Nursing Chapter 5 Homework Challenges Result Contemporary Social Conditions Affect

Chapter 5: The Ethical Responsibility of the Nurse Leader

Learning Outcome 1

Understand basic concepts and principles related to ethics in nursing and health care.

Concepts for Lecture

1. Ethics examines what is right and wrong with regard to free acts. Ethical judgments

assume there are principles determining how we ought to act in order to be a good person

2. Ethical dilemmas are situations presenting conflict between two or more ethically

relevant factors. An example is competing needs of different persons; nurses are

3. Brought to focus in the late 1970s by Beauchamp and Childress, along with governmental

ethics commissions, the ethical principles used as basic considerations by health care

professionals in relation to clients are:

a. Nonmaleficence: avoiding harm and risk of harm; example: Nurses should not

PowerPoint Slides

1. Ethics

• What is right and wrong with regard to free acts

• Beyond individual opinions and customary standards

Ethical judgments

2. Ethical dilemmas

• Situations presenting conflict between two or more ethically relevant factors

3. Ethical principles

• Brought to focus in late 1970s by Beaucham and Childress and governmental

ethics commissions.

• Basic considerations used by health care professionals in relation to clients

o Nonmaleficence: avoiding harm and risk of harm

APPENDIX A: Patient’s Bill of Rights

Suggestions for Classroom Activities

• Have an in-class discussion analyzing the importance of ethics comparing

nonmaleficence and beneficence with the other basic principles. What makes these

principles important to the field of nursing?

Reference

• Flaherty, M.J. (1980). Ethical decision making in an interdisciplinary setting. In K.

Sward (Ed.), Ethics in nursing practice and education. Kansas City, MO: American

Nurses’ Association, p. 3.

Learning Outcome 2

Become familiar with the Code of Ethics for Nurses.

Concepts for Lecture

1. The American Nurses Association’s Code of Ethics for Nurses embodies the four basic

2. The Code of Ethics for Nurses tenets:

a. The nurse, in all professional relationships, practices with compassion and respect for

the inherent dignity, worth, and uniqueness of every individual, unrestricted by

considerations of social or economic status, personal attributes, or the nature of health

problems.

b. The nurse’s primary commitment is to the patient, whether an individual, family,

PowerPoint Slides

1. American Nurses Association’s Code of Ethics for Nurses

• Nurses entering profession make a public commitment to the tenets.

• Code of Ethics embodies the four basic considerations previously mentioned.

• Also includes:

o Respect for the inherent dignity of humans

2a. Code of Ethics for Nurses tenets (1–4):

• 1) The nurse, in all professional relationships, practices with compassion and

respect for the inherent dignity, worth, and uniqueness of every individual,

2b. Code of Ethics for Nurses tenets (5–9):

• 5) The nurse owes the same duties to self as to others, including the

responsibilities to preserve integrity and safety, maintain competence, and

Suggestions for Classroom Activities

• Split the class into nine groups and assign each group a corresponding tenet from the

Code of Ethics for Nurses. Have each group defend its tenet by listing reasons for their

tenet’s importance, and then have each group present its reasons to the entire class.

Reference

• Quinn, C., and Smith, M. (1987). The professional commitment: Issues and ethics in

nursing. Philadelphia: Saunders, 180.

Learning Outcome 3

Know various challenges to ethical decision making in nursing practice.

Concepts for Lecture

1. Challenges to ethical decision making still occur, even if using the Code of Ethics as a

framework for ethical decision making. Situations can be complex, with many people’s

2. Challenges resulting from contemporary social conditions affect sound ethical decision

3. Situations can have both ethical and legal ramifications. Current social attitudes place an

emphasis on individual rights rather than responsibilities, so there is a tendency to use the

4. Advances in technology have raised questions about appropriate respect for persons at

5. Challenges to ethical judgment exist in the nursing practice environment. Nurses have

overlapping responsibilities with other professionals, making it unclear exactly where

PowerPoint Slides

1. Challenges to ethical decision making

• Still occur, even when using the Code of Ethics for ethical decision making.

2. Challenges as a result of contemporary social conditions

• Affect sound decision making.

3. Challenges as a result of ethical and legal ramifications

• Current social attitudes place emphasis on individual rights.

4. Challenges as a result of technological advances

5. Challenges as a result of nursing practice environment

• Nurses have overlapping responsibilities with other professions.

• Makes it unclear exactly who is accountable.

Suggestions for Classroom Activities

• Create an ethical debate by setting up three or four ethical scenarios common to

nursing. Split the class into groups and assign each group a different ethical situation,

Learning Outcome 4

Concepts for Lecture

1. Nurses have control over their own moral development and readiness to carry out their

professional obligations. Nurses who feel uneasy questioning physicians’ orders can

2. Effective coping with stress is important because stress can interfere with ethical decision

making. Nurse leaders should recognize burdens that nurses regularly experience, such as

3. Nurse leaders should promote ethics education and staff-development programs to keep

staff up to date on ethical issues in practice. Without continuing reflection on ethical

4. Vigilance against unconditionally accepting the health care decisions of administration

and the medical staff will help the nurse leader guard the role of client advocate in ethical

PowerPoint Slides

1. Enhancement strategies through own moral development

• Nurses have control over their own moral development.

2. Enhancement strategies through effective stress coping

• Stress interferes with ethical decision making.

3. Enhancement strategies through ethics education

• Nurse leaders should promote ethics education and staff-development programs.

4. Enhancement strategies through vigilance

• Vigilance against unconditionally accepting administrative health care decisions

in ethical dilemmas

Case Study: Ethical Decision Making

Suggestions for Classroom Activities

• Split the class up into four groups corresponding to each enhancement strategy listed.

Reference

• Pendry, P.S. (2007). Moral distress: recognizing it to retain nurses. Nursing Economics,

25(4), pp. 217–221.

Learning Outcome 5

Understand the role of institutional ethics committees.

Concepts for Lecture

1. The role of ethics committees is primarily to educate others in how to identify and solve

ethical issues, and to offer consultation to health care providers, clients, or their families

PowerPoint Slides

1. The Role of institutional ethics committees

• Educate others how to identify and solve ethical issues.

• Offer consultation to health care providers and clients making ethical decisions.

Suggestions for Classroom Activities

• Request a description of the ethics committee from the department head of an agency to

which students are assigned for clinical practice. Include information about how the

data will be used as a learning opportunity for students. Offer to abide by any

Reference

• Fletcher, J.C. (1992). Ethics committees and due process. Law, Medicine & Health

Care, 20, 291.

Learning Outcome 6

Understand common ethical issues facing nurses in their various professional relationships.

Concepts for Lecture

1. Employer–employee relationships exist between the Department of Nursing, nurse

managers, and the professional nursing staff. Before agreeing to work for an

2. Effective, positive relationships with other health care professionals require mutual

respect, collegiality, and cooperative interdependency. At times, the ethical issue at hand

3. The nurse–patient relationship is the foundation for all professional nursing activity.

Nurses ought to fulfill their commitment to clients by: ensuring that treatment decisions

PowerPoint Slides

1. Employer–employee relationships

• Exist between the Department of Nursing, nurse managers, and professional

nursing staff.

• Before agreeing to work for an organization, nurses should:

2. Relationships with other health care professionals

• Effective relationships require mutual respect and cooperative interdependency.

3. The nurse–patient relationship

• The foundation for all professional nursing activity

• Nurses fulfill their commitment to clients by:

o Ensuring treatment decisions reflect the free and informed consent of

Suggestions for Classroom Activities

• Student exercise number 5 in the text presents a peer relationship situation. Have

students read the chapter and ask for volunteers to role-play the two characters in the

situation presented. Provide the audience with directions for observing the interaction

that include:

(1) The approach to the nurse stealing insulin syringes;

Reference

• American Hospital Association (1998). A patient’s bill of rights. Obtainable from the

GENERAL CHAPTER CONSIDERATIONS

1. Have students study and learn key terms listed at the beginning of the chapter.

2. Have students complete the end-of-chapter exercises either in their book or on the

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