On creating an ethical culture in nursing

Editor's Note

For any nurse, moral distress and conflict can arise when treatment plans, family wishes, or institutional pressures don't align with patients' expressed preferences. Strategies to plan for professional and ethical judgment across nursing care can provide a solution. This is according to insights from a vice president and chief nursing officer within the Cleveland Clinic health system who recently discussed the topic in a December 17 podcast.

In the podcast, the nurse executive reflected on the moments of ethical uncertainty a nurse faces when teams question whether care decisions truly align with patient wishes, family values, and professional standards. Delving deeper into this topic can uncover several common trends, including the constant “micro-ethics” of rapid choices in nursing care.

Several strategies she highlighted in the podcast can help nurses evaluate approaches to ethical care within their facility and practice. For example, she suggested taking a closer look at the organization’s code of ethics and reaching out to clinical ethicists or ethics committee within an organization. Doing this can help a nurse get questions answered and help them bring information to their colleagues.

Spiritual care, per the podcast, can also be engaged prior to needing to have a difficult conversation with a patient's family to prepare as a team. This proactive approach is especially helpful because the values of the family might be very different from the values of the care team, “and that's usually where conflict arises,” she said.