Xavier University - Ateneo de Cagayan

College of Nursing

In partial fulfillment of the requirements for the subject

NCM 119: NURSING LEADERSHIP, MANAGEMENT AND PROFESSIONAL
ADJUSTMENT

ASSIGNMENT1 - DESIGN THINKING IN PROBLEM-SOLVING AND

DECISION-MAKING

Submitted by:
Abas, Ericka Casandra M.
Abdul Majid, Sarima M.
Abing, Clarke Selwynne M.
Agapay, Keisha Nicole G.
Amatos, Abbygail P.
Arancon, Regina Isabela M.
Asio, Clint Brylle O.
Bantol, John Louise T.
Behiga, April Rose F.
Cabilin, Franz Joshua M.
Carbajosa, Maria Bianca D.
Cariño, Anna Michaela N.

BSNE4 - Group 1

Submitted to:
Dean Mary Grace M Paayas RN MAN PhD

October 24, 2022

Questions:

With the significant degree or moral knowledge she has, is the RN obliged to

educate the client along the morality of contraception? Explain your answer.

The group has agreed that how the nurse responded to the patient who was

seeking information about artificial contraceptives was not right and very

unprofessional. We acknowledge that all people have the freedom to choose and

practice their religion and there’s absolutely no problem with that, however, a

problem comes in when we begin to force our beliefs on other people. Especially as

nurses, it is not our place to educate the patient on the religion and beliefs that we

practice, it is unprofessional, it is not our job, and it’s not the reason why the patient

came to see you in the first place.

Should she immediately give contraceptive methods as part of Family

Planning Program of the Department of Health? Elucidate your answer.

Despite having personal beliefs, the nurse should educate the patient about

contraceptive methods, as it is a part of a nurse's responsibility. Although it may be

against her beliefs, the patient has the autonomy to decide whether she should be

on contraceptives or not. The nurse should be able to educate about contraceptives

but not impose beliefs, and to not educate morally.

What do you think should the RN do about this situation? Expound your

answer.

We identified a better way the nurse could handle the situation in relation to

situations like this. The nurse must explain to the patient that this is against her

beliefs and what she stands for, therefore she won’t be able to provide information
on this particular aspect, however the nurse is still responsible for finding another

registered nurse that is willing and able to provide quality and accurate information

that the patient is asking for.

Design Performance Tasks - Competencies

Thinking

Stage

1: Empathize The client seems to be feeling anxiety towards the

responsibility of being a parent and the financial cost that comes

with it. The client stated that life is hard for them at the moment

and that they do not want children since they would only burden

them and that they would not be able to give them a decent way

of living. The client used words such as “hard” or “burden” which

are words that can carry feelings depending on the way that they

are used. When the client said that life was hard for them at the

moment, the client was already hinting her feelings towards their

livelihood; that they may not be financially doing well at the

moment, and when the client stated that children would only

burden them, the client is showing that she and her partner are

not ready to raise children and will not be able to financially

support their living through health seeking behaviors and the firm

decision to avoid having a child through preventive measures. I

would use the word understandable to describe the client’s

feelings. I think that it is understandable to feel anxious when one

is not financially stable, I think even more so if there is a risk that

you would have to provide for a child when not being financially

stable.

From the list of learning outcomes these are what we have

identified to fit this stage.

Learning Outcome 4: This can be applied as the nurse is

experiencing an ethical distress and moral dilemma in whether

she should provide for the client’s educational needs or stick to

her own beliefs and values as a catholic nurse.

Learning Outcome 9: This can be applied especially as the nurse

encounters an ethical dilemma where she can show her growth

as a professional and try to solve it competently.

Learning Outcome 10: This can be applied as a standard when

the nurse is treating the patient with respect and addresses the

concerns of the patient professionally by providing quality health

education.

Learning Outcome 14: This learning outcome can be applied

since this case can be connected to the national family planning

program, and one of the responsibilities of the nurse in this

program is patient/client education.

2: Define Identified problems:

For nurse:

1. What interventions can the nurse provide to the patient

considering:

1.1 The mother and father

1.1.1 Take the family's side. Getting the families Point

of view

1.2 Nurse

1.2.1 By educating the family the benefits of natural

contraceptives and being cost effective and listening to

their understanding/beliefs about artificial contraceptives.

1.2.2 Assuming that the family will push through with

their decisions regarding artificial contraceptives, the nurse

can delegate the task to another nurse by asking the chief

nurse about her beliefs. Also explaining to the family the

importance of values and beliefs to give the best care

possible for the patient without forcing or that the family is

influenced by the decisions of the nurse.

2. How will the nurse provide the best possible care to the

patient considering

2.1 Ethical standards

2.1.1 Given that the nurse values her beliefs, and has

the right to say no in giving or doing interventions, the

patient/family also has the autonomy to decide whether

they will use contraceptives or not. The nurse can educate

the family regarding the benefits of natural family planning

or other alternatives to the extent of the nurse not

imposing or forcing the family of his/her beliefs.

2.2 Legal standards

2.2.1 Consider also the decision of the mother and

father since they are married considering they are Legally

bound. This is found in Executive Order No. 209, s. 1987

The family code of the philippines.

2.2.2 Autonomy: Since the patient (mother) has the

right to participate or pursue her decisions given that she

is well and able to stand for herself, nurses must respect

the decisions made by the parents given that the nurse

already provided education to the client.

2.2.3 Assuming that the parent will pursue the use of

artificial contraceptives, nurses should check in with the

hospital protocols if they allow with the said method.

2.3 Moral standards

2.3.1 The nurse must have a high level of respect for

all individuals, and allow dignity in regards to dealing in

care and communication. In this case, the nurse

expressed her own beliefs without even assessing the

 patient's opinion why they think they cannot have the baby

yet. As a nurse, she must also assess the patient's

knowledge about artificial contraceptives and educate

them about alternative ways instead of using artificial

contraceptives.

Learning Outcome 1: Is applicable to this situation because it

requires critical thinking to identify a problem. With knowledge,

observations can be analyzed to higher thinking and can

therefore be synthesized to a clearer problem statement. Given

that adherence to ethico-legal considerations when providing

care is imposed. For example is justice in which nurses must be

fair in distributing care to the family thus, accepting the opinions

and beliefs of the family since they also have autonomy.

Learning outcome 4: Is applicable to this situation because

ethical reasoning and decision making process is important in

dealing with this ethical dilemma. The nurse and the patient must

consider their own beliefs and values in solving the problem. The

decision must not limit between the nurse and the patient only,

delegating the task with another nurse if conflicts of interests

occur can also help to address this situation.

Learning Outcome 5: Customizing nursing interventions based on

Philippine culture and values is appropriate for this stage

 because the Nurse also has the right to refuse to care for a

certain patient by explaining to the family and telling them your

values and beliefs regarding the care the family wants. But also

reinforcing them by delegating or assigning this task to another

nurse who can give the best care possible for them.

Learning Outcome 8: Is applicable to this situation because it

provides nurses with lifelong learning. It provides knowledge that

nurses can use for future situations like this. It also helps to

promote personal development especially when dealing with

patients with different cultures and beliefs. As nurses learn from

one situation to another and deal with different cultures, this helps

nurses to maintain competence especially if we work abroad

taking care of patients with different cultures.

Learning outcome 11: This is applicable to this situation because

contraceptives are not allowed in our country. The nurse is right

when she explains that the contraceptives are against our natural

law which represents a good image as a Filipino nurse. However,

she was not able to assess the patient's knowledge and beliefs in

dealing with this situation.

3: Ideate As nurses, we cater to the needs of the patients and their

family and we advocate for them. We could approach this

problem by looking at it from the perspective of the patient and

her partner who are legally married and have the right and are
entitled to their opinion. As nurses, it is not our place to force our

beliefs upon our patients. As a nurse, she should realize and play

the important and supportive role of nurses in caring and

advocating for the clients.

As nurses, we are also responsible for determining patient

needs and when to delegate tasks to another nurse. In the case

presented, the patient's needs are beyond the moral beliefs and

values of the nurse. A nurse may approach the nurse leader

regarding the issue in order to make an informed decision on

whether or not delegation is appropriate for the given situation.

Moreover, as responsible nurses, we must follow up with the

delegated nurse and the patient after the delegated responsibility

has been completed to maintain overall accountability for the

patient.

Learning Outcome 4: In this case, it is appropriate to use ethical

reasoning and decision-making processes to address situations

of ethical distress and moral dilemma. It is critical to distinguish

between correct thinking, decisions, and actions and those that

are wrong, hurtful, and/or harmful to others and ourselves. If the

nurse in this case had used therapeutic communication and was

familiar with the process of task delegation, he or she would have

responded in a client-centered manner rather than emphasizing

his or her moral beliefs.This learning outcome enables nurses to

make decisions that are more thorough and well-reasoned than

mere opinion or intuition.

Learning Outcome 5: Customize nursing interventions based on

Philippine culture and values. Filipinos are family-oriented and

respectful. Filipinos have different ways of showing their respect.

As nurses, we must acknowledge and respect the wishes of our

clients. We must also remember that nurses advocate for both

the client and the family. Every now and then, nurses are faced

with situations wherein their personal beliefs clash with the

client’s. Whatever action the nurse takes, it is important to

maintain a respectful environment.

Learning Outcome 8: Nurses must be responsible for their own

lifelong learning, personal development, and competency

maintenance. The case presented exemplifies why nurses should

investigate, learn, and develop skills and expertise in a variety of

areas of nursing care. To remain competent, nursing

professionals must stay informed and participate in continuing

education opportunities such as task delegation and patient

rights. A commitment to lifelong learning improves care quality

and patient outcomes, as well as career prospects. A

commitment to lifelong learning improves care quality and patient

outcomes, as well as career prospects.

 Learning Outcome 13: Manifest caring as a core of nursing,

including the love for God and people. Care is truly the core of

nursing, as well as our love for God and the people. We may

have different beliefs however, care and love are what should

unify us. As nurses, whatever actions we plan to make must be

anchored from and geared towards our core.

4: Prototype ● Possible solutions:

○ Decisions must be patient centered. Nurse’s beliefs on

the morality of artificial contraceptives should not affect

the patient’s decision. The client has the right to avail

procedure or treatments within the law or policies set in

the country.

○ Review the country’s law and policies on artificial

contraceptives.

○ If the nurse is not willing to provide the artificial

contraceptives, he/she may endorse the patient to

another nurse.

○ If the patient is willing to consider other alternatives

besides artificial contraceptives, the nurse may opt to

educate the patient on other natural methods of

contraception.

Learning outcome 4: “Practice nursing in accordance with

existing laws, legal ethical and moral principles and standards”

can be applied to ensure that the nurse does not violate any laws

when providing care to the client.

Learning outcome 5: “Communicate effectively in speaking,

writing, and presenting using culturally appropriate language” can

be utilized to adequately relay the possible solutions and find

relevant cues that may aid the nurse in decision making.

Learning outcome 7: “Work effectively in collaboration with inter-,

intra-, multi- disciplinary and multicultural teams in leadership and

management” can be applied because the nurse must work with

colleagues to ensure continuity in care.

Learning outcome 10: “Engage in a lifelong learning with a

passion” to keep with current national and global health

developments in general, and nursing and other relevant matters

affecting nursing leadership and management to effectively

advocate better for patients and be a stronger part of a

multidisciplinary clinical team.

5: Test Out of all the possible solutions that the group has come up

with, we have agreed that the best possible solution is to educate

the patient despite their different values and beliefs. As Atenean

nursing students, we have always been taught to respect and

learn about the various cultural beliefs and values of other

people. Consequently, we decided to uphold these learnings and

apply these to the given situation. Moreover, as nurses, we also

have the duty to advocate for the patient’s rights and respect their

autonomy.

According to Article 2, Section 4 of the Code of Ethics for

Registered Nurses, patients have the freedom to make rational

and unconstrained decisions, and this should be respected. This

could be observed by considering the individuality and totality of

patients as well as their own culture and values. With this, we

show our respect for the patient’s decision by educating the

patient about artificial contraceptives which she specifically asked

about even if it is against the nurse’s beliefs. The nurse might

also suggest natural family planning while educating about

artificial contraceptives as an alternative instead of imposing on

the patient her beliefs about the morality of contraceptives. It is

not the job of the nurse to educate about morality and it is not

ethical to force a patient of the nurse’s own beliefs.

Learning Outcome 2: “Implement strategies/policies related to

informed consent as it applies in multiple contexts”. As this

thinking stage involves testing the solutions, implementing

strategies related to informed consent is helpful to educate the

patient about the risks, benefits, and alternatives of her chosen

method.

Learning Outcome 9: “Demonstrates continued competence and

professional growth” can be applied especially as the nurse

encounters an ethical dilemma where she can show her growth

as a professional and try to solve it competently.

Learning Outcome 10: “Models professional behavior” can be

applied when testing the solutions to guide the nurse on treating

the patient with respect and address the concerns of the patient

professionally by providing quality health education.

Learning outcome 13: “Adopt the nursing core values in the

practice of the profession” some of the core values of nursing

include professionalism and autonomy. This means that despite

difficult circumstances or when encountering situations wherein

you beliefs do not align with the patient, we must remain

professional and care for the patient in their time of vulnerability

or those who are seeking help. Another core value is autonomy.

As nurses, we must uphold the patient’s autonomy and recognize

their right to the best care which involves health teaching and the

right to choose their decision regarding their care. We must not

 influence their decision but instead make them feel at ease and

without judgement while educating them without bias on their

choice or their personal beliefs and values.

BIBLIOGRAPHY:

Philippine Nursing Act of 2002, R.A. No. 9173, PROMULGATION OF THE CODE OF
ETHICS FOR REGISTERED NURSES, Board Resolution No. 220, Series of
2004

The 6 core values of nursing profession. (n.d.). Medical Staffing. Retrieved October
23, 2022, from
https://www.medicalstaffing.co.uk/blog/2022/02/6-core-values-of-nursing?sour
ce=google.com

APPENDIX:

Link to The Recorded Discussion of The Group

GROUP E1