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Phoenix Forward

Ethics in nursing put patients first

As nurses become more autonomous in their decisions, ethics play a greater role

Ethics are at the forefront of 21st-century workplaces regardless of discipline or industry. But the very nature of nursing as a profession places a particular importance on ethics.

“I have been a nurse for over 40 years, and ethics have been a big part of my work from the beginning of my nursing career,” says Kathy Watson, RN, MS, CPNP and director of nursing for the University of Phoenix Southern Arizona Campus. “There is greater focus on it now than ever before, especially in this era of health care reform.”

Increased emphasis on ethics in nursing

Today’s nurses face ethical dilemmas at almost every turn, according to Watson. She says that when she first became a nurse, decisions of an ethical nature were made by others. Now, nurses are considered more professional and find themselves in more autonomous roles. Thus, they are expected to make complex ethical decisions on their own. The American Nurses' Association even developed a standard of ethics and code of conduct for the profession.

We must live up to the promises of our profession.

“Perhaps the most common ethics situation that nurses encounter are mistakes in medication dosages,” Watson says. “These types of mistakes happen every day. The question is, should the nurse report every mistake to supervisors, even if no patient harm occurs? This becomes an ethical dilemma, given that both safety and veracity are part of the nursing profession’s standard of ethics.”

Making ethics part of the curriculum

Watson strongly believes that all nurses should complete ethics-related coursework and training. “Ethics weren’t always formally taught to nurses,” she explains. “All the ethics a nurse had came from her own personal values system, it wasn’t a professional code. But now that it is, we should be preparing nurses for that.”

Watson discusses how the College of Nursing at University of Phoenix incorporates ethics instruction into its courses. “In these courses, we talk about ethical standards and also give students role-playing exercises,” she says. "There are no right or wrong answers, and these exercises allow our students to think critically, and consider the consequences of different courses of action.”

One of the exercises employed in the courses involves EthicsGame, which uses real-time simulations of real-world nursing dilemmas to help students assess and inventory their ethics skills, as well as identify weak areas where more study might be warranted.

“Some of the situations we encounter involve how nurses must learn to put their own personal feelings aside when treating patients whose personal conduct we find abhorrent, like a murderer or child abuser,” says Watson. “These kinds of situations can be a challenge, but we are nurses first and we must put our patients’ needs first, regardless of who they are or what they might have done.”

Overall, the most important reason for nurses to study and understand ethics lies in the ideals of the nursing profession itself, according to Watson. “As a profession, nurses believe in justice, equality and human dignity,” she explains. “We must live up to the promises of our profession.”