This paper delves into the ethical vision that nurses (and importantly, nursing leaders in colleges and other training venues) should have in order to carry out their duties on a high moral level. The paper points to empirical research projects that cover a number of situations in which nurses and ethics dovetail. In other words, ethics is not just another topic in a nursing handbook; rather, it is a vision that must be renewed and reviewed regularly, before it can be put into practice.
Nurses Ethical Leadership
There are myriad valid definitions and descriptions of leadership in society, and in the healthcare field there are important leadership styles of substance. Nurses, a vitally important component of the healthcare field, must be trained in leadership skills but also nurses must have a vision of ethical leadership to go along with their hands-on day-to-day leadership skills.
Ethics in Nursing Leadership -- Key Concepts
For the nursing field, it is not enough to study ethics and ethical practices in college and attend seminars annually that focus on ethics. These activities are important but in order to truly keep ethics in the forefront of everyday nursing situations there is a need for the building of a stronger vision. It has been proven that this can be done through regularly scheduled dialogue and reflection.
In order for nurses to engage in meaningful dialogue and reflection vis-a-vis ethical leadership principles they must believe in and have evidence that they are supported in their quest by their own nursing leadership. The support that working nurses have from their executive leadership is fundamental to the building and maintaining of their own vision of ethical professionalism.
Another key concept in the development of a vision for ethical leadership entails a phenomenological approach to specific healthcare practices at the nursing education level. The education that nurses must successfully complete is of course heavily weighted in specific healthcare-related procedures, environments, theory and problem-solving. But a key part of a nurse's education must also dovetail with an ethical vision of how to approach tough situations.
Critiques of Evidence that Support a Vision of Ethical Behaviors in Nursing
In a peer-reviewed article, Mary Tod Gray empirically approaches the phenomenological approach to nursing at the college / learning level. Gray focuses on those educational approaches which in turn "…foster greater understanding of the nature of moral leadership as it is lived in nursing education" (Gray, 2008, 332). In this research three of four nursing educators surveyed chose "integrity" as the most critical value to be taught to nursing students.
Another peer-reviewed article in Nursing Ethics (Storch, et al., 2013) addresses existing research on ethical leadership and in the empirical studies that the authors uncovered it appears that many nurses do not feel that they are being supported by their supervisors when it comes to ethical healthcare practices.
A third article presented in this paper reviews a project in which ethical issues are discussed through a "participatory action research study of ethical practice in nursing" (Makaroff, et al., 2010). The need for collaboration between academic leaders and those nurses practicing their craft -- with reference to ethical standards and practices -- is vital, according to this article.
Specific Examples of the Impact and Importance of the Ethical Vision
Gray's pilot study tapped into four nursing leaders' experiences regarding the ethical vision necessary for effective healthcare delivery by nurses; she delved into four major themes: a) the power of information; b) integrity; c) justice; and d) "wrestling with decisions in the light of consequences" (333).
This vision reflected in this piece, in terms of which themes are most important to nursing leaders, was achieved through a one-to-two hour in-depth audio taped interviews, empirically grounded when each interview was transcribed "…line by line" for data-gathering. The first value identified by the four leaders was "integrity" and the second most often identified value was "justice," which has deep ethical foundations. One nursing leader, discussing integrity and justice in the nursing education classroom, noted that ethical dilemmas "…demand a careful scrutiny for information bias… presented by the education leader" (Gray, 342). The vision of the nursing educator is founded upon integrity, justice, and an open dialogue with future nurses.
In the Storch article the authors revisited numerous research pieces from the past twenty years; they found that only twelve of those previous scholarly research articles on ethics in nursing -- articles based on direct empirical research -- directly related to ethical leadership. The nurses that did not receive support from their supervisors in matters of ethics suffered from "moral distress" -- and hence managers and executives in nursing are perhaps the key to keeping ethical visions alive and function. When they fail to provide that leadership, nurses under their leadership struggle to come to grips with what is ethical and what is unethical.
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