Ethical Nursing Practice: It Begins With You, the Nursing Student

What Are Ethics?

In common terms, ethics are established beliefs or rules that allow individuals to determine in their own minds what is morally good as opposed to what is bad or unacceptable behavior. Ethics are those beliefs that are valued and utilized to help guide one’s behavior. Aristotle’s philosophical belief was that individuals have a natural ability to possess good character, but it must be cultivated through practice. The discussion of ethics in nursing practice has existed as far back as Florence Nightingale and has evolved over time to the development of adopted codes of ethics for nurses.

How Does This Apply To Me, A Nursing Student?

A question to ask yourself is: “What do I use each day to guide what I do as a student nurse?” Many things that you were taught as a child guide your current pattern of decision making. In your role as a student nurse, you are faced with many challenges, difficulties, and even situations where it might be easier to make a personal decision that you know is not in the best interest of the patient you are caring for or for you personally.

What do you do when you accidentally make a medication error? Do you try to cover it up and hope that no one will notice? What do you do when you are faced with a deadline on a paper that is due? Do you consider simply using someone else’s work as your own? These are examples of common situations that often place the student nurse in a situation where a decision has to be made to act ethically sound or compromise ethical principles.

The codes for nursing practice that have been established provide nurses with ethical guidelines to follow. However, these are simply standards to follow, and unfortunately, cannot cause nursing professionals to automatically behave in an ethical manner. Nursing students and nurses face many dilemmas in practice that call for actions that are based on an intrinsic desire to use sound moral judgment.

Is there room for ethical compromise in nursing?

Hurst Review believes that the answer is simple. No! Throughout the history of nursing, many unfortunate stories have surfaced where unethical decision making by the nurse-led to poor or sometimes tragic results. Nurses are called to high standards of decision making and are accountable to those they serve. A component that should guide ethical behavior in nursing is integrity, which involves being honest at all times, even when it is not easy.

Selected Characteristics of Ethical Nursing Practice To Remember:

Accountability – Student nurses accept the responsibility of caring for patients with a high level of accountability for the care that is provided. Being prepared to provide safe care is crucial for accountability as a student nurse. As a licensed nurse, the level of accountability rises and is based, in part, on established standards for nursing practice as well as policies and procedures. A key ethical term to remember is nonmaleficence, which simply means “do no harm”.

Confidentiality – A key part of ethical practice is maintaining strict confidentiality of information that the student nurse is privileged to access or gain through experiences. This not only involves the patient but should include information gained in nurse-to-nurse or other health care professional interactions. Trust from the patient and others within the healthcare environment is based somewhat on the expectation of confidentiality. Although of great importance, the need for confidentiality exists far beyond the avoidance of sharing information verbally. In today’s society where the use of social media is prevalent, the nursing student must use extreme caution to avoid jeopardizing the confidentiality of nursing matters using social media sites or other technology-based avenues.

Dignity – The patient deserves to be treated with dignity and respect. This can encompass many things from providing privacy for patients to treating them with the utmost respect and concern when end-of-life care is needed.

Diversity – Student nurses will most likely encounter patients from different cultures and with diverse belief systems. Sometimes, these views will be in opposition to those of the nursing student or nursing staff. However, nursing students and nurses should be able to accept the person as they are, and be willing to provide culturally competent and safe nursing care.

Honesty – The importance of honesty in nursing practice cannot be overemphasized. This is not always easy when having to admit an error or omission of care. It takes courage to admit a wrong. Therefore, honesty reflects the true character of the individual and is vital in both the academic and clinical settings.

In summary, providing ethically sound nursing care may not always be the easiest professionally nor personally, but the decisions that are made represent who the individuals truly are when no one is looking. Patients deserve and are counting on nurses to provide care that is reflective of high ethical and moral standards.

January 12

Debra S. McDonough, RN, MSN, EdD