According to Gallup polls, nursing has ranked as the most honest and ethical profession 16 years in the running. Nursing has been highly regarded since Florence Nightingale, the founder of modern nursing, made it into a reputable, ethical profession. In fact the ethical principles in nursing, which now guide contemporary nursing, have many ties to Nightingale's morals. Nurses face ethical situations on a daily basis at the societal, organizational and clinical level. How they choose to respond does not happen without decisions being made. These decisions are based on the application of ethical principles. These principles need not only be applied in dealing with patients but also in the care of their families and related groups.
These principles ultimately optimize patient care and outcomes:
- Respect for autonomy. Autonomy means that the patients are able to make independent decisions. This means that nurses should be sure patients have all of the needed information that is required to make a decision about their medical care and are educated. The nurses do not influence the patient's choice. Examples of nurses demonstrating this include obtaining informed consent from the patient for treatment, accepting the situation when a patient refuses a medication, and maintaining confidentiality.
- Non-maleficence. This means that nurses must do no harm intentionally. Nurses must provide a standard of care which avoiding risk or minimizing it, as it relates to medical competence. An example of nurses demonstrating this principle includes avoiding negligent care of a patient.
- Beneficence, defined as kindness and charity, which requires action on the part of the nurse to benefit others. An example of a nurse demonstrating this ethical principle is by holding a dying patient's hand.
- Justice. Justice means being impartial and fair. Nurses making impartial medical decisions demonstrate this, whether it relates to limited resources or new treatments regardless of economic status, ethnicity, sexual orientation, etc.
Another valuable resource for nurses is the American Nurses Association (ANA) Code of Ethics. Originally adopted in 1950, the Code is used in challenging situations and is considered to be non-negotiable The Code was revised in 2015 and includes interpretive statements, which can provide specific guidance for nurses in practice.
Wondering what's included in the Code of Ethics?
- In Provisions 1-3, the fundamental values and commitments of nursing are explored.
- In Provisions 4-6, the boundaries of duty and loyalty are identified.
- Finally, Provisions 7-9 recognizes nursing duties, extending beyond patient interactions.
The Code is applicable to all types of nursing, from researcher, to manager, to staff nurses, and public health nurses. At times nurses may also may need approach ethical situations from a team approach, as the most challenging decisions are not to be made by just one person. This interprofessional team (which can be comprised of doctors, nurses, pharmacists, social workers, etc.) is commonly called the ethics committee.
The role of ethics in nursing will continue to prove important as healthcare is ever changing and challenging the status quo. Nurses need to have an understanding of the ethical principles to recognize and consider ethical dilemmas. This must be discussed early in the educational journey of students, and nurses must be held accountable to the standards and principles set forth, as they shape the future of nursing.
Dr. Stacey Rosenberg joined SNHU as an adjunct faculty in 2014 and transitioned to the role of Associate Dean of Faculty early in 2018. She is a Board Certified Adult Health Clinical Nurse Specialist and a Certified Nurse Educator with clinical experience in acute care and community/public health.