Consider the “Four Topics Approach” (or Four Box method) to ethical decision making on page 61, Table 2.1 in Butts (below). Apply this model to a
challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care.
Specifically apply and address the questions within each topic area as they pertain to your situation.
In your conclusion, discuss the impact of the Four Topics process. Did applying these principles shape your decision making in any way? Does this seem like
a valid process for you to apply in your practice?
Sample Solution
I remember a time in my nursing career when I was faced with a particularly challenging situation. One of my patients, Mrs. Smith, had been admitted to the hospital for breathing difficulties. Her symptoms were getting worse as the days went by and her family was growing increasingly worried about her condition. As the nurse assigned to caring for Mrs. Smith, it fell on me to assess her needs, coordinate care with other members of the health care team, and provide support and education to her family so they could make informed decisions regarding her care. It was a difficult balancing act given that I wanted to provide optimal care while also respecting their wishes as much as possible given their anxiety level.