Dealing with ethical issues is often one of the most challenging parts of nursing. On top of what’s already a fast-paced job, having to make fast decisions on moral questions can be tricky. With that in mind, here’s a quick look at the most common ethical issues in nursing and helpful tips on important to address them.
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What Are Ethical Issues in Nursing, and Why Do They Matter?
So, what are ethical issues in nursing, and why are they so important? Ethical issues are choices that need to be made that go beyond clinical care. These aren’t the black-and-white decisions of basic patient care where most nurses receive much of their training, like whether a patient needs immediate intervention, what type, and who needs to do it.
Instead, ethical issues involve a gray area. These are often choices that go beyond basic clinical care. They usually include questions of whether it’s proper to do something at a certain time. For instance, a patient who needs a life-saving intervention may refuse treatment. Or a fellow nurse may behave in an inappropriate way, endangering a patient as a result.
Ethical issues in nursing can sometimes be hard to recognize, much less solve in the moment. But failing to do so could not only impact successful care, but even make a difference between life and death. That’s why it’s important for nurses to understand these issues, and what the best course of action may be. Patient safety or even lives could be at stake. And so could your future career, or that of a co-worker.
Why Is It Important to Understand Ethical Issues in Nursing?
The American Nursing Association (ANA) understood this challenge way back in 1950, when it introduced its first Code of Ethics. Often simply referred to as “the Code,” this document outlines some of the most common ethical issues in nursing. Of course, the ANA has updated the Code many times since its original version to reflect the growing challenges facing the daily lives of nurses and the people they work with.
Ethical issues in nursing are especially important for nurse managers. Because they serve as leaders and mentors to other nurses and aides, they’re often called upon to make tough decisions. But the truth is, pretty much any nurse can expect to come to face to face with an ethical issue at some point in their career. This is especially true in fast-paced nursing settings like the Emergency or ICU unit, where lives hang in the balance.
And these issues only seem to grow more complicated each year, especially at a time when personal beliefs about vaccinations are impacting many workplaces. So, if you’re a licensed nurse or CNA who’s looking to become a registered nurse or an RN looking to specialize in management you can expect your education to include ethical concerns. This is especially true in Master of Nursing programs.
Top 3 Common Ethical Issues in Nursing
So, what kind of moral concerns can you expect to deal with? Here are 10 of the most common ethical issues in nursing.
#1: Issues with Coworkers
One example could be working with a new nurse who’s struggling with their duties. How do you address this issue? Do you bring it to the attention of a manager? And if you are the manager, how to you help the nurse fulfill their duties in a way that doesn’t endanger patients or other staff?
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#2: Patient Boundaries
Another example could involve patient boundaries. This might be a matter of keeping patient data confidential in light of the Health Insurance Portability and Accountability Act (HIPAA). It could also include improper behavior. For instance, the Code makes it clear that nurses shouldn’t accept gifts from patients, or engage in romantic relationships. But as obvious as that may seem, it’s not always so easy to know what to do in the moment.
#3: Patients Who Refuse Care
Another more specific ethical issue involves artificial nutrition and hydration. For instance, how do you deal with a patient who who cannot eat, but who also refuses to have a feeding tube used on them? The code maintains that the patient’s wishes should be followed, but this can be hard to do when someone is suffering.
Indeed, caring for noncompliant patients — or those who refuse certain care, procedures, or medication — is one of the most common ethical issues in nursing. Additionally, dealing with difficult patients can also be one of the most challenging issues. This is especially true when it comes to vaccinations, or when they’re in intensive care and their survival is at stake.
More Common Ethical Issues in Nursing
Of course, ethical dilemmas may not be limited to just these three scenarios. Other common ethical issues in nursing include:
#4: Whether to prescribe opioids for patients who are at risk of addiction
#5: Providing aggressive interventions to patients who aren’t responding (also known as “futile care”)
#6: Sharing important information with patients when it’s against the family’s wishes (sometimes known as “informed consent”)
#7: Reconciling a patient’s wishes with the demands of a family, which sometimes can be at odds
#8: Avoiding discussing your own personal beliefs on religion or spirituality with patients, and not letting them interfere with care
#9: Understanding how to respect a patient or family’s personal beliefs or religion in a way that doesn’t interfere with their care
#10: Understanding how to balance limited resources (including an understaffed nursing team) with the priorities of patient care
How Should Nurses Address Ethical Issues?
These are all tough questions. There usually isn’t an easy answer, or a clear course of action — even for nurses with decades of experience and training. But they still need to be faced. Nurse managers in particular must be able to spot and address ethical concerns in a way that protects patients and other staff members.
Nonetheless, there are steps that all nurses can take to prepare themselves as much as possible. Some of the most common ways to address ethical issues in nursing include:
- Get familiar with the ANA’s Code of Ethics, and have it handy at all times.
- Consult more experienced nurses, clinicians or doctors, if they’re available. (But be aware that this can be its own ethical issue! Be careful not to share sensitive patient info with someone who’s not authorized to hear it.)
- Try to speak truthfully to patients and families, and make their options clear at all times.
For Nurses Managers
And for nurse managers, some best practices to address ethical issues include:
- Hold training sessions to help fellow nurses understand and address ethical issues.
- Encourage staff nurses to always come forward with ethical concerns they may have.
- Update your facility’s ethics guidelines, or create an ethics committee.
- Hold regular meetings to discuss ethical issues nurses have faced in the past week or month, and talk about how to address them. Encourage honesty, and don’t be afraid of disagreements!
- Take on care planning in a way that doesn’t negatively impact other nurses’ duties, or that asks more of them than is normally required by their job.
- Help new or inexperienced nurses understand their ethical responsibilities.
- Involve the entire nursing team in decisions around budgeting.
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Another way to help deal with ethical issues in nursing is working a job where you’re fully supported. At CareerStaff, we’re proud to offer a 24/7 Clinical Services team for all our nurses and clinicians to access resources during their assignment.
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