Educating Nurses for Ethical Practice in Contemporary Health Care Environments

Abstract

Because health care professions exist to provide a good for society, ethical questions are inherently part of them. Such professions and their members can be assessed based on how effective they are in developing knowledge and enacting practices that further the health and well-being of individuals and society. The complexity of contemporary health care environments makes it important to prepare clinicians who can anticipate, recognize, and address problems that arise in practice or that prevent a profession from fulfilling its service goals and obligations. Different health care professions have evolved distinct perspectives about appropriate goals for, and the purposes of, their clinicians, even when the goal of improving health and well-being for society is shared across professions. While medicine and nursing goals are shared in principle, they differ in the particulars. Given the centrality to nursing of ethical questions, the profession has a collective responsibility to help clinicians at all levels of practice become ethically savvy and to reinforce their moral agency as needed. Both knowledge of nursing ethics and knowledge of the interdisciplinary field of bioethics are critical to nursing work.

Developing Abilities to Navigate Through the Grey Zones in Complex Environments: Nurses’ Reasons for Applying to a Clinical Ethics Residency for Nurses

“…Derived from the essays of nurses in different specialty areas and levels of education and responsibilities, they paint a panoramic picture of difficulties faced and the perceived knowledge and skills needed to practice ethically. While it is generally accepted that ethics education is very important for nurses at all levels of practice (American Association of Colleges of Nursing, 2008Nursing, , 2011Gastmans, 2002;International Council of Nurses, 2012), what this should entail and how it should be incorporated into nursing education, initial and ongoing, is less clear (Grace & Milliken, 2016;Grace et al, 2014;Peirce & Smith, 2008;Robinson et al, 2014;Zakaria, Sleem, & Seada, 2016). Findings support contemporary thinking that adequate ethics education must address three aspects foundational for moral agency-the ability to bring about a good (Grace, 2014): the development or refinement of personal and professional characteristics facilitative of moral agency, knowledge of ethics language and associated analytic tools, and the ability to influence those changes necessary to achieve the profession's goals of quality patient care.…”

“…The emotional experience of MD is linked to the lack of power to affect a good resolution. Moral agency-the ability to bring about a goodon the other hand has been proposed as likely to lessen MD (Grace & Milliken, 2016;Liaschenko & Peter, 2016).…”

Time use of advanced practice nurses in hospitals: A cross‐sectional study

“…The limited amount of time spent on ethical decision-making activities could also be due to APNs not feeling competent enough to fully take on the role of initiator and facilitator of ethical discussions (Van Hecke et al, 2019). As ethical decision-making skills are expected of APNs, who are in leadership positions (Grace & Milliken, 2016), it is vital that advanced practice nursing curricula focus on clinical, research, business, and legal ethics (Peirce & Smith, 2008 (Cannaerts, Gastmans, & Dierckx de Casterlé, 2014). As literature on APNs' ethical decision-making competencies is rare, further research is indicated to uncover barriers and facilitators for the full execution of this advanced practice nursing role.…”

Revised competency inventory for evaluating nursing students

“…Ethical competence is the root of the professional discipline of nursing in the sense that it is good for society. [34] For many nursing regulatory groups worldwide, competence or literacy in ethics is required for a license to practice nursing. The 9-item "ethical literacy" competency in this refined scale is similar to the "ethical practice" competency measured by the Canada's Competencies in the Context of Entry-Level Registered Nurse [35] and "prioritize people" in United Kingdom's code for Nurses, [7] such as "respects and preserves clients' rights", "promotes a safe environment for clients", "minimize the potential influence of personal values", "provides care for all clients", "Respect people's right to privacy and confidentiality".…”