Perplexed conscience I have many experiences that I encountered this perplexed conscience.

In nursing, you will really experience different types of decision making in which ethical dilemma is inevitable. Same with perplexed conscience, the ethical dilemma is confronted with two alternative precepts in which the nurse must be wise enough in making a decision. He or she must know how to choose what appears to be lesser evil. Professional responsibilities, tradition, and personal conscience along with legal, philosophical, and religious convictions dictate nursing interventions. Inevitably, these factors embrace life-sustaining therapies; however, in view of complications, prognosis, pain and suffering, and their own views of quality of life, some patients express wishes inconsistent with life-sustaining measures. In other situations, the health care provider as well as the patient may view heroic efforts as more debilitating than restorative. Resolving the conflict while preserving the patient's best interests requires a confrontation with the status of "do-not resuscitate" policies within the nurse's institution, informed consent, refusal, and competency as the necessary underpinnings for the development of an ethical and legal posture within the profession, with which to approach significant decisions regarding life-sustaining therapies. Literally every hour of every day nurses are immediately and directly involved with resolving ethical dilemmas based upon judgements and interpretations of oral or written orders, patient and family wishes, professional training, and an infinite number of other factors. When clear policies or orders are lacking, the nurse is left with the burden of making a life or death decision. Certain conscience In this type of conscience, there are times that I am certain with my decisions, allowing less space of fear in committing errors in my heart. Best example for this is still in the hospital setting wherein I am about to give a medication to a client who complains severe pain. As a student nurse, I assessed the client first if he or she is really experiencing pain or just a psychological thing. With that, I decided to take first his or her vital sign before giving the medication. I was certain in my decision to assess that person first because if I was doubtful of my action, I would have given him or her medication that could lead to drug dependence (if that person is really not experiencing pain). I was certain because I believe that nothing will be lost in me if I will assess that person first then giving immediately the medication. Doubtful conscience As human nature, it is really inevitable to doubt. There are times that we will be doubtful in every action that we will make and with that it makes us more human. An example for this is absent or not to absent in a class. There are many times that I will think to absent but I am really not that certain to my decision if I will really absent because there are lot of “what if” coming into my mind.

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