INTRODUCTION
The concept of nursing ethics is a broad one; it encompasses many different disciplines, and myriad issues. The manner in which a nurse behaves and cares for their patient is of paramount importance; their needs and their desires must both be met, in order to achieve a significantly high level of care. In this concept analysis, various approaches and concepts related to nursing ethics will be explored.
The two primary means of achieving nursing ethics are ethics of care and virtue ethics. Virtue ethics involves applying one’s own personal beliefs regarding compassion and kindness to the patient, and ethics of care revolves around maintaining an appropriate level of care to the most desperate and needing patients above others, remaining true to the patient’s wishes and beliefs.
Relational knowledge depends greatly on the autonomy of the patient; the patient and nurse relationship can become very close, as the nurse is the primary caregiver – emotional engagement is encouraged, as the relationship that is formed causes empathy with the experience of the patient. Embodied knowing “involves crossing socially prescribed boundaries of professional-personal interaction;” this often means touching the physical body of the patient in order to treat them (Wright and Brajtman, p. 25). These two methods are a good way of becoming more ethical through personal contact (both emotionally and physically) with the patient.
Given the greater level of technology, and the changing face of medicine throughout the globe, it is more important than ever to learn how to apply nursing ethics to these new medical practices (Ito et al., 2011). Learning these ethics is also becoming a major issue – nurses must learn critical thinking, flexibility, and awareness of their own abilities and education. Techniques such as blended learning (e-learning and classroom lectures) help use innovative technology to further their learning, as well as allow continued education to be provided more freely (Hsu, 2011). Ethics is often a vastly overlooked issue in nursing care, and interest in it must start at the education level (Numminen et al., 2009). Even value systems can be influenced at the education level, requiring a more standardized yet flexible system for imparting these approaches in order to offer nursing students the chance to pick an approach that works for them (Chiou-Fen et al., 2010).
There are three basic themes to the nursing code of ethics that must be carried over to each different nurse – one is the need to make sure that human rights are upheld. First and foremost, the dignity of the patient is paramount, and it is up to the nurse to uphold that dignity. Secondly, commitments to the patient must be fulfilled. When a nurse is asked to do something for the patient, and he or she agrees to do it, it must be done. Lying to them or flaking on your responsibility is ethically dishonest, as well as disrespectful to the patient. Lastly, competent practice of nursing is necessary – one must do the best job they can. This is the best way to serve the patient, and the most effective means of providing their medical care (Creel and Robinson, 2010).
The ethical image of nursing, according to nurses interviewed, carries with it five perspectives: proper fulfillment of duties, assertive advocates for their patient, welcoming and generous people; full of compassion and talent in their profession; and generous yet authoritative figures to their patients. These various attributes, in conjunction with each other, provide a comprehensive picture of the type of ethical nurse all in the profession should aspire to be. They must be morally upright individuals who are also hardworking and compassionate (Araujo Sartorio and Zoboli, 2010).
There are some mistakes that people make in their behavior as nurses – unethical behavior that must be curbed. The most grievous mistake that one can make as a nurse is to treat the patient as the ‘other’; this serves to alienate them from the nurse and provide distance. While this can shield an emotionally sensitive nurse from getting too close to a patient, it also deprives the patient of needed compassion and empathy, especially from someone so instrumental to their care. Another problem is conflicting loyalties; often, religion and contradictory attitudes regarding how to treat patients of certain genders, ages and ethnicities can get in the way of skilled nursing. These prejudices and biases must be eliminated in order to provide a higher quality of nursing for the patient (Lagerway, 2010).
Nursing ethics also extends beyond the hospital; home-based care requires a closer relationship with the patient than ever, which legal norms make more difficult. Nurses must extend their role and responsibility whenever possible in these contexts, as they are often the most dedicated and consistent medical care these at-home patients receive (Tonnessen et al., 2011).
In conclusion, nursing ethics stands for a great many things. There are many different methodologies and ways of achieving it, but they all basically involve a number of similar base concepts. Among these are utmost care and compassion for the patient, putting their needs above one’s prejudices and emotional distance, and remaining emotionally close and true with the patient. Virtue ethics and ethics of care concepts, among others, are the chief means by which to approach nursing in an ethical manner. With these things in mind, one can become more acquainted with the patient, forge a relationship, and provide needed emotional care along with one’s ethical nursing practices.
APPENDIX PAGE – CONCEPT IN ACTION APPROACHES
Some people argue for the virtue ethics approach – in essence, nurses are asked to merely be kind to their patients, and treat them as they would like to be treated (Holland, 2010). However, this type of ethics does not work very well, as utilitarians and the like can have different definitions of virtue; therefore, there is no standardized level of ethics that is applied to all patients. This can create rifts in care between nurses and patients, and unfairly connects one’s personal life with one’s professional endeavors. With this in mind, the virtue ethics approach to nursing ethics is not one that should be applied.
In my actual work in the nursing field, I use a series of tools to perform as ethically as I can. The Satisfaction with Decision Scale (SWD) is a nice point-based system to determine what actions I would and would not take. The Judgments About Nursing Decisions (JAND) scale is also useful for taking yes/no responses to whether or not I would make a certain decision in an ethical dilemma. In terms of approaches, I am very particular towards ethics of care as an ethical theory; it allows me to consider those who are especially affected by the choices I make as a nurse. I feel I need to give them extra attention, as they are much more reliant upon me. Also, ethics of care asserts that context is king; I must look at each individual patient’s situation in order to make the best decision for them.
References
Choiu-Fen, L., Meei-Shiow, L., Chun-Chih, C., & Che-Ming, Y. (2010). A comparison of problem-based learning and conventional teaching in nursing ethics education. Nursing Ethics, 17(3), 373-382.
Creel, E., & Robinson, J. (2010). Ethics in independent nurse consulting: Strategies for avoiding ethical quicksand. Nursing Ethics, 17(6), 769-776.
Holland, S. (2010). Scepticism about the virtue ethics approach to nursing ethics. Nursing Philosophy, 11(3), 151-158.
Hsu, L. (2011). Blended learning in ethics education: A survey of nursing students. Nursing Ethics, 18(3), 418-430.
Ito, C., Ota, K., & Matsuda, M. (2011). Educational content in nurse education in Japan: A Delphi study. Nursing Ethics, 18(3), 441-454.
Lagerway, M. D. (2010). Ethical vulnerabilities in nursing history: Conflicting loyalties and the patient as 'other'. Nursing Ethics, 17(5), 590-602.
Numminen, O., Leino-Kilpi, H., der Arend, A. v., & Katajisto, J. (2009). Nursing students and teaching of codes of ethics: an empirical research study. International Nursing Review, 56(4), 483-490.
Tonnessen, S., Nortvedt, P., & Forde, R. (2011). Rationing home-based nursing care: professional ethical implications. Nursing Ethics, 18(3), 386-396.
Wright, D., & Brajtman, S. (2011). Relational and embodied knowing: Nursing ethics within the interprofessional team. Nursing Ethics, 18(1), 20-30.
Araujo Sartorio, N. d., & Zoboli, E. P. (2010). Images of a “good nurse” presented by teaching staff. Nursing Ethics, 17(6), 687-694.
