple words, beneficence entails taking action to help others, whereas non-maleficence entails avoiding behaviors that injure others.

Some people mistakenly believe these two concepts are one and the same because of the two sides of the same coin connotation, however ethics states otherwise.

Nursing Considerations related to Non-maleficence

Nurses, on the surface, appear to have no compulsion to harm patients or anyone else. Isn’t it unimaginable that a nurse would intentionally do something bad to a patient? Non-maleficence is the ethical principle entails avoiding harm as a result of good actions.

When a desirable action has the potential to cause harm, the potential for harm must be carefully evaluated against the potential return. Experimental research, for instance, in which it is reasonably certain that volunteers may be harmed is prohibited, as is the conduct of superfluous procedures for monetary benefit or only for the purpose of learning.

Hitting a client with a needle for the sole goal of inflicting pain, as another example, is always harmful and provides no value. Immunization, on the other hand, while painful, has the advantage of safeguarding the client from a serious disease that can be avoided through vaccination.

Nurses face many circumstances in their daily practice where the line is blurred, either because the harm done appears to be equal to the benefit received, because the outcome of treatment cannot be guaranteed, or because opposing views and beliefs exist.

Consider analgesia for patients with a painful terminal illness. Opioids may be the only option for treating extremely severe pain. Opioids, when used in the doses required to relieve pain, can cause addiction and death.

Another example is the widespread practice of ordering patients to have nothing by mouth (NPO) before diagnostic testing and surgical procedures, which most nurses accept without question.

There have been reports of geriatric patients being denied meals for up to five days while examinations and procedures were performed. Several consulting physicians who were unaware of the whole duration of NPO orders presumably ordered or performed the tests and treatments.

The effects of starvation on the elderly can be serious, but the norm of following NPO orders for extended periods of time is generally considered acceptable.

As nurses, we must be aware of instances where harm may surpass benefit, taking into account our own principles as well as those of our patients.

Understanding Non-maleficence between Nurses and Patients

The objective of all nursing and medical interventions for a patient is to improve his or her overall health and wellbeing. When evaluating interventions for medical disorders, healthcare providers must balance the principle of non – maleficence.

The foundation of professional interactions between patients and healthcare providers, especially nurses, is to provide recommendations based on the patient’s best interests. Healthcare practitioners must always discuss the potential negative impacts of suggested interventions so that the patient can make an informed choice.

The vast of medical treatments come with the risk of side effects and inconvenience. Both healthcare providers and patients must decide how far these impacts will step over the line into damage.

Non-maleficence in Advanced Healthcare Settings

In today’s technology-driven healthcare system, how might non-maleficence be incorporated? Certainly, the concept of this principle does not rule out the possibility of healthcare practitioners causing harm in order to help their patients.

Harmful action is sometimes essential, but it should never be taken automatically. Procedures should give advantages that outweigh the potential for discomfort.  Non-maleficence, like many other aspects of health care, is complex when modern technology is being used.

Withholding or removing life support, taking exceptional measures, and dying with dignity all include judgments about preventing further injury to the person.

Healthcare providers and family members, for example, appear to be more comfortable withholding treatment than discontinuing it.

Pulling the plug, in some ways, appears to be more detrimental to the patient than not activating the technology to support life. With the advancement of advanced life-sustaining technology, the distinction between extraordinary and routine care has grown blurry.

When there was little hope of benefit, healthcare may not go to exceptional lengths.

Non-maleficence and Working Environment

The principle of non-maleficence can be applied to healthcare settings, not just patient care. When working with any member of the healthcare team, it is also important to remember the principle of non-maleficence.

Health professionals have an ethical commitment to offering a safe and healthy working environment for other members of the healthcare team. Concerns can be expressed without fear of retaliation in such an environment. It should also be a good workplace where principles are upheld and healthcare workers may perform at their best on behalf of the patients they serve.

All healthcare employees, regardless of their position within the organization, should be free of harassment, imposition, and discrimination in this healthcare setting.

Nonmaleficence in Nursing Examples

In nursing, the principle of non – maleficence can be presented in a variety of ways, particularly in difficult and demanding situations. Nurses can use the non-maleficence principle in various contexts, including but not limited to the following.

Example of Nonmaleficence in Nursing 1

A 12-year-old girl patient suffered full thickness burns on various parts of her body, causing her to struggle with several daily activities as well as emotional health. The patient developed depression as a result of the experience.

Her treatment plan included active motions of the afflicted joints to enhance mobility, as well as the practice of functional activities, massage, and passive stretches. The patient, on the other hand, considered the treatment tedious and rarely participated fully in it.

She also acquired a phobia of therapy sessions since she correlated them with pain due to the uncomfortable passive stretches.

Every day of the week, the patient told the nurse that the treatment plan causes her excruciating pain and discomfort. The nurse recognizes that passive stretches have the benefits of preventing contractures and maintaining range of motion in affected joints.

In a conclusion, the treatment itself is not essentially improper, and the objective is solely to achieve a positive result, despite the fact that the stretches are extremely painful for the patient, especially at her age.

Knowing that the positive effects of the therapy sessions outweigh the negative effect and that while it may be painful now, it is of great benefit to the patient in preventing future secondary problems, the nurse continues to encourage the patient to receive treatment while putting her feelings of pity for the patient aside.

Example of Nonmaleficence in Nursing 2

A nurse is working as a volunteer in a poverty-stricken and poorly health-educated community in a remote part of the country.

A group of city volunteers hands out limited dosages of expensive antibiotic treatment to the community where bacterial illnesses are rampant. The drug must be taken three times every day for seven days, however, the free antibiotic medications are insufficient for the residents of the afflicted community.

The volunteer group says they will not be providing any more free drugs, and the nurse knows the residents can’t afford them even at a lower price. Some patients can obtain full medication treatment, while others can only receive a fraction of the minimum treatment days if the drug will be distributed according to the donors’ instructions.

The nurse displayed the principle of non-maleficence by reorganizing the drug distribution accordingly. She insisted on not distributing the remaining medications that could not be given in a complete cycle, knowing that the symptoms would worsen if the treatment was halted and not completed. Although fewer patients will have access to the medications, the nurse knows that doing so will prevent more severe health consequences.

Example of Nonmaleficence in Nursing 3

The nurse is caring for a patient who has been diagnosed with Hodgkin’s disease and has been admitted to the hospital. During the history-taking process, the patient mentioned all known medicines to which he had previously developed an allergy.

The nurse meticulously documented all of her assessments throughout the shift and handed them along to the next shift’s nurse.

The next day, the nurse noticed that one of the drugs to which the patient had previously developed an allergic reaction had been administered intravenously for the past two hours.

According to the outgoing nurse, the medication was ordered by the attending physician during her shift, and they both forgot to check the patient’s history in the patient’s chart.

Despite the fact that the outgoing nurse had noted and documented no adverse effects, the incoming nurse promptly discontinued the infusion and informed the attending physician.

The nurse demonstrated the principle of non – maleficence by causing no further harm to the patient and preventing a potentially adverse or even life-threatening condition.

Example of Nonmaleficence in Nursing 4

A patient with multi-resistant tuberculosis (TB) refuses to visit the hospital and is not adhering to the treatment regimen.

Non-maleficence may overthrow the nursing principle of autonomy in this case to protect the community by compelling the patient to receive proper treatment.

Nurses and other medical professionals must always weigh the risks and benefits of any situation or decision they make.

The risk of infecting the entire community in which the TB patient lives, as well as the potential complications of TB for the patient if left untreated, are both quite significant.

Example of Nonmaleficence in Nursing 5

During the endorsement process, the nurse notices that one of the incoming nurses is clearly impaired and under the influence of illegal drugs.

The nurse immediately reports her observations to the charge nurse and suggests that no patients be assigned to the impaired nurse while his condition is unconfirmed.

The nurse who reported the impaired nurse with suspected substance abuse clearly demonstrated the principle of non – maleficence by preventing patients from suffering or being injured.

Issues and Concepts Related to the Non-maleficence Principle

• Preserving due care standards entails adhering to the requirements that are specific with one’s profession, namely the accepted and expected care that a reasonable person in that area would provide.
• Negligence occurs when there is a lack of due care and a risk of harm, whether it be an accidental thoughtless potential for harm or a purposeful irresponsible risk of harm.
• Understanding boundaries between nontreatment and end-of-life decisions, as well as the norms that govern them.

Conclusion on Non-maleficence in Nursing

The principle of non-maleficence, or doing no harm, is strongly intertwined with the nurse’s responsibility to ensure the patient’s safety, which requires him or her to avoid endangering the patients.

This ethical principle also plays an important role in all nursing judgments, particularly in tough, challenging circumstances.  It requires that nurses must consider not only the immediate but also the long-term effects of possible interventions.

As a guide for nurses, the following fundamental aspects of non-maleficence must be remembered at all times:

1. An intervention should not be inherently negative.
2. The action must be meant to have a beneficial impact.
3. A positive result cannot be a consequence of an adverse effect.
4. If an action has negative consequences, the potential benefits must outweigh the negative repercussions.

Nurses who fail to control certain factors of their jobs that have unfavorable and detrimental consequences for others, particularly their patients, are not following the principle of non – maleficence.

Like the other nursing principles, the principle of non – maleficence influences every element of nursing practice, and determining whether one option is fully risk-free for the patient is not always easy.

Ethical judgments must be based on evidence, with individual rights in mind, and after careful analysis of benefits and risks.

Nurses should not be intimidated by the practical application of nursing principles, as there are no right or wrong solutions in many circumstances, and as long as proper ethical balancing is taken into account, the outcome is likely to be an adequate and proper action to take.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

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