In the emergency room, this distinction can have a determinant impact on the ability of the staff to preserve life and diminish pain and suffering. The introduction of a bioethical perspective into this dialogue invokes a question as to the primacy of an interest in pursuing to the utmost the well-being of the patient. This speaks to one of the core values associating the principles of the ANA with the treatment outcomes desired in patiences. An examination of the ANA's Code of Ethics reveals that a theoretical basis exists to contend a direct correlation between the nurse's self-interest and that which is best for any given patient. There exists an essential obligation for such healthcare practitioners to "examine the conflicts arising between their own personal and professional values, the values and interests of others who are responsible for patient care and health care decisions, as well as those of the patients. Nurses strive to resolve conflicts in ways that ensure patient safety, guard the patient's best interests and preserve the profession integrity of the nurse." (ANA, 2.2) Here, there is provided an ethic based upon the theoretical presumption that a nurse will view his or her own benefit to be inextricably linked to the effective treatment of the patient. Professional associations such as this are constructed with the intent to help the nurse achieve balance between personal value systems and those which are necessarily reflected by the healthcare institution.

This is a theoretical approach which assumes that the nurse will base all treatment decisions -- or in this case, non-decisions -- on an interest in achieving the patient's best overall health outcome. In defining our terms, there may be great insight to be gained in the theoretical discourse on the implications of emergency room treatment as it is understood under the current perspective proposed by the World Health Organization. This internationally representative group states as its primary definition for individual health, "a state of complete physical, mental and social well being and not merely the absence of disease or infirmity." (WHO, 9) Here, ethical leadership demands that the nurse practitioner engage all necessary effort in order to ensure that the patient receives the highest level of treatment and personal attention. This means that proper bedside manner and effective emotional engagement of the patient are relevant to the task of ensuring an overarching wellness. The intercession between the behavior inclined by the ANA and that suggested by the WHO demonstrates an increasing coalescence of domestic and international expectations from nurses which suggest the consistency achieved by membership in such professional associations.

This is to argue that the ethical nurse will be guided by an institutional interest in retaining the patient's overall state of health that is defined according to a carefully devised set of shared standards. The emphasis at a healthcare institution must be on the facilitation of a relationship between hospital staff and patients that follows from these standards. Such professional organization standards recognize that healthcare is most essentially a human process, and that the interactants on either side will define the success of this process. Creating the healthcare where personnel behave toward patients with understanding and humanity would be a remarkable and effective feat indeed and is one to which the ANA demands its affiliates aspire.

Such associations play a leading role in creating a staff minded this way. Accordingly, facilities must take an aggressive stance toward accountability, ensuring that all practitioners are aware of the weight of their respective responsibilities as promoted by such groups as the ANA. This can be a critical instrument to benefit the work of nurses as the ANA, among others things, offers means defining clear procedural norms for informing grieving relatives of passed love ones, for consulting individuals facing terminal conditions or for advising individuals facing risky health decisions. These distinct challenges of the job are facilitated by the type of standardization and communicational support which is provided through the ANA, helping the nurse to feel that even in the most challenging of scenarios that he or she is not working alone. Associations like the ANA help to underscore the philosophical premise that healthcare is conducted through a team orientation.

So is this further demonstrated by those specialty associations which have been designed to facilitate similar connectivity and support but with specificity to select contexts of practice. One of the more prominent of these is the Emergency Nurses Association (ENA), which provides support and networking opportunities to nurses specifically working in Emergency Room (ER)...

As with other associations here discussed, ENA was founded as a means to giving practicing nurses a point of reference when confronted with dilemmas over best practice, when seeking access to other qualified professionals, when determining those resources which are available for personal advancement and for establishing a connection with a national population of one's professional peers.
In its Mission, ENA stresses its role as a an "advocate for patient safety and excellence in emergency nursing practice." (ENA, 1) This is a role which it seeks by providing various resources to its members, including a research-based journal with a specific emphasis on issues impacting Emergency Room nurses, a newsletter which it published throughout the year reporting on relevant current events and upcoming activities in the profession and a set of standards for best practices in emergency room care that it presents as a 'core curriculum' for ER nurses. It also promotes a continuing education that seeks to help Emergency Room nurses attain higher levels of leadership within their staffs and healthcare facilities.

Also, as with the ANA, the ENA provides its members with a clear code of ethics based on the presumptions concerning patient treatment, interaction with staff members and a relationship to the facility as a whole. Here, ENA indicates that it is of the utmost importance that emergency nurses display "compassion and respect for human dignity and the uniqueness of the individual [and] competence within, and accountability for, emergency nursing practice." (ENA, 1) These traits are, of course, universal to the work of nursing in general, but are elaborated by the ENA with the understanding that a professional comfort my be found in establishing this connection through an association of peers in the specialty area. Quite to the point, there is virtually no limit to the specificity of association membership in the medical profession, with practitioners often claiming membership in a wide array of overlapping support and accreditation groups. To an extent which must also be addressed in this discussion, membership in a reputable association is often a sign of professional credibility to one's peers. Thus, where nurses are concerned, especially with respect to the pursuit of a leadership role, a key benefit of association membership may be the reputation which it accords upon one in the eyes of others.

Naturally, many of the above are benefits which apply not just to practicing nurses but to those receiving the developmental education to eventually serve in this capacity. Thus, there are a number of professional associations in the field that are centered specifically on the experience of students in the areas of gaining access to professional mentors, being considered for scholarship support, being placed in a network with others aspiring to the nursing profession and achieving a greater understanding of the ethical, practical and legal parameters that inform the nursing discipline.

Among these associations, the National Student Nurses' Association (NSNA) is a prominent one, boasting a membership of roughly 50,000 individuals in the U.S. (NSNA, 1). Founded in 1953, it has since become a powerful advocate for nursing students as they navigate the rigors of both the education and practice in the field. Here, the purpose of the professional association is illuminated to those students who will eventually seek membership into those comprised of practicing nurses. Thus, the NSNA provides in its preamble a delineation of the correlation between "rights, responsibilities and ideals." (NSNA, 1)

This describes these not as elective or diverse but as requisite and defined according to particular standards. As the preamble states in representation of its membership, "we believe the quality and quantity of participation are not exclusive, but bear the responsibility of participation." (NSNA, 1) This is to indicate as a point of introduction to the students gaining membership here and in the eventuality of membership in any of the professional associations elaborated here above that nurses are held to specific expectations and standards of practice that are not subject to resistance. This speaks to one of the primary purposes in such an association, which is intended to streamline the ethical orientation and practical approach taken by all nurses. In a manner, the association is a channel through which those measures established as best practices are proliferated.

The NSNA is especially a valuable organization in the face of the practical stresses of the profession, not the least of which is a nursing shortage beginning at the enrollment level. Today, there is a heavy demand for practical nursing professionals due to a shortage of healthcare professionals. Shortages of…