Ethical Decision-Making in Healthcare

Study Notes

Skills and Resources for Ethical Decision-Making

The presentation outlines strategies for ethical decision-making in the healthcare field, particularly nursing.
The presentation discusses four responses to ethical situations: moral uncertainty, moral dilemmas, moral conflict, and moral distress.
Moral distress occurs when a healthcare provider knows the ethical action needed, but is unable to act on that knowledge.
Recognizing moral distress is crucial for creating a supportive healthcare environment.
Personal factors contributing to moral distress include powerlessness, past experiences, and emotional stability.
Powerlessness stems from the hierarchical nature of the healthcare system.
Past experiences often lead to dread, helplessness, and disengagement when faced with recurring ethical dilemmas.
Emotional stability is important for managing stress and maintaining composure in emotionally challenging situations.
Organizational factors contributing to moral distress include a lack of ethical or supervisory support, inadequate or incompetent staff, excessive workloads, bullying, lateral violence, incivility, and workplace violence.
Effective leadership and support are essential for ethical nursing practice, increasing patient safety, satisfaction, and reducing nurse turnover.
Adequate staffing, including ongoing training and competency verification, are important.
Nurses need to maintain professional relationships with colleagues, commit to fair treatment, transparency, integrity, compromise, and conflict resolution.
Staff needs to create an ethical environment by treating everyone with kindness and dignity while having a proactive approach to prevent harm.
Disregard for others' actions, bullying, harassment, intimidation, threats, and violence are unacceptable.
Nurses must address incompetent or unethical practices that harm patients, reporting situations of concern to appropriate authorities.
Adequate assignment and delegation practices protect both patients and staff.
Maintaining personal health through diet, exercise, rest, and maintaining healthy relationships, leisure activities, and spiritual well-being are crucial.
Nurses have an obligation to express concerns to the appropriate authority or committee.
Ethical leaders must preserve the moral integrity of nurses through proper policies and procedures, educational resources, and support for conscientious objection.
Collaboration with palliative care services and strengthening the unit's ethical climate are essential for ethical practice

Personal and Professional Competencies: Ethics Education

Ethics education is crucial for nurses to develop moral confidence and action.
Specific ethics courses are not universal in undergraduate or master's programs.
Nurses need a good understanding of the components of ethical situations to effectively navigate them.

Effective Communication and Conflict Engagement Competencies

Effective communication and conflict resolution skills decrease moral distress among healthcare providers.
Developing these skills involve scripting and practice.
Support from nurse managers creates an ethical environment where concerns can be voiced.

Self-Care Competencies

Moral distress can positively influence awareness of obstacles to ethical practice.
This awareness can lead to a proactive approach to ethical situations.
Developing self-care competencies improves cognitive, somatic, and affective dimensions, mitigating the physical and psychological symptoms associated with moral distress.

Organizational Competencies: Supportive, Ethical Leadership

Formal nurse leaders and administrators are responsible to recognize and respond to ethical issues to reduce moral distress amongst nurses.
These leaders must create policies and protocols to address ethical concerns.
Ensuring that nurses have access to ethics resources and support is essential.
Providing support to nurses exercising conscientious objection is key.

The Environment and Ethical Obligation

Nurses in all roles promote excellence and support ethical standards for all.
Collaboration within nursing and interprofessional teams, fostering communication, mutual respect, and shared decision-making promotes quality patient care.