Ethics in Nursing Introduction Every professional in the field of healthcare has a special responsibility and obligation to treat patients with care and dignity – and at all times there should be an ethical approach as well. Nurses, too, is a vitally important component of healthcare, are nurses are certainly bound by ethical rules and values, and this paper delves into the various aspects of ethics in nursing. Ethics and Nursing "Codes of ethics refer to systems of rules and principles by which a profession is expected to regulate the moral behavior of its members and demonstrate its responsibility to society" (Numminen, et al, 2011, p. 710).
Ethics in Nursing
Every professional in the field of healthcare has a special responsibility and obligation to treat patients with care and dignity -- and at all times there should be an ethical approach as well. Nurses, too, is a vitally important component of healthcare, are nurses are certainly bound by ethical rules and values, and this paper delves into the various aspects of ethics in nursing.
Ethics and Nursing
"Codes of ethics refer to systems of rules and principles by which a profession is expected to regulate the moral behavior of its members and demonstrate its responsibility to society" (Numminen, et al., 2011, p. 710).
Ethics in nursing boils down to taking responsibility for providing good care to patients, being fair, professional and just, Zane Wolf writes in the peer-reviewed journal Nursing. But there is more to it than just offering professional care, Wolf continues. The author, who is the Dean and Professor in the School of Nursing and Health Sciences at La Salle University in Philadelphia, notes that while the majority of nurses are "…committed to the welfare of their patients" there are exceptions (Wolf, 2012, p. 16). Those exceptions include nurses that "…display controlling, angry, or distancing responses to patients" and also those nurses that make mistakes either from acting "recklessly and intentionally" (Wolf, 16). In both cases the lack of ethical considerations is blatantly obvious and cannot be tolerated in the nursing field.
While conducting research through the literature on nursing and ethics, Wolf found too many instances of "…incivility in nursing education" displayed by faculty as well as nursing students (16). And since nursing programs are "…the first filters of character for the profession" Wolf believes that there needs to be changes in nursing programs (16). In fact the author asserts that a better assessment of the "personal characteristics of applicants to nursing programs" needs to be made.
There certainly are "unsuitable applicants" that get into nursing programs and too often they become the nurses that Wolf cites as showing "incivility" towards their patients (16). In order to weed out unsuitable applicants to nursing program Wolf suggests two ideas: a) the "emotional intelligence of applicants should be assessed before admission to nursing programs"; and b) the applicant should be tested in order to evaluate "…applicants' sensitivity to patients' verbal or nonverbal behavior" (16). Moreover, when faculty members in nursing programs perceive that a students' performance is "…unsafe or unprofessional, and remediation strategies to help them improve fail," that student should be dismissed from the program (Wolf, 16).
In his research Wolf discovered evidence of "…noncaring, uncaring, and biocidic nursing," and a "small number of nurses commit serious crimes" (18). The reports Wolf studied contained feedback from patients' experiences; they were asked to describe "…caring nursing actions" but they initially reported nursing actions that "were not caring" (18). Instances of being treated roughly, of being "belittled," and being treated "as objects" were reported by patients (Wolf, 18). Some patients noted unethical behaviors from nurses that made them feel "…like a little kid"; other reported being treated aggressively. The values portrayed by nurses while serving patients must be ethical and according to sound polices, Wolf concludes, and those nursing students that don't display ethical behaviors should be dismissed from nursing programs.
On the subject of nursing students and ethics, a peer-reviewed article in the International Nursing Review (Numminen, et al., 2009, p. 483) evaluated the perceptions of nursing students as to how they perceive as proper ethical behaviors. In general, students in this research "…assessed their own knowledge and ability apply the codes [of ethics] as mediocre" and students felt that the educators needed to teach codes of ethics "…more extensively" (Numminen, 483). In other words, the research in this article leaves the distinct impression that from the point-of-view of research involving 214 graduating nursing students from polytechnic universities, ninety-one percent of those graduates reported that "visiting lecturer[s]" brought in to emphasize ethics "…was used fairly little or not at all" (Numminen, 486). This raises a number of important questions about nursing education, mainly that these schools are not doing enough to train students in the vitally important aspects of ethical professional behaviors.
Author Vicki Lachman (clinical professor at Drexel University) hits the nail on the head when she references Dr. Jean Watson's caring theory as pivotal to the work of an ethical professional nurse. Watson's theory has three main elements: a) the carative factors; b) the "transpersonal caring relationship" that must be established; and c) the "…caring occasion/caring moment" (Lachman, 2012, p. 112). When Watson relates to "carative factors" she is alluding to the need to "…honor the human dimensions of nursing's work and the inner life world and subjective experiences of the people we serve" (Lachman, 112). In order to be a caring professional, a nurse must have "…a deep connection to the spirit within the self and to the spirit within the patient," Lachman asserts. And clearly, if the spirit of the nurse that is providing the care to the patient is not linked to the spirit of the patient -- or aware of the patient's spirit -- there is always the possibility that an unethical situation can emerge.
Meanwhile, in the peer-reviewed Scandinavian Journal of Caring Sciences the author, Mari Kangasniemi (doctor of health sciences) writes that "Equality is a central concept in the Western way of thinking" when it comes to health care. This is a rather esoteric article, not immediately easy to understand, but with careful consideration the article has value and an application to the concept of ethics in nursing. Kangasniemi mentions two "dimensions" or "themes" that link equality to ethics; at the "theoretical level" the two are "equality of being" (a universal human value, not just related to nursing) and "distributive equality" (that is, offering equal opportunities, circumstances and results) (Kangasniemi, 2010, p. 824).
The point of this article was to review existing scholarly research to see how the concept of equality is linked to nursing ethics. How has equality been defined in previous research? That was the salient question in this article, and Kangasniemi critiqued 63 previous articles on ethics in nursing to see how equality has been approached as a value in nursing. Certainly "equality of being" is indeed a universal value that goes well beyond the specifics of nursing, and it goes back to the idea of "moral rights" -- equal treatment for nurses and patients -- that mirrors views held by Aristotle, John Hobbes, John Locke, Rousseau and Immanuel Kant (Kangasniemi, 825).
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