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48 unit 1 | Professional Considerations CikguOnline
reactions, choices, values, needs, insights, attitudes, What are the values and beliefs of the organization?
interests, and expectations. To embrace a virtue Do they blend with yours,or are they in conflict with
means that you are a person with a certain complex your value system? To find out this information,look
way of thinking. Nursing has practiced virtue ethics at the organization’s mission, vision, and value state-
for many years. ments. Speak with other nurses who work in the
organization. Do they see consistency between what
Nursing Ethics the organization states and what it actually expects
Up to this point, the ethical principles discussed from the employees? For example, if an organization
apply to ethics for nurses; however, nurses do not states that it collaborates with the nurses in decision
customarily find themselves enmeshed in the bio- making, do nurses sit on committees that have input
medical ethical decision-making processes that into the decision-making process?
gain the attention of the news media. However, the
ethical principles that guide nursing practice are Ethical Issues on the Nursing Unit
rooted in the philosophy and science of health care Organizational ethics refer to the values and
and are considered a subcategory of bioethics expected behaviors entrenched within the organi-
(Butts & Rich, 2008). zational culture.The nursing unit represents a sub-
Nursing ethics deals with the experiences and culture of the organization. Ideally, the nursing unit
needs of nurses and nurses’perceptions of their expe- should mirror the ethical atmosphere and culture of
riences (Varcoe, et al., 2004). It is viewed from the the organization. This requires the individuals that
perspective of nursing theory and practice (Johnstone, comprise the unit to hold the same values and
1999). Relationships are the center of nursing ethics. model the expected behaviors.
These relationships focus on ethical issues that impact Conflicts of the values and ethics among indi-
nurses and their patients. viduals who work together on the unit often create
issues that result in moral suffering for some nurses.
Organizational Ethics
Moral suffering occurs when nurses experience a
Organizational ethics focus on the workplace and feeling of uneasiness or concern regarding behav-
are aimed at the organizational level. Every orga- iors or circumstances that challenge their own
nization, even one with hundreds of thousands of moral beliefs and values. These situations may be
employees, consists of individuals. Each individual the result of unit policies, physicians’ orders that
makes his and her own decisions about how to the nurse believes may not be beneficial for the
behave in the workplace. Each person has the patient, professional behaviors of colleagues, or
opportunity to make the organization a more or family attitudes about the patient.
less ethical place. These individual decisions can Perhaps one of the most disconcerting ethical
have a powerful effect on the lives of many others issues nurses on the unit face is the one that
in the organization as well as in the surrounding challenges their professional values and ethics.
community. Shirey (2005) explains that employees Friendships often emerge from work relationships,
need to experience uniformity between what the and these friendships may interfere with judg-
organization states and what it practices. ments. Similarly, strong negative feelings may
Research conducted by the Ethics Research cloud a nurse’s ability to view a situation fairly and
Center concluded the following: without prejudice. Take the following example:
■ If positive outcomes are desired, ethical culture
Addie and Jamie attended nursing school together
is what makes the difference;
and developed a strong friendship.They work together
■ Leadership, especially senior leadership, is the
on the pediatric surgical unit of a large teaching hos-
most critical factor in promoting an ethical
pital. Jamie made a medication error that caused a
culture; and
problem, resulting in a child having to be transferred
■ In organizations that are trying to strengthen
to the intensive care unit. Addie realized what had
their culture, formal program elements can help
happened and confronted Jamie.Jamie begged her not
to do that (Harned, 2005, p. 1).
to say anything. Addie knew the error should be
When looking for a professional position, it is reported, but how would this affect her long time
important to consider the organizational culture. friendship with Jamie? Taking this situation to the