Page 67 - Essentials of Nursing Leadership and Management, 5th Edition

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54 unit 1 | Professional Considerations CikguOnline
The Human Genome Project is dedicated to map- When faced with the prospect of a child who is
ping and identifying the genetic composition of dying from a terminal illness, some parents have
humans. Scientists hope to identify and eradicate resorted to conceiving a sibling in order to obtain
many of the genetic disorders affecting individuals. the stem cells for the purpose of using them to save
Initiated in 1990, the Human Genome Project was the first child. Nurses who work in pediatrics and
projected to be a 13-year effort coordinated by the pediatric oncology units may find themselves deal-
U.S. Department of Energy and the National ing with this situation. It is important for nurses to
Institutes of Health. However, because of swift examine their own feelings regarding these issues
technological advances, in February 2001 the sci- and understand that, regardless of their personal
entists announced they had cracked the human beliefs, the family is in need of sensitivity and the
genetic code and accomplished the following goals best nursing care.
(Human Genome Project Information, 2002): A primary responsibility of nursing is to help
patients and families cope with the purposes, ben-
■ Identified all of the genes in human DNA.
efits, and limitations of the new technologies.
■ Determined the sequences of the three billion
Hospice nurses and critical care nurses help
chemical bases that make up human DNA
patients and their families with end-of-life deci-
■ Stored this information in databases
sions. Nurses will need to have knowledge about
■ Developed tools for data analysis
the new genetic technologies because they will fill
■ Addressed the ethical, legal, and social issues
the roles of counselors and advisers in these areas.
that may arise from the project.
Many nurses now work in the areas of in vitro fer-
Rapid advances in the science of genetics and its tilization and genetic counseling.
applications present new and complex ethical and
policy issues for individuals, health-care personnel, Professional Dilemmas
and society. Economics come into play because, Most of this chapter has dealt with patient issues,
currently, only those who can afford the technology but ethical problems may involve leadership and
have access to it. Efforts need to be directed toward management issues as well. What do you do about
creating standards that identify the uses for genetic an impaired coworker? Personal loyalties often
data and the protection of human rights and confi- cause conflict with professional ethics, creating an
dentiality. This is truly the new frontier. ethical dilemma. For this reason, most nurse prac-
tice acts now address this problem and require the
Stem Cell Use and Research reporting of impaired professionals and providing
Over the last several years, issues regarding stem rehabilitation for them.
cell research and stem cell transplant technology Other professional dilemmas may involve
have come to the forefront of ethical discussion. working with incompetent personnel.This may be
Stem cell research shows promise in possibly curing frustrating for both staff and management.
neurological disorders such as Parkinson’s disease, Regulations created to protect individuals from
spinal cord injury, and dementia. Questions have unjustified loss of position and the enormous
been raised regarding the moral and ethical issues amounts of paperwork, remediation, and time that
of using stem cells from fetal tissue for research and must be exercised to terminate an incompetent
the treatment of disease. Stem cell transplants have health-care worker often make management look
demonstrated success in helping cancer patients the other way.
recover and giving them a chance for survival when Employing institutions that provide nursing
traditional treatments have failed. services have an obligation to establish a process
A new business has emerged from this technol- for the reporting and handling of practices that
ogy as companies now store fetal cord blood for jeopardize patient safety (ANA, 1994). The
future use if needed. This blood is collected at the behaviors of incompetent staff place patients and
time of delivery and may be used for the infant and other staff members in jeopardy; eventually, the
possibly future siblings if necessary. The cost for incompetency may lead to legal action that may
this service is high, which limits its availability to have been avoidable if a different approach had
only those who can afford the process. been taken.