To the writer .please response in 150 words/plus minus   to each peer in single line space. Thanks
  
Note: Peer responses should provide alternate suggestions for how to address the ethical dilemma
 

Engagement in Meaningful Dialogue: Engage peers by asking questions, and offering new insights, applications, perspectives, information, or implications for practice:

 

Respond to at least one peer.
Respond to a second peer post.
Communicate using respectful, collegial language and terminology appropriate to advanced nursing practice.

Professionalism in Communication: Communicate with minimal errors in English grammar, spelling, syntax, and punctuation.

Peer 1 POST/Morena 
An ethical dilemma I have encountered in my nursing practice involved caring for a patient with end-stage renal disease who refused hemodialysis despite being alert, oriented, and deemed to have decision-making capacity. The healthcare team strongly believed dialysis was necessary to sustain life, yet the patient consistently declined treatment, stating they no longer wished to continue living with the burden of ongoing dialysis. This situation created ethical dilemma between respecting patient autonomy and the healthcare teamâ€s obligation to preserve life (American Nurses Association [ANA], 2015).
The key stakeholders in this situation included the patient, the patientâ€s family, the nursing staff, and the healthcare providers. The patient was directly impacted because refusing dialysis placed them at significant risk for deterioration and death; however, the patient also had the ethical right to make informed decisions about their own care The family experienced emotional distress and moral conflict as they struggled to accept the patientâ€s decision while wanting life-sustaining treatment to continue. Nurses experienced moral distress related to honoring patient autonomy while also feeling responsible for preventing harm, whereas providers faced ethical challenges balancing beneficence and nonmaleficence with respect for patient autonomy.
This situation emphasized the importance of patient-centered care and ethical principles such as autonomy, beneficence, and nonmaleficence. Nurses play a critical role in advocacy by ensuring patients understand the consequences of refusing treatment while supporting informed decision-making. Interdisciplinary collaboration and ethics consultation are essential strategies for managing ethical dilemmas in complex clinical situations (ANA, 2015).
Reference:
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. https://www.nursingworld.org/coe-view-onlyLinks to an external site.
 Peer 2 post /Ismaily
Brief Synopsis of the Situation
While working as a charge nurse at an inpatient psychiatric hospital, I witnessed an incident of workplace incivility during a particularly stressful shift. The unit was short-staffed, several patients were experiencing acute psychiatric symptoms, and overall stress levels were high. During shift report, a more experienced nurse openly criticized a newly hired nurse in front of the team. The feedback was delivered in a dismissive and demeaning manner rather than in a supportive or constructive way, and it was shared publicly instead of privately.
How the Situation Made Me Feel and My Response
This situation made me feel uncomfortable and frustrated, and I was concerned about the potential impact on staff morale and patient care. As the charge nurse, I felt a responsibility to address the behavior while also maintaining safety and stability on the unit. In the moment, I redirected the conversation to prevent further escalation and reminded the team that clinical concerns should be communicated respectfully. After the shift report, I spoke with both nurses individually. The newly hired nurse expressed feelings of embarrassment and discouragement, while the senior nurse acknowledged feeling overwhelmed but did not initially recognize how their behavior affected others.
Consequences and Impact on the Work Environment
The tension from the incident persisted throughout the remainder of the shift. The new nurse became noticeably quieter and appeared hesitant to ask questions, which is particularly concerning in a psychiatric setting where teamwork and open communication are essential for patient safety. Workplace incivility can contribute to an unsafe environment by discouraging collaboration, increasing stress, and raising the risk of clinical errors. Research indicates that incivility among nursing staff is associated with increased burnout, decreased job satisfaction, and negative patient outcomes (Clark et al., 2022).
Prevention and Evidence-Based Strategies
This situation could have been prevented through clearer expectations regarding professional communication and earlier leadership intervention. Evidence-based strategies to promote a healthy work environment include consistent leadership modeling of respectful behavior, education on workplace civility, and fostering a culture in which staff feel safe speaking up without fear of embarrassment or retaliation. The American Nurses Association emphasizes that nurses have an ethical responsibility to maintain respectful relationships with colleagues and to treat others with dignity and respect (American Nurses Association [ANA], 2015). As a charge nurse, addressing incivility promptly is essential to supporting staff well-being and ensuring safe, effective patient care.
References
American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. ANA Publishing.
Clark, C. M., Rogers, K. A., & Gaining, C. (2022). Workplace civility: Nurses†perspectives on incivility and patient safety. Journal of Nursing Management, 30(4), 872–880. https://doi.org/10.1111/jonm.13589Links to an external site.

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