Abstract
This article is aimed at presenting the nursing ethics and the phenomenon of patient's safety. This paper considers the underlying principles and values of both the nursing ethics and patient’s safety. It considers the implication of the nursing ethics and the safety of patients on nursing management and also states the strategic role of the nurse managers in patient safety. How nurses accomplish a good balance between patient choices and the patient’s safety through the use of Chiovitti’s theory of protecting empowering and the reflective questions that re associated with it. Core categories of the ethical principles of patient autonomy, non-maleficence, and beneficence as stated in the standards and codes of ethics at the international level were applied.
Introduction
Ever since the creation of the nursing profession there has always been a concern for the safety of patients. The root of patient’s safety can be traced far back as Nightingale’s underpinning ideas of ensuring that patients are prevented from bedside harms. Patient’s safety has been described as the absenteeism of avoidable harm to a patient for the duration of passing through the healthcare process. It may also be defined as the prevention of adverse effects and errors which results during healthcare processes rather than the principal disease process of the patient. Emphasis has been laid on the significance of ethical patient safety right from the 90s, but it is yet to be clearly defined. (Kangasniemi et al.)
Standards and Codes of Ethics in Nursing
There is the international code of ethics, known as ICN. Just as the name implies, this international code of ethics presents the standards and codes of ethics that must be abided by in all the countries. In some countries, registered nurses uphold the international codes and standards as presented by the ICN but goes further to create a national code of ethics based on the laws, customs, and societal values of the country. For example, in Canada the nursing standards and codes of ethics follows a patient autonomy-oriented approach to ethics. The national standard of ethics in Canada is known as the Canadian Nurses association’s (CNA) codes of ethics while it is called the Colleges of Nurses of Ontario (CNO) ethics standard at the local level. Both the CNA and CNO codes of ethics are consistent with the ICN code, this can be said to be as a result of the fact that the ethical principles of respect for the beneficence, non-maleficence, and autonomy which caters for the well-being of patients can be seen in these codes of ethics.
The Underlying Principles and values of Patient Safety
These principles and values of patient are found in its functioning culture which has been integrated into the structural culture. It is not ethical for the safety of patients to be promoted by the allocation of these patients to several wards based on their personal characteristics and not according to their healthcare needs. Also, it is a must on the nurse managers to prevent guilt, humiliation, or shame in a patient due to their illness or treatment that may not be in line with the dignity of these patients. Therefore, human dignity is regarded as a crucial phenomenon as far as the nursing profession is concerned. The concept of patient safety and that of human dignity are intertwined, every safety action is aimed towards the promotion and protection of patient safety, and this is because the ethical values of the safety of patients are located in a central field where the values of the healthcare also emerges. It is worthy of note to point out that for human dignity to be duly incorporated into patient’s safety, it is important to understand the patient’s characteristic, religious, and cultural background. Also, other healthcare values like accountability, trustworthiness, non-maleficence, and justice should be promoted and added to human dignity.
The ethical principle of utilitarianism can also aid in justifying the goal of patient safety. This justification is best-attained when population is the target and not individuality, because the real essence of this is the attainment of the utmost benefit for the biggest population of people. What this mean is that, individual rights to safe healthcare may get overridden with the aim of realizing a summative benefit across the population. It is therefore the responsibility of the Nurse Managers to guide the nurses on how to attain a good balance between the safety of an individual patient and the safety of the group and to deploy strategies that would prevent the commissioning of acts that might be unethical.
Strategic Role of the Nurse Managers in Patient Safety
The role of the nurse managers, as far as the safety of patients is concerned, is to ensure that the ethical values of patient safety is incorporated, at every level in an organization, into decision-making. The nurse managers are also to encourage clinical nurses to put values into considerations when providing healthcare to patients.
Patient’s Roles in Patient Safety
Every patient as a role to play in ensuring their safety. These roles might come from the patient is a healthcare participant or just as a citizen. In many of the developing countries, patients are given the task of providing basic care so as to enable the nurses to focus on tasks that need the nursing specialty. It has however been a great challenge to create an ethically sustainable patient safety by facilitating the collaboration between these patients and families.
Accomplishing a Good Balance between Patient Choices and Patient’s Safety
Addressing the ethical principles of autonomy, non-maleficence, and beneficence no matter the magnitude of the ethical principle in a culture has been a daunting task for health nurses, especially those in psychiatric mental health section. In order to ease this challenge, the nurse-generated theory of protective empowering was created.
Patient choice and restrictions to patient choice are in combined existence at the principal category of protective empowering. This combined existence are parallel to elements of choice and safety within the standards of ethics and the nursing codes. The theory of protective empowering can function as a yardstick from which quality practices can be advocated with the tendency to influence the education, policy, practice, and further research.
References
Chiovitti, R. F. (2011). Theory of Protective Empowering for Balancing Patient Safety and Choices. Nursing Ethics, 88-101.
Hill, J. (n.d.). Patient Safety and Ethics: A Conflict of Goods. Oncology Nursing Society.
Kangasniemi, M., Vaismoradi, M., Jasper, M., & Turunen, B. (2013). Ethical Issues in Patient Safety: Implications for Nursing Management. Nursing Ethics, 904-916.
