Applying an ethical decision-making tool to a nurse management dilemma

Abstract

This article considers ethical dilemmas that nurse managers may confront and suggests an ethical decision-making model that could be used as a tool for resolving such dilemmas. The focus of the article is on the question: Can nurse managers choose the ethically right solution in conflicting situations when nurses' rights collide with patients' rights to quality care in a world of cost-effective and economic constraint? Managers' responsibility is to ensure and facilitate a safe and ethical working environment in which nurses are able to give quality care to their patients. In nursing it is frequently declared that managers' main obligations are to patients' needs and their rights to receive quality care. However, managers' ethical responsibilities are not only to patients but also to the nurses working in their institution. This article describes a real (but disguised) situation from an Israeli health care context to illustrate the dilemmas that may arise. The question is posed of whether nurse managers can maintain patients' and nurses' rights and, at the same time, fulfill their obligation to the conflicting demands of the organization. The article also offers a way to solve conflict by using an ethical decision-making model.

Elements and Strategies for Ethical Decision-Making in Nursing

“…The final sample included 19 studies, nine were empirical articles [12][13][14][15][16][17][18][19][20] (when data collection of the study is from people), eight theoretical 1,4,[21][22][23][24][25][26] (when the study discusses a topic or a theoretical question, with no intervention at the level of experience) and two case studies [27][28] (when the study has an empirical intervention, which allows the phenomena to be studied in depth in real contexts). The majority of the studies (95%) were published in English.…”

“…The majority of the studies (95%) were published in English. 1,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Six studies were published in Nursing Ethics (impact factor 1.093, evaluation year 2013), three in the Journal of Advanced Nursing (impact factor 1.685, evaluation year 2013) and two in the Journal of Community Health Nursing (impact factor 0.65, evaluation year 2013). Considering the classification that has seven levels of quality of evidence, 29 the results of this integrative review present a level of evidence of six, as they were derived from a single descriptive or qualitative study.…”

“…20,[22][23] Five studies were performed in the United States, 1,14,[22][23]28 three in the UK, 20,[25][26] two in Australia, 15,19 Sweden, [12][13] Norway 17,24 and Canada 16,18 and one in Israel, 27 Brazil 4 and Chile. 21 Six studies were conducted in the hospital context, [12][13]15,[19][20]24 one with nurses of primary healthcare, pediatrics, adult health and obstetrics 14 and one only with nurses of primary healthcare.…”

“…17 The study participants were supervisors nurses, [1][2]15 nurses, 3,5,9 nurses and students, 15,18 healthcare professionals 17,19 and nursing managers. 27 The majority of the authors (95%) were university professors. 1,4,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]28 In one study 27 the author was the president of a nursing association.…”

Consideraciones éticas en la gestión enfermera: una revisión actual

“…Uno de los principales objetivos de la ética enfermera es inspirar y examinar cuáles son las decisiones y las acciones éticamente correctas en situaciones en las que se requiere optar entre dos o más alternativas "poco deseables" 5 .…”