Interprofessional collaboration has been one of the growing trends within the health care sector lately. It involves interdependence of the different health care professionals such as nurses, physicians, laboratory staff, and even patients. The complexity of the patient-care concerns that need to be tackled by these professionals can be efficiently and effectively addressed through appropriate collaboration among the professionals. However, the various evidenced provided by different researches on the benefits of collaboration are yet to be seen and applied in the activities in health care institutions (Porter-O’Grady, 2011).
As mentioned, nurses are one of the stakeholders who are actively involved in the different health care activities and decisions. Thus, it is also important for nurses to develop leadership skills and flexibility to be able to adjust to the continuous evolution of the health care dynamics and eventually help in the transformation of health care (Porter-O’Grady, 2011). Implementation of the different roles of nurses in advanced nursing practice also need adequate leadership skills from the nurses (Carter, et al., 2010).
Some of the roles that can be done by nurses include managers, chief executive, administrators, leaders in the professional practice, and even policy makers. The qualities that are essential for these nurses to be effective include being an advocate for different causes such as quality care, mentor, risk taker, and even as a role model (Carter, et al., 2010).
The current problems that are prevalent in the health care sector are one of the main concerns that should be addressed by nurses. Some of the problems in the health care sector include complexity of issues when it comes to the dynamics of healthcare, inadequacy of funding for healthcare services and delivery, shortage of health care professionals who are trained to solve different problems, and even the growing need for health care services which are focused on the elderly or the aging population (Carter, et al., 2010).
The scopes that are included in the roles of nurses when dealing with the core of advanced nursing practice are patient care, consultation, collaboration, leadership, and study or research. Leadership of nurses can be viewed in different ways since nurses have different leadership styles. Some nurses naturally engage and use an effective leadership style while others find it hard to look for a particular leadership style that suits their needs. Thus, one of the known and necessary skills for nurses that play a significant role in health care delivery, patient safety, and staff development is the development of effective leadership skills (Zydzyunaite, 2012).
Some of the notable skills and quality that should be portrayed by nurses include effectivity when dealing with problem-solving process, appropriate and innovative developments for identification and effectiveness of groups. These skills are necessary for the nurses to be able to adequately and effectively deliver quality health care and patient safety. Aside from these, nurses are expected to be zealous, active, inspirational, and focused on solving different problems especially when it comes to health care services and delivery. Nurses are supposed to embody these qualities and characteristics for them to have the ability to be able to establish a strong working relationship with other professionals (Zydzyunaite, 2012).
Since nurses who are skilled leaders portray various roles in the health care sector, it is normal that they are also responsible for handling different conflicts that may arise during problem-solving processes and collaboration works. Some of these conflicts may involve ethical concerns which makes it important and necessary for nurses to know more about ethics and its application in the nursing practice.
Bioethics is sometimes used interchangeably with the term healthcare ethics because both concepts are basically focused on the different moral issues that are prevalent in the health care sector. The moral dilemmas faced by health professionals, patients, and even friends and families. The health professionals directly involved with bioethics include physicians, nurses, and laboratory staff. The main objective of this discipline is to continuously look for different solutions to issues associated with life, death, and significance of human life (Rich & Butts, 2012).
One subdomain of bioethics is nursing ethics which involves unique moral problems that are experienced in the field of nursing. Majority of the controversies and cases tackled in nursing ethics are practice based. The additional subdomain of bioethics was necessary for tackling issues and cases that are unique to the nursing practice especially when it comes to the involvement of the nurses with the patients, families, and other health care professionals (Rich & Butts, 2012).
According to Krause (2011), some of the ethical concepts involved in nursing practice include ethics of care and ethics of justice. These concepts involve ethics but address different spheres of the human life. It has been stated that ethics of care mainly focuses on the personal sphere of human life while ethics of justice focuses on the political sphere. Various experts on ethics and health care reported that these ethical concepts are not necessarily mutually exclusive. However, concepts that are addressed using ethics of care can also be addressed by ethics of justice (Krause, 2011).
Ethics of care is considered as a type of virtue ethics. It can also be referred to as “ethics of love” or “relational ethics” (New World Encyclopedia, 2013). As stated above, the main focus and concern of ethics of care is on solving problems or situations that are associated with the personal or private sphere. As a result, it can be claimed that issues solved by ethics of care cannot be solved or tackled by problems that are associated with the public or political sphere. However, these issues or problems can be supported by ethics of justice (Krause, 2011).
Ethics of care was originally based on a feminist point of view. The main stakeholders or individuals involved in the public or private sphere include spouses, children, siblings, parents, and even friends. Ethics of care in the nursing practice basically share empathic care for the individuals listed above. The main ethical concepts involved in thus virtue ethics type include compassion, sympathy, concern and care for other people, and empathy. Ethics of care consider the family as a primary sphere where virtues and values are usually hereditary and civilized (New World Encyclopedia, 2013).
The main focus of ethics of justice is not only the equality of treatment individuals but also of their ability to provide autonomous choices. As mentioned in the earlier paragraphs, ethics of justice may vary according to a particular individualistic or communistic dimension. Studies revealed that the perspectives involved in deontological, teleological, and consequentialist ethics are the main focus of the ethics of justice perspective. In addition, it has been claimed that attention and focus on the intentions and purpose of a certain action is the main objective of ethics of justice rather than the methods or procedures or even consequences behind the action (Sojka and Wempe, 2012).
Ethics of justice can also be referred to as “morality of justice” or “ethical principlism”. This concept is focused on the commonly used concepts of morality. The major principles associated with this concept include autonomy, beneficence, non-maleficence, and justice (Rich & Butts, 2012).
Autonomy can be defined as one’s ability to respect another’s decision or right to decide for one’s own. It is the principle associated for individuals that have the ability to respect one’s ability to respect and support another person’s ability to decide for himself (Frank, 2013). In the nursing profession, autonomy is showed when nurses allow patients to decide for their own choice of treatment or medication. However, when the patient does not have the ability to make his own decision, the appointed directive or representative will be the one to make the decision for the patient.
Beneficence refers to an individual’s ability to share compassion or to provide assistance or help to other people. It can also be defined as one’s ability to do well. It is considered as the core principle necessary for patient advocacies (McCormick, 2013). In the nursing practice, nurses can show beneficence by immediately providing pain medications to patients who were hospitalized due to traumatic and painful accidents such as fractures and care accidents.
Non-maleficence is the term used to describe an individual’s capability to avoid hurting other people and prevent harm from happening. The ethical characteristic of non-maleficence has been reported as the core principle when dealing with associations of ethics of nurses and oaths of physicians and other medical professionals (Sundean & McGrath, 2013). For example, nurses can show their non-maleficence by not using and applying various techniques and medications that have not been proven as safe for patients or are proven to have serious side effects to patients.
Justice can be defined as an individual’s ability to equally and fairly distribute resources and services to patients and to adequately assess the benefits and burdens of a particular medical decision (Equity for Children, 2013). As an example, nurses can demonstrate justice in the nursing when vaccines provided for children are fairly distributed to children without any bias (Alqahtani, et al., 2015).
Crisis management is considered as one of the main roles of nurses. Thus, it has been revealed that nurses are supposed to acquire adequate and appropriate knowledge, skills, and application of ethics especially in the health care sector. Health professionals have identified the main ethical frameworks that are needed to appropriately address crisis concerns. These frameworks include ethics of justice, ethics of care, and virtue ethics. Among these, the most effective framework when it comes to crisis management is the ethics of care approach. Ethics of care is focused on creating relationships and maintaining connections with other people. The identified factors that help implement ethics of care include attentiveness when it comes to relationships and connections created, being conscientious and even responsible in handling the relationships, and consideration when assessing the various consequences of one’s actions (Linsley & Slack, 2013).
Since ethic of care is focused on the morality issues commonly faced and experienced by individuals, it is the most effective framework that can be used in health care. Currently, the application of ethic of care has been viewed as a combination of personal, political, and global perspectives starting from the acknowledgement being central and undisputed. Thus, the claim that the most basic moral value acknowledged by different experts is care (Corsetti, 2011).
According to the study conducted by Deghani, et al. (2015), the main factors that affect professional ethics or ethic of care in the nursing profession include characteristics and responsibility of the individuals concerned, challenges when it comes to communicating with other professionals, patients, and families, preconditions that are present in the organization or institutions, support systems, and even development when it comes to educational and cultural sectors. Adequate and appropriate knowledge when dealing with professional ethics and its contributing factors can greatly influence the nurses’ ability to provide health care services that are of higher quality (Dehghani, et al., 2015).
One of the difficulties faced by nurses is the ethical challenges that may lead to ethical conflicts due to the apparent increase in the dynamics of the health care sector in the recent years. Recent studies have shown that despite the need to meet the various requirements when it comes to patient care, the standard of ethics in the professional level are yet to be observed in the nursing field. The numerous conflicts that may arise due to various differences when it comes to perspectives and opinions about a particular concerns is one of the reasons why ethical issues and concerns should be considered as a basic requirement among nurses (Dehghani, et al., 2015).
As an example, a nurses will be able to provide higher quality of health care services when they are accountable, knowledgeable, and devoted to their work and to their patients. Another example involves being conscientious which is considered as an important factor when dealing with a nurse’s work discipline and sense of duty. A nurse is considered as conscientious when he or she finishes his or her task first even after their shift is already over. These behaviors and characteristics vary according to who the person is dealing with. It is also influenced by a person’s culture, values, and individuality (Deghani, et al., 2015).
In conclusion, it is apparent that ethics and ethical issues are significant factors and concerns that should be focused on by nurses especially since they affect and influence the quality and accessibility of health care services. By ensuring that nurses have the adequate skills and knowledge to deal with various ethical concerns, patient safety and outcomes can also be significantly improved. Two of the frameworks of ethics have been discussed namely ethic of care and ethics of justice. These two frameworks differ with the types of spheres where they can be applied. The former is more focused on the personal sphere while the latter is more focused on the political sphere. Regardless of certain differences, it is worth noting that knowledge of these frameworks can greatly help in the improvement and development of various health concerns.
References
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