BEATRIZ MARTINEZ 1

Ethic Paper
Beatriz Martinez
James Madison University
April 19, 2015

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Not being judgmental is an important topic that is mentioned through out nursing
school courses. I have heard many of my professors speak about this topic through out
the nursing courses and emphasize that we shouldnt judge our patient but instead, focus
on treating them and providing them the proper care and support. Students look up to
role models such as instructors, nurses, and physicians and are influenced by their
professionalism. Their attitude and personality towards patients can influence the way a
student may interact with patients. Medical student have recognized continuing an
inappropriate joke if their attending were the one to start the joke (Wear, Multaman,
Varley, & Zarconi, 2006). There are certain patients that get made fun of the most. These
patients include those that are obese, have an illness because its their fault, psychiatric
patients, or sexually appealing patients (Wear et al., 2006). Many overweight and obese
patients feel that they are being judged by their physician, which can affect the treatment
outcome (Gudzune, Bennett, Cooper, & Bleich, 2014).
I was in the psychiatric unit for my clinical rotation. My clinical instructor gave a
couple students the opportunity to listen into a morning meeting. In this meeting, the
physician, nurse practitioner, charge nurse, social workers, and a case manager come
together to discuss treatment plans for each patient. I was pleased to be picked because I
was interested and curious to hear what would be discussed during the meeting. I sat
quietly in the room while they were giving report. The charge nurse was reporting to
everyone in the room about a particular patient. The case manager made a comment
about the patients past marriages. The patient has been married seven times and was
currently in a relationship. Comments were being made left and right about why they
thought she kept getting divorce. The room filled with laughter as each person had a

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suggestive comment. The doctor was also including comments into the conversation.
Once they finished making comments about the patient, the charge nurse continued down
the list of patients. The charge nurse made a comment in a doubtful tone about how
another patient mentioned she wanted to become more spiritual. Rude comments began
to flare again. I looked to see the reactions of the other nursing students, and it was
similar to mine. No crack of smile appeared on any of the students, including myself. I
was shocked to hear the jokes that continued to appear throughout report. Although they
did discuss treatment plans for the patients, many rude comments were not necessary
during the morning meeting.
During report, I was having mixed emotions about the comments being made.
The main emotion I was experiencing was anger. I was angry that the patients put a lot of
trust towards their providers and to hear that these providers were making jokes made me
think otherwise. I was upset that the majority of the providers were participating in the
conversation when the patients personal issues were being brought up. I was feeling
morally distressed because I felt powerlessness as a student. I knew the right thing to do
was to speak up for the patient and suggest to not talk about them in that way, but I felt
that it wasnt my place to say anything because I am a student. Although they were
making inappropriate jokes, I decided to not let that impact my thoughts about the
patient. I wanted to keep a respectful attitude towards them; therefore, I did not laugh
with them or add to their conversation.
Many of my emotions and thoughts about the ethical situation reflected from the
JMUs Eight Key Questions, which are examples that can direct our decision-making
during an ethical dilemma (The Eight Key Question, 2015). The Questions include

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fairness, outcomes, responsibilities, character, liberty, empathy, authority, and rights. This
will help individuals see the situation in a different perspective that may allow them to
take the right action. Although during the ethical situation I was experiencing, I did not
take action, but looking at the Eight Key Question, I now know what I could have done
differently.
I looked at the situation asking myself, was it fair what the healthcare providers
were commenting about the patients? I believe what they were saying was not fair to the
patients and their family. I asked myself, What if the patient was my brother, how would
I feel? I knew at that moment that I would not appreciate having them talk about him in
that manner. Being empathetic toward the situation allowed me to confirm that they were
not being professional during report. I thought the patient had the right to be respected
and nonjudgmental while being hospitalized. Then I started to question myself about my
character and how I should have handled the situation differently. To speak up for the
patient would have been the best action I could have done that would reflect the person I
am, but because I felt that I was powerless, I kept quiet. If I would have spoken up, then
the outcome of the meeting may have been different. Maybe everyone would have
spoken appropriately during report instead of making jokes about the patients. I thought it
was everyones responsibility to keep the discussions in the meeting in a professional
manner, which I thought only a few providers did. Although the providers were at liberty
to speak freely about the patient during the meeting, I felt that keeping the meeting
professional still should have been met. There were many authority figures in the room,
and before arriving at the meeting, I would have thought they would be the role model

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figure to follow. In my mind, I expected for them to be professional during the morning
meeting; however, they were contributing to the inappropriate comments.
The American Nursing Association Code of Ethics (Code of ethics for nurses with
interpretive statements, 2015) provides provisions that can guide a nurse during an ethical
dilemma. The Code of Ethics that are proposed are reminders what actions we need to
take to provide maximal care and support to our patients and their families. Provision 1
helped guide me by promoting respect and compassion while giving care to each patient.
During my ethical dilemma with the healthcare providers in the morning meeting, I could
have used this to help me recognize where the conversation was headed. I knew the
comments were not respectful neither were they being told in a compassionate manner. I
could also use Provision 5 to help remind me that I too have the same responsibilities as
others to promote health and safety, preserve wholeness of charter and integrity,
maintain competence, and continue personal and professional growth (Code of ethics for
nurses with interpretive statements, 2015, p.V).
This exercise allowed me to think about the situation in different perspective. I
was able to think what went wrong and what could I have done differently at the time. I
definitely learned that my actions in the future would be different compared to my actions
during this situation. I will speak up for my patient and respectfully handle the situation
by reaching out towards those who are disrespecting the patient and ask to redirect the
manner of the conversation. I would recommend other nursing students to keep in mind
that there will be healthcare providers that will speak inappropriately about their patients
but to not be easily influenced by their behavior. Instead, keep the important values in
mind and continue to care for patients the way you would like to be treated.

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Reference Page
Gudzune, K. A., Bennett, W. L., Cooper, L. A., & Bleich, S. N. (2014). Patients who feel
judged about their weight have lower trust in their primary care providers. Patient
Education & Counseling, 97(1), 128-131. doi:10.1016/j.pec.2014.06.019

Hegge, M., Fowler, M., Bjarnason, D., Godfrey, T., Lee, C., Lioce, L., Ngai, M.,
Robichaux, C., Schroeter, K., Shije, J., Swanson, E., Tanner, M., Thomas, E.,
Wocial, L., Zanni, K. (2015). Code of ethics for nurses with interpretive
statements. American Nursing Association, V. Retrieved from
http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthic
sforNurses/Code-of-Ethics-For-Nurses.html

The eight key questions. Retrieved from The Madison Collaborative: Ethical Reasoning
in Action website: https://www.jmu.edu/mc/8-key-questions.shtml

Wear, D., Aultman, J., Varley, J. D., & Zarconi, J. (2006). Making fun of patients:
Medical students perceptions and use of derogatory and cynical humor in clinical
settings. Academic Medicine, 81(5), 454-462. Retrieved from
http://journals.lww.com/academicmedicine/Abstract/2006/05000/Making_Fun_of
_Patients__Medical_Students_.9.aspx