Every day, nurses are confronted with situations that call for close examination of ethical principles and behaviors. Unlike other professions, nurses must constantly evaluate and compare their own ethical standards with those of other colleagues, patients, and family members. For many nurses, this presents a difficult challenge.
The American Nurses Association (ANA) Code of Ethics offers guidance for implementing a more ethical approach to nursing care. But how can nurse leaders in all practice areas act as help to create safe forums for ethical discussion, reasoning, and influence? From nursing administration to new graduate floor nurses, each nurse has a responsibility to help lead the profession toward a more positive ethical practice environment.
Regardless of the circumstances, any ethical decision involves an examination of four basic ethical principles that must be understood and implemented in practice. Encouraging nurses to review each principle as it applies to unique workplace situations is the first step in fostering a more ethical practice environment.
Nurse leaders are at the forefront of efforts to increase ethical thinking and discourse within the workplace. After identifying the need for resources to address ethical issues, it is possible to implement a successful ethics program to promote better decision making and collaboration for the good of each patient. Failure to do so may result in increased rates of moral distress, which occurs when nurses carry out actions that do not meet their ethical standards. As moral distress on a unit increases, so too does staff turnover and a loss of job satisfaction.
As a first step toward more ethical practice, many nurse leaders elect an ethics champion to facilitate the ethical decision-making process. In many cases, ethics champions receive additional training to broaden their understanding of medical ethics and the ethical challenges nurses may face as part of their daily work. Ethics champions may be nurses familiar with specific patient populations and the unique needs each type of patient presents.
But nursing is an evidence-based practice, and evidence-based results can help pave the way toward a more ethical workplace. Beyond designating an ethics champion, nursing leadership should be prepared to help other nurses evaluate ethical dilemmas by taking specific steps that promote ethical dialogue, including: