Elaine Briones

Professor Nolan

Engl 1301

5 November 2021

Essay 3: Radiology Nursing Ethics

Nursing has played a huge role in the world over the decades, starting back in ancient

history in 300 AD. With nursing, it also came along with nursing ethics which builds the whole

purpose of a prophecy called Hippocratic Oath. The basis of what the Hippocratic Oath is, is that

this oath is a sacred promise being made by any medical field worker that to the best of their

ability, they will provide the best care for their patients as well as providing them with privacy

rights; a promise that the patient wouldn’t be put in harm’s way. Although every healthcare

worker swears by this oath, there has been a history within radiology nurses not holding to their

pledge. The article, “Radiology Nursing Ethics and Moral Distress”, overviews the struggles

throughout the years within radiology nursing ethics and how it can put patients under radiology

care through dangerous treatments. The author, Lisa Haddad, makes a claim to which radiology

nurses feeling the need to stride away from knowing they can make the right decisions but take

the opposite direction (also known as Moral Distress), and with the evidence that is provided, her

claims were proven affirmative.

Lisa Haddad’s layout for this article is that she first gives a brief rundown on “Ethics and

bioethics”, this section explains that the word ethics comes from the origin Greek meaning

“character” and the role that ethics plays is that from the person’s distinctions, they should be

able to signify the differences between right and wrong with their profession (contextual
examination of motives, attitudes, and relationships) (Guido, 2014). It is also explained that

bioethics covers the science area to which patient’s are intended to be treated with great care by

healthcare professionals and subjects of research (Campbell, 2017). Haddad supports her

argument by analyzing that working in the medical industry includes treating patients as cases

rather than building an emotional, raw connection.

Lisa Haddad then states that back in the 19th century, there had been effects upon nurses

that experienced CF, or compassion fatigue, burnouts (exhaustion, frustration, anger, and

depression), and traumatic stress and suffering, and with that it goes to show that due to the

stressors nurses acquire, it can take into effect to their patient’s care. This argument was proven

by a study conducted by Toby Bressler (vice president in Oncology Nursing), Debra R. Hanna

(an associate professor at Molloy College, Rockville Centre, New York) and Elizabeth Smith (a

clinical nurse specialist) that covers over nurses giving medical care to victims involved in the

Jewish Holocaust diagnosed with a chronic ventilator-dependent respiratory failure. The nurses

that developed moral distress from providing care to the Holocaust patients, resulted in the

workers making careless decisions and stress reactions were observed; the nurses poor

performances were caused by depression, powerlessness, guilt that led to improper quality care

and lack of patient satisfaction (Bressler et al., 2017). It was also concluded that the moral

distress was originated from concerns with retention as well as deficiency in workers. (Buston &

Tuckett, 2012). Soon after, a tool was created to measure out the moral distress among healthcare

providers along with “the perception of a positive climate” by Ann Baille Hamric, Todd

Borchers and Elizabeth Gingell Epstein. With this tool, it was constructed to measure out the

moral distress and it resulted that moral distress occurred when patients were undergoing

procedures that were seen as “futile, nonbeneficial, or potentially inappropriate”. Futile care was
known as the care provided to patients who had no hope in recovering from their circumstances

or chances of a survival rate, meaning that the care that is being received is defying its purpose.

This is where radiology nursing comes into play. Radiology nurses follow a protocol

made by Association for Radiologic and Imaging Nursing Association (ARIN). Back in 2018,

ARIN addressed some discussion matters that included patient safety, sterile technique, nurse

staffing, bariatric, and nursing leadership. As the topics were discussed, the clinical guidelines

were also updated and applied to the following: moderate sedation and analgesia, extravasation

of contrast media, capnography, and dealing with chemotherapy/cytotoxic medications. (ARIN,

2020). Haddad believes that new position statements should be incorporated into ARIN in terms

of how radiology nurses can communicate the goals-of-care with the patient/patients families

about potentially inappropriate treatments that can be done. So if a nurse comes into a

predicament, not only can they use biomedical principles, components of relational ethics, the

ANA Code of Ethics, the PC team, and an ethics committee (used for consultation) as a guide,

but along with updated ARIN position statements in order for ARIN to prove what they stand for

in patient care. For instance, the example that is used in the article is a nurse handling a patient

undergoing at the interventional radiology, nurses come into a problem of knowing whether or

not the decision was made beforehand about the goals-of-care for interventions. Some questions

nurses run into are “If this gastric tube is placed, will it prolong the patient's life or lead to

aspiration pneumonia just as dysphagia would? If the biopsy results are positive, will this person

undergo curative treatment, and if so, will it cause them to suffer?” and leads the nurse to second

guessing their care as well as their development for moral distress.

Another act that could potentially come into play within a nurse’s profession is an elder

man sustaining vertebroplasty, a procedure where a fractured vertebra is injected with a special
cement (to relieve spinal pain), while using practically no sedation due to the man’s age and the

less like probability being monitored laying face down. With this pressure and power in the

scenario, this puts the nurse into distress from trying to maintain a procedure that will consist of

intolerable pain to their patient, which leaves the nurse in a case that they wouldn’t want the

patient to go through with the procedure in fear of the patient feeling pain. However, one way the

nurse can prevent from experiencing moral distress is that they can receive consultation from a

PC team (personal consultation). PC teams are usually consulted when a nurse is questioning

whether a nephrostomy tube placement should be conducted for case involving a patient’s

malignancy-related ureteral obstruction (diseased that contain abnormal cells dividing

uncontrollably and invade tissues near the abnormal cells, aka cancer), but the consults are

proceeded after all the procedures have been finalized. Unless the patient themselves

contemplates the placement of the tubing, which then the PC team involving other healthcare

workers such as nurses, social workers, nurse practitioners and physicians come in and converse

with the patient “before the procedure his or her priorities/goals of care and any poor prognostic

factors” (Alawneh et al., 2016; Cordeiro et al., 2012). The discussion that takes place is other

options the patient can consider than having to undergo unethical procedures, such as having

concern about displacement, trouble sleeping, and limitations with regular day to day activities.

By this going into effect, radiology nurses can consult a PC Team resulting to reducing moral

distress in radiology nurses, in addition to patients/patients families being better and properly

informed by a PC team to make wiser decisions.

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ARIN: https://www.aringoldengatechapter.org/about-us#:~:text=The%20Association%20for

%20Radiologic%20and,body%2C%20and%20Diagnostic%20imaging%20modalities