Integrity can be preserved only if nurses' actions are consistent with the values and ethics of the profession. If honesty and integrity are compromised, we lose self-respect , which further menaces the wholeness of character. The Code of Ethics for Nurses supports your right to conscientious objection "in situations of compromise that exceed acceptable moral limits or involve violations of the moral standards of the profession, whether in direct patient care or in any other forms of nursing practice. It's refusing to participate because you find the requested action morally unacceptable.
Caring and compassion and fairness and justice are also addressed in the Code: "Excellences such as compassion, patience, and skill are habits of character of the morally good nurse. Nurses are obligated to create and sustain a nursing practice environment that enables them to fulfill their ethical obligations.
This could involve participating on an ethics committee or practice council, acting as a preceptor for new nurses, or working to change unfair polices within or outside the organization. Your obligation to justice extends beyond the walls of the workplace because nurses have a responsibility to address broader health disparity concerns, such as world hunger, violation of human rights, and inequitable distribution of health care resources.
Source: Fletcher JC, et al. Here are three ways of responding to moral problems. To practice ethically, all must be overcome. Moral blindness describes seeing a dilemma as an administrative or clinical quandary rather than an ethical issue. For example, the understaffing of the unit doesn't allow for time-consuming comfort care to terminally ill patients, but the problem is considered an administrative staffing problem rather than a moral problem.
Or inadequate pain control might be seen as lack of pain management expertise instead of a nurse's lack of awareness of her ethical obligation to manage pain. Moral complacency indicates a general satisfaction with one's own opinion of a situation. For example, a nurse might conclude that all terminally ill patients are naturally depressed. This contentment with one's opinion can lead to a lack of action in advocating to treat a patient's depression.
A nurse who lacks the virtue of competency doesn't think through the problem critically. Moral distress can be described as "the conflict between the nurse's knowledge of the ethically appropriate action and the institutional constraints that prevent or make the action difficult. However, no matter how difficult, the nurse's ethical duty is to advocate for patients. This requires the virtues of integrity, respect, caring, and courage.
American Nurses Association. Code of Ethics for Nurses with Interpretative Statements. American Nurses Publishing, Buckman R. Johns Hopkins University Press, Lachman VD. Moral courage: A virtue in need of development? Medsurg Nursing. Kidder RM. Moral Courage.
HarperCollins Publishers, Lachman VD ed. Applied Ethics in Nursing. Springer Publishing, Davis AJ, et al. Churchill Livingstone, Corley MC, et al. Nurse moral distress and ethical work environment. Nursing Ethics. Principles of Biomedical Ethics.
Oxford University Press, Making ethical choices: Weighing obligations and virtues. Share This. Authors Lachman, Vicki D. Abstract Here's a practical guide to solving difficult ethical dilemmas by considering your professional duties and your own qualities of honesty, compassion, and self-respect. No caption available. Here's a practical guide to solving difficult ethical dilemmas by considering your professional duties and your own qualities of honesty, compassion, and self-respect.
When a mutual friend asks about his status, what should you say? What should you do? Nurses face ethical dilemmas such as these every day, often with little to guide them.
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In this article, I'll provide a practical road map to sorting through difficult ethical issues by focusing on two perspectives: your obligations as a professional nurse and the virtues needed to make morally sound decisions, such as honesty, compassion, and self-respect.
By addressing the ethical obligations and duties of nurses, the Code of Ethics for Nurses helps you answer the question, "What should I do in this situation? A related concept, virtue theory, addresses the question, "How should I be? Although it doesn't ignore the question, "What should I do? Virtues are best understood as qualities a person possesses that motivate her to act in a moral or ethical way.
The Code defines virtues as character traits that incline people to do the right thing. Provision 5 in the Code speaks directly to importance of character. A nurse owes the same duties to herself as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth. For more discussion of these points, see How key virtues apply to nursing.
Now let's look at how your four primary professional obligations to patients are influenced by the six virtues.vomismonaking.ml
Derek Sellman, What Makes a Good Nurse: Why the Virtues Are Important for Nurses - PhilPapers
Protecting privacy and confidentiality. The basic obligation to maintain a patient's privacy and confidentiality has existed since the time of Hippocrates, yet many nurses violate this principle without thinking. For example, suppose a friend asks you about your neighbor who's been admitted to the hospital unit where you work.
Even a casual reply about his condition violates his privacy. In fact, so does simply verifying his admission to the hospital. Respecting the patient means not invading or denying his privacy. If you commented about your patient to your friend, even though you weren't acting out of malevolence, you'd fail to demonstrate the virtue of respect and integrity. Your patient has a right to expect that you'll hold his diagnosis, prognosis, and personal history in utmost confidence.
Share information about his condition only with those involved in his care who need to know. Communicating honestly. Veracity is the ethical principle that obligates you to tell the truth. At times the truth may be painful for the patient or his family to hear, but honesty is a core virtue; only under unusual circumstances is violating it acceptable.
To act from the virtues of honesty and compassion requires you to make sure that bad news is delivered in an honest and compassionate way. Here's a six-step model to help you discuss unwelcome news in a competent way.
Ask the patient if he'd like to have any family members present when the physician discusses the results of tests or surgery. As much as possible, prevent interruptions to the conversation. Encourage the physician to sit down to deliver news to the patient or his family. Have a box of tissues close by. For example, when the physician leaves and the patient begins to ask you questions, you can ask, "What do you understand about your illness? Ask him, "Did you receive enough information to understand your condition?
As a nurse, you won't be the first person to break bad news about a diagnosis, a prognosis, or test results. But the patient may ask you to clarify the message he's received. For example, you may need to say, "I'm sorry to have to tell you this. Yes, your physician said the scan did show a tumor in your abdomen. Then pause and wait for his reaction. Don't try to soften or minimize the severity of the situation because this may confuse him.
You could say, "This is difficult news. How can I help you now?
Discuss potential sources of support. Assess the safety of the patient if he's leaving after receiving bad news.
Courage as a Virtue Necessary to Good Nursing Practice
You'll sometimes need the virtue of courage when you tell the truth to a patient or family and in many other circumstances you encounter as a nurse. I've defined moral courage as the capacity to overcome fear and stand up for one's core values.
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Besides physical harm, these forces include the threat of humiliation, rejection, ridicule, unemployment, and loss of social standing. Women rely on their nurses, often more than anyone else, to stay by their side and ensure their comfort and safety. This is especially true among new mothers, who often feel nervous or anxious about giving birth for the first time, or women facing unexpected challenges, like my friend.
As leaders in the birthing room, nurses are in a unique position to provide the best quality care to women and their babies. Simply put, women and babies deserve nursing care that is optimal, expert, and empathetic. When put into practice, these characteristics ensure that nurses are providing the best possible care to women and their babies--care that is grounded in evidence-based knowledge and which places their health and safety as the paramount concern.
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By keeping these virtues in mind, nurses can be confident their care will have lasting positive effects on the women and families they serve. These virtues encompass the nursing care that AWHONN believes all women and babies deserve and should receive from their care providers. We ask nurses to ensure that they are fostering these virtues in their practices each day. Nurses are critical to a woman's satisfaction with her labor and birth experience, and they should be acknowledged for the leadership they demonstrate throughout this process.