Living the Nursing Code of Ethics

Understanding Ethical Dilemmas

In 1950 the ANA adopted its first code of ethics. Since then, it’s undergone many revisions to offset advances and changes in analysis, technology, law and overall challenges in nursing. the rules are divided into 9 provisions that cover topics that embrace human dignity, confidentiality, ethical virtue and care as a right. According to Laukkanen et al, the term “ethical dilemma is used when a choice has to be made between two equally unsatisfactory alternatives and there is a clear conflict between competing moral principles and values” (2016 p.2). Every day, nurse managers tackle an array of responsibilities – from employees leadership, patient care, and budgeting to record keeping, hiring and coaching – that include a bunch of moral dilemmas. moral problems happen once selections have to be created, the answers might not be clear and therefore the choices don’t seem to be ideal. The result may well be declines within the quality of patient care, problematic clinical relationships, and ethical distress.

The following are some other examples of common ethical situations that nurse managers face:

1. Science vs. Spirituality – Healthcare  that is science-based and results-driven, will impede on spiritual or personal beliefs. Some religions prohibit medical interventions and rescue techniques. Nurses target providing medical aid to scale back suffering, and to permit patients to focus on self care. For patients or their families with strong spiritual or religious convictions, the main focus could also be on adhering to a strict set of guidelines. The ANA’s code of ethics states nurses respect the “unique differences of the patient,” including “lifestyle, value system, and religious beliefs.” However, respect for the beliefs “does not imply that the nurse condones those beliefs or practices on a personal level.”
2. Autonomy vs. Beneficence – Nurses are needed to administer prescribed medication, however patients, at the same time, will refuse them. Patient autonomy will go against medical directives, despite clearly outlined desires. Patients have a right to refuse all treatment. The ANA highlights that it’s necessary for nurses and nurse managers to know patient backgrounds and individual circumstances to tell the patient of the medical necessity. “Using ethical principles to arrive at a solution should be done in an atmosphere of caring, respect, openness, and honesty. This process should be based on a sound ethical, decision-making model, using the best evidence-based-practice guidelines available,” the ANA explains.

Why is the dilemma specific to the Nurse Manager role?

A recent study found the foremost often occurring and nerve-wracking moral things are protecting patients’ rights, staffing, advanced-care planning, and decision making. aggravating the matter is that the sizable amount of inexperienced nurses coming into the sphere, many that have not faced  healthcare-related moral questions. Such challenges make knowledgeable nurse managers all the more crucial to daily aid needs nationwide. According to Felicia “Liz” Stokes, JD, RN, senior policy advisor at the ANA’s Center for Ethics and Human Rights, ANA considers the top three

nursing ethics

issues as:

• Creating and maintaining an ethical work environment
• Nursing’s role in social justice, such as opposing capital punishment
• Moral distress and moral resilience.

“The Code of Ethics for Nurses with Interpretive Statements is clear that nurses are bound in their duty to protect human health,” said Ruth McBain on behalf of ANA. “As the guiding voice for nursing ethics in the United States, the ANA feels that it is important to take a strong position on issues affecting human dignity and societal health.”

How does it differ from the role of the staff nurse?

In essence, a nurse manager makes many decisions using internalized ethical values, that include maintain organizational functioning, keep staff members safe, advocate for the patient/family and avoiding moral transgression. Managers resolve internal conflicts among their ethical values by repeating a simultaneous approach and holistic assessment consisting of damagecontrol and dialogue. As stated by Finkelman (2015), “nurses have responsibilities related to ethics, including maintaining knowledge of the professional

Code for Nurses

(2015), recognition of personal values, understanding of the decision-making process and its application to nursing practice, recognition and understanding of the importance of policy and legal issues, and the ability to be assertive” (p. 54).

What elements of the Nursing Code of Ethics are challenged?

“Ethics refers to a standardized code or guide to behaviors. Morals are learned through growth and development, whereas ethics typically is learned through a more organized system, such as a standardized ethics code developed by a professional group” (Finkelman & Kenner, 2016, p. 174) such as the Guide to the Code of Ethics for Nurses with Interpretive Statements (American Nurses Association, 2015).

On a policy or social level, broad queries are asked by nurses. In a situation that places then in an ethical dilemma for example a patient who is non-compliant with a life saving treatment and its admitted in the hospital, in this situation nurses are faced with a question about what to do with the patient and how right to do it without infringing on the patients rights and autonomy.

The Desired Outcome

The nurse manager is to use the principle of fairness and justice in any managerial actions. the specified outcome is for nurse managers to debate moral problems in daily practice and build moral choices so as to provide high-quality nursing care. Additionally, nurse managers with a with a good understanding of moral and ethical problems and the best way to resolve them quickly can efectivelly improve the standard of patient care and employees well-being.

Plan for Creating the Desired Outcome

Nurses should be knowledgeable about their state’s practice act and use this law and its related rules and regulations as a guide in making decisions about issues and complaints to the board. If nurses have any concerns about legal issues and personal professional liability, consulting an attorney is also recommended.

Nurses should apply the ethical guidelines provided in the American Nurses Association’s Code of Ethics. One of the first methods of creating a desired outcome is to identify and the define the issiue about the dilemma. An example is Autonomy, this refers to the right of the patient to retain control over his or her body, leaving nurse to only advise and educate the patient ont their desired outcomes.

Secondly the nurse must respect the choices of the patients and must consider individuals choices and circumstances for the benefit of patients outcomes. The choices have to be outlined and examined together with people who are less realistic and conflicting. This stage is intended just for considering choices and not for creating a final decision. the subsequent part is to resolve the dilemma by reviewing the problems and choices and applying basic principles of ethics to every choice. the most effective choice is then determined based on the views of all those involved within the dilemma.

The other step will be to implement the choices already agreed upon by all the interdisciplinary which is typically the foremost difficult because in healthcare not one solution fits all,as a result of it, the needs for actual implementation will also take in consideration about the situations and the patient’s wish.Nurses will always treat each individual as a unique and analysied what is in front of them with dialogue in order to make an informed decision. Finally, thorough analysis of the complete process will help in directing nurses to create moral ethics-related choices.

The American Nurses Association’s Code of Ethics, has outlined ethical analysis and decision-making process in nursing practice which contains elements that emphasize and speak to advocacy, collaboration with others, the maintenance of client safety, the dignity and worth of all human beings, the prohibition of any discrimination, accountability, the preservation of patient rights, such as dignity, autonomy and confidentiality, and the provision of competent, safe and high quality care of nursing care. (ANA, 2015)

Limitations Anticipated for the Plan

The nurse managers are faced with moral dilemmas which can have a detrimate to their own moral upbrings and the need them to make tough choices and better decisions among for their patient irrespective of unwanted options. As Christian and health proffesional, choices of moral  dilemma should not be taken lightly. Our christian worldview in a way influence our daily lives and decision making.

Overcoming the limitations

A nurse should respect the dignity and worth of patients and colleagues, and treat all persons equally irrespective of personal attributes or medical condition. Related to this is the responsibility to continuously respect the patient’s right to self-determination in her treatment.

Suggestions to prevent occurrence or reoccurrence

Nurse managers are expected to use moral guidelines provided within the american Nurses Association’s Code of Ethics to ensure that all staff members are educated and familiar with moral ethical practice. Additionally nurse managers should make sure that moral principles are being applied effectively to their daily practice utilizing resources available, such as codes of ethics and also the professional literature should also be used.

How does your biblical worldview impact your interpretation of this dilemma and the ethical standards involved?

As stated Matthew 7:12 “in everything, therefore, treat people the same way you want them to treat you, for this is the law and the Prophets.” So as a christian nurse managers have a choice to make a decision to teach and to correct in a way that their Christian vewi would ve of benefit to others.Thus, as Christian nurse managers, our choices concerning moral dilemmas and issues should be clear and not be compromised.

References

• Finkelman, A. (2016).
  
  Leadership and management for nurses: Core competencies for quality care
  
  (3rd ed.). Upper Saddle River, NJ: Pearson
• Ethical Issues and Solutions for Nurse Managers. (2019, January 20). Retrieved from https://onlinenursing.duq.edu/blog/ethical-issues-solutions-nurse-managers/
• Jones, R. A. P. (2007). Nursing leadership and management: Theories, processes, and practice. Philadelphia, PA: F.A. Davis Co.
• American Nurses Association. (2015a). American Nurses Association position statements on ethics and human rights. Retrieved on Janaury 20, 2019 from
  
  http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses
  
• Laukkanen, L., Suhonen, R., & Leino-Kilpi, H. (2016). Solving work-related ethical problems: The activities of nurse managers. Nursing Ethics, 23(8), 838-850. doi:10.1177/0969733015584966
• Epstein, B., & Turner, M. (n.d.). The Nursing Code of Ethics: Its Value, Its History. Retrieved from
  
  http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-20-2015/No2-May-2015/The-Nursing-Code-of-Ethics-Its-Value-Its-History.html#Moon
  
• Home. (n.d.). Retrieved from https://www.nursechoice.com/traveler-resources/4-common-nursing-ethics-dilemmas/
• Ito, C., & Natsume, M. (2016). Ethical dilemmas facing chief nurses in japan: A pilot study. Nursing Ethics, 23(4), 432-441. doi:10.1177/0969733015574923