Importance of Reflection in Nursing Ethics

Professional Standards

• Discipline standards are guided by sound ethical standards and scientifically based practice with standards developed by experts.
• Evidenced-based practice is essential, and standards are developed as a result of evidence, serving as minimum requirements for quality and effective care.

Clinical Judgment

• Clinical judgments are influenced more by the nurse's personal values, beliefs, and feelings than objective data.
• Knowing the patient and their typical pattern of responses, as well as engagement with the patient and their concerns, is crucial for sound clinical judgment.
• Clinical judgments are influenced by the context and culture of the nursing care unit.
• Nurses use various reasoning patterns alone or in combination.
• Reflection on practice is triggered by a breakdown in clinical judgment and is critical for knowledge development and improvement in clinical reasoning.

Processes of Clinical Judgment

• Noticing involves the synthesis of background knowledge, contextual knowledge, and knowing.
• Interpreting involves analytical, intuitive, or narrative reasoning.
• Responding is based on the nurse's interpretation and planned assessment.
• Reflecting occurs both during and after the action.

Moral and Ethics Reasoning

• Ethics is the formal systematic study of moral beliefs, while morality refers to an individual's adherence to informal personal value systems.
• Nursing ethics addresses moral situations specific to the nursing profession and patient care.
• Basic ethical principles include autonomy, beneficence, nonmaleficence, justice, fidelity, confidentiality, double effect, paternalism, respect for persons, veracity, and sanctity of life.
• Ethical dilemmas occur when there is a clear conflict between two or more competing moral principles or claims.

Steps in Ethical Analysis

• Assess ethical or moral situations or problems.
• Collect relevant information.
• List alternatives.
• Compare alternatives with applicable ethical principles and professional code of ethics.
• Decide and evaluate the decision.

Cultural Influence on Critical Thinking

• Culture significantly influences attitudes, beliefs, and values, which in turn affect critical thinking.
• Cultures provide a framework for understanding the world, which can sometimes be helpful in organizing and making sense of information.

Components of Nursing Skill

• Systematic
• Organized
• Conscious
• Outcome-oriented

Critical Thinking Skills

• Interpretation
• Analysis
• Evaluation
• Inference
• Explanation
• Self-regulation

Aspects of Critical Thinking

• To develop into an expert critical thinker, the nurse needs to use reflection, language, and intuition.

Levels of Critical Thinking

• Basic Critical Thinking
• Complex Critical Thinking
• Commitment Critical Thinking

Critical Thinking Competencies

• General critical thinking competencies used in many disciplines and everyday situations include the scientific method, problem-solving, and decision-making.
• Specific critical thinking competencies in clinical situations are used by physicians, nurses, and other healthcare professionals.