As a healthcare keynote speaker, healthcare consultant and author, it is surprising – and more than disturbing, how often the subject of nursing ethics rises to the surface of question-and-answer sessions. And, I “get it.” For as a healthcare keynote speaker and healthcare consultant, I know what everyone involved in a healthcare setting should know: in a world of ethically changing areas nurses are frequently placed in high stress, sometimes miserable, no-win situations. I would like to share a few of my thoughts in regard to this area with a special nod to the unseen pressures nurses encounter on a daily basis in regard to ethical issues.
What is ethically based nursing?
Nurses are instilled with the principles of four basic parameters. However, it is important to look beneath the surface.
- Autonomy – That patients have the right to determine their fates and to make the decisions in regard to their care. However, in addressing healthcare provider groups and learning from nurses for quite a long time, the concept of autonomy is easier said than done. This is no secret, but it is a matter deeply rooted in ethical behavior. Patients (and we are all patients) are not robots; determining one’s fate it not automatic.
- Beneficence – Compassion is often rooted in authenticity; how authentic can healthcare providers be when respecting the dignity of patients. How do nurses find authenticity and compassion when often the system itself is lacking in compassion?
- Justice – Is the organization framework in which nurses must work, a “just” system? The world outside the healthcare system traditionally believed there was, but is it?
- Non-maleficence – With respect to Hippocrates, the concept of “at least do not harm,” in all of its varying nuances, is often stretched to its limits, especially when nurses must act under the orders and constraints of others.
Now that I’ve Depressed You
I hope I haven’t depressed you, but verbalized some things that are reality, rather than textbook-based. For in fact, the nursing profession – as noble as it truly is – often operates in an atmosphere that is far from “automatic,” is lacking in compassion, can be unjust and can be potentially harmful under the guidance of others. To ask, ‘What is ethically based nursing?” is to embrace the realization that in a profession where ethical behavior is the highest standard, it often isn’t.
However, there are also inescapable realities that are “You-based.” Ultimately the system in which healthcare providers, nurses in particular, must operate is dependent upon the mindset of everyone in the nursing profession. By “You-based,” I am referring to the determination of each nurse to believe in choices and consequences, the essence of ethical behavior. Every choice does have a consequence.
Despite all of the modern tools available to the healthcare profession, an ethical mindset, rooted within each one of us, is the most powerful tool. Because an authentic and compassionate response is often really the most influential, response to a question. Authenticity is powerful.
No, the system is not always just, but the system is you and you can be just and stand up for others. It is an ethical imperative.
In regard to at least doing no harm, every nurse understands they are not only the gatekeepers of doing what is right, but doing what is ethical.
What is ethically based nursing?
Ethically based nursing is always within you. And, I know, it is often a fight but far beyond policies and procedures, HIPAA even, the authentic and ethical response to a crisis is within you for good. As an ethics speaker and ethics consultant it is what I believe.
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