Nurses must uphold a strong set of ethics to provide high-quality care. New nurses must learn the ethics under which they are bound to operate. Not only are ethics important for creating a good healing environment, but they are also essential to maintaining professionalism and staying within legal boundaries wherever a nurse may be practicing.
The nursing code of ethics
Below are the four main components of the nursing code of ethics.
Autonomy
This principle acknowledges that each patient is an individual who deserves total transparency when it comes to their health. Nurses must explain clearly the condition that the patient has been diagnosed with and answer any questions they may have. If the nurse cannot answer a question to the satisfaction of a patient, they should try to get another medical professional’s opinion. In most cases, this is the specialist or doctor who the nurse is working with.
Autonomy means that patients have the right to be educated about all treatment options that are available to them before any major medical decisions are made. Patients should know the advantages of each treatment and any possible side effects, even if the risk may be considered small.
Nurses and other medical team members are responsible for creating a complete treatment plan that considers the patient’s wishes. Some choices that a patient makes may not be exactly what is recommended by their doctor as being in their best interests. While this may be hard to accept, it is imperative that medical professionals are always aware of patient wishes, and that they follow them as long as they are within the bounds of what is ethically and legally allowed in the area in which they are practicing.
Beneficence
Nurses must always act compassionately when treating and supporting patients. This is essential even if patients lash out due to pain or frustration.
Acting in the best interests of patients includes going the extra mile when possible to make patients comfortable and increase their level of morale. It is very important to be attentive, listen to patients’ concerns and do what is possible to address them.
Nurses also support and interact with the family and loved ones of those facing illness. This is especially true in the case of patients who must be hospitalized. Over time, nurses may come to know some family members very well. Nurses should take the time when possible to make sure that family members are comfortable and feel as welcome as possible. Patients do better when they feel loved and supported. Having family and friends visit regularly can help patients recover and heal faster.
Justice
Everyone is entitled to equal and fair treatment when in need of medical care. Nurses must do whatever they can to ensure that no one experiences unfair treatment or discrimination based on gender, race, sexual orientation, age or financial status.
There is no room for any form of prejudice in the medical world. Nurses have a duty to try to ensure that equality occurs. This means being culturally aware and helping others in the medical community increase their cultural awareness when possible.
With many areas of the country becoming more diverse, it has become more apparent that there is a need for increased awareness of religious customs, interpreters and more. If possible, having medical staff who are bilingual is very beneficial when trying to offer some patients the same level of autonomy offered to others.
Non-maleficence
Nurses must take an oath to not knowingly do something that causes harm to a patient. This is perhaps the most well-known principal of ethics in the medical world. This means that nurses must do what they can to help patients and doctors choose the treatments and medications that are most likely to have the best chance of success with the least amount of side effects.
Although it can be intimidating to some people to be in a position of reporting harm, nurses are bound by their oath to report any treatments at their medical facility that appear to be doing more harm than good. Even if it is discovered later that there was no actual harm, neglect or abuse, it is far better to have a matter examined than to find out that harmful practices were ignored.
Other ethical principles
Staying up to date on training and knowledge
It is important that nurses continue their education. While some amount of continued education is required to maintain a nursing license, nurses should take extra steps to learn about the latest medical treatments. Earning an advanced degree is a great way for nurses to update their skills and learn the latest advances in the medical world. No matter your experience or education level, there is always something new to learn in the world of medicine. The University of Ottawa offers some of the best healthcare courses in Canada.
Responsibility
Nurses always need to consider the consequences of any actions they choose to take. How will the action affect patients, families and colleagues? A good example of this is social media. Many professionals choose to severely limit the amount of information they have on social media and refrain from talking about work entirely. In fact, there are rules about confidentiality that make it best to avoid any work details whatsoever.
Workplace rules and regulations vary
Nurses work in many different environments. Hospitals, long-term care or assisted living facilities, and private medical practices will have their own rules and policies that nurses must comply with. Some religious-affiliated facilities may not perform some medical treatments, for example.
Company policies may include specific dress codes that include policies on hair, makeup and other aspects of personal appearance.
Policies regarding employee or patient fraternization may come into play. These policies are in place to prevent uncomfortable situations in the workplace. For example, a non-platonic relationship with someone you work with may be frowned upon or even prohibited by your employer. There may also be rules about social media profiles.
Gifts between patients and nurses are often prohibited.
Ethical dilemmas are inevitable in medicine
If you work in a medical field, you will encounter ethical dilemmas. While this might not happen every day, you must be prepared for it. A great example of an ethical dilemma is when a nurse must respect the patient’s autonomy against their family members’ wishes.
For example, a spouse or loved one may ask a nurse or doctor to limit the amount of information they share with the patient because they do not want them to be even more upset. While sparing the feelings of a patient may seem like a good idea, it is not the ethically responsible thing to do. Nurses and doctors have a professional obligation to share any relevant health information with the patient, even if it is upsetting or goes against the patient’s moral or personal ethics.
There are some cases where patients may decide not to extend their life by utilizing treatments that are available for personal or religious reasons. In this case, the ethical obligation is to do whatever the patient agrees to and provide as much support as possible.
Nurse managers and administrators can provide support and guidance
Nurses should always feel comfortable approaching their supervisors or administrators if they have questions or concerns. This is especially true if they are put in a position where they are facing pressure to do something that does not go along with the strong code of ethics and rules they are bound to uphold. Sometimes there are situations where it is hard to tell if a decision crosses the line into unethical territory.
Nurses face ethical dilemmas related to staffing shortages
There is a major shortage of healthcare workers. Registered nurses, in particular, are in high demand and will continue to be for many decades due to a large aging population and the simple fact that people live longer nowadays.
When nurses work at facilities that are facing staffing shortages, it can be challenging to provide the highest level of care to each and every patient. Nurses are faced with the ethical dilemma of how best to split their attention and skills among all the patients they need to look after in a given time. During times when there are many people seeking care, it is unfortunately true that patients that have the lowest-priority problems do not get care as quickly or as much personal interaction with healthcare workers.
Major legal concerns of nurses
Malpractice
A nurse can be accused of malpractice if they authorize or carry out a procedure that they are not qualified or authorized to do. It is important that nurses follow exact procedure instructions as set forth by the physician or treatment plan. When in doubt, a nurse should always ask for clarification before proceeding with any treatment plan. Patients can sue nurses if there is evidence that they performed any procedure beyond their job description that caused harm or put the patient at increased risk.
Negligence
While it may seem like malpractice and negligence are the same thing, they are actually quite different. Negligence is when a patient experiences neglect or harm due to a nurse making a careless mistake or not performing the treatment and care they are assigned to do.
A good example of negligence would be a nurse failing to double-check medications and administering the wrong drug or incorrect dosage. Failure to keep patient records up to date at all times is another example of negligence.
Defamation
Everyone has bad days at work. At large medical facilities, there may be colleagues who you do not get along with or like more than others. Regardless, it is important to maintain a high level of professionalism at all times. Any derogatory comments regarding someone you work with or a patient could be construed as slander. Repeating gossip or rumors about someone’s personal or work life can you get you into trouble. This can include being reprimanded at work or fired, or having lawsuits brought against you.
Defamation is a charge that can follow you throughout your career, so it is best to keep any comments and rumors to yourself. The exception, of course, is if you observe or hear something that you feel impacts the health and wellbeing of patients and staff. In this case, a private conversation with the administration is the professional way to handle the situation.
Battery
Harmful physical contact can be construed as battery. The definition of what constitutes battery can vary, so it is always important to know the policies and ensure that a patient consented to any physical contact or help. Sometimes consent is written into documents that patients sign upon checking into a medical facility.
Nurses can lose their license if they get into legal trouble
In extreme cases, nurses can permanently lose their licenses or be forced to give up their licenses for a set number of years if charged with malpractice, negligence or battery. Defamation typically results in being reprimanded, and in more extreme instances, a nurse may be demoted or have their employment terminated.
Conclusion
Nurses must maintain a strong set of ethics at all times. Knowing the legalities of patient care and practice is also essential. While some rules may seem like common sense, it is still good to stay up to date on any regulations.
When nurses strive to maintain ethical standards, patients receive better and more efficient care regardless of the illness they are battling.