Table of Contents
Ethics is defined as the idea of having the moral requirements and behaviors that are acceptable within our society. In our society, we have acceptable “good” ways of behaving and we have unacceptable “bad” ways of behaving. In nursing, we rely on ethics in order to have a standard of values and morals that we use as guidance towards our patients. “The codes outline how the nurses should behave ethically as a profession, and how they should decide when encounter barriers preventing them from fulfilling their professional obligations. (The Code of Ethics for Nurses, 2013)
As nurses we rely on this guidance in order to fulfil the fundamentals of ethics. They are the building blocks of how we advocate for patients. We incorporate into our practice how to treat others and our patients, how to act professionally, and how to know what needs to be done and when it needs to be done. “Ethics is an essential component of leadership qualifications and the ethical leader can help create an ethical atmosphere and offer ethical guidance.” (Barkhordari-Sharifabad, Ashktorab, & Atashzadeh-Shoorideh, 2017)
Ethics play a big role within leadership management. Our leaders are the ones whom help us in ethical dilemmas. Our leaders are also whom we seek guidance from when we are questioning certain aspects within nursing. Having a complete understating of ethics creates an upstanding leader within the field of nursing. Leaders often need to make sure relationships are developed with staff in order to have trust.
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Two ethical principles that I am going to be focusing on are justice and beneficence. I am going to also additionally be talking about how the two ethical principles listed above apply to leadership within the health care setting and how they prevent and solve current issues within leadership concerns. I will also explain how I can relate and incorporate the two selected principles into my own leadership activities and how I will use them in the progression of my career.
Explanation and Application of Ethical Principles to Leadership
The ethical principle beneficence is the act of compassion, positive engagements and the knowledge of being able to realize and report suspected abuse. “Beneficence is defined as an act of charity, mercy, and kindness with a strong compassion of doing good to others including moral obligation.” (Kinsinger, 2009) Nurses are expected to protect the patient. Nursing is currently listed as the most trusted profession in the United States.
The ethical principle justice is the act of treating all patients fairly and equally. “The nursing profession has had a longstanding commitment to social justice as a core professional value and ideal, obligating nurses to address the social conditions that undermine people’s health.” (Johnstone, 2010) Justice tends to be seen as a basic human need relating back to Maslow’s Hierarchy of Needs. As nurses, we promote health and prevent disease. We are the patients advocate.
It is the accountability of a nurse leader to ensure that the utmost level of ethical standards is being provided while staff are caring for patients. Also, that all nurses understand the decision-making process when confronted with an ethical dilemma. As a nurse leader, one must remain competent in managing conflict and creating solutions. The position of management is to be able to provide their staff and patients on their unit with the guidelines needed if at any time they are confronted with a difficult decision or an ethical dilemma.
The use of ethics come into play when a decision must be made, we as leaders are reminded to always protect dignity and to always advocate. Beneficence is used in leadership in order to provide a safe practice setting for nurses. Here is where they are able to feel safe and give high-quality care to their patients. Leaders incorporating beneficence as a target goal helps keep the workplace free from violence and conflict. Learning how to deal with conflict in a profitable way helps staff trust the leaders of unit. Justice is used in leadership when leaders are considering new programs or solutions.
Evaluations on staff, scheduling and acuity are all examples of leaders ensuring that everyone regardless of their role are being held to the same performance standards. Leaders rely on justice in order to make sure that all hospital policy and procedures are being upheld to its highest standard. Creating a fair environment is the ultimate goal. (Doucette, 2013)
Application of Ethical Principles to Leadership Issues
The use of the ethical principles justice and beneficence is used in order to prevent and or solve different leadership concerns within healthcare. Two leadership concerns within healthcare I find are the scheduling and acuity of the staff, as well as the accrual of overtime fairly. (Zahedi, et al., 2013) Scheduling is a big topic of discussion within healthcare. Most hospital organizations will do staffing based off the acuity of the unit at a given time.
Depending on the unit it is usually safe to have a mixture of levels of experience between the nurses. For example, if the acuity is high perhaps having all fairly new nurses on are not fair to the staff or the patients. Leadership of a given unit must be able to balance and fairly distribute schedules that best fit the needs of the nurses as well as the organization itself.
Accrual of overtime is another topic of discussion that leaders must deal while exercising fairness. Having open opportunities available to all of staff will create a fair and equal opportunity approach for whom receives overtime. Many organizations will go by seniority, but it raises the question of if a senior nurse is continuously jumping at every opportunity that leaves very few shifts left to pick up amongst the rest of the staff. (Barkhordari-Sharifabad, Ashktorab, & Atashzadeh-Shoorideh, 2017)
For example, you are the leader of an 8-bed intensive care unit. Schedule wise you usually have 4 nurses on based off a 2:1 ratio. While making the schedule you realize on Saturday you have 4 new graduate nurses on. Looking at the census you see the acuity of the unit is high and you might even need an extra nurse for the unit that day anyways. You take a look at the schedule as a whole and see that many of the senior nurses have been taking themselves off on weekends, leaving a large number of new graduates only working weekends.
Because of the amount of resources available to staff on the weekends are less than during the week you find that perhaps this is an unsafe environment for the staff as well as the patients. As a leader, you are going to use the ethical principles of justice and beneficence. Realizing that the current schedule is unfair and needs to be improved in order to promote function and organization within the unit. Also as a leader it is your responsibility to make sure good decisions are being made on behalf of the staff.
Another example was the accrual of overtime. Leaders needs to be mindful of how they are distributing overtime. Some organizations go by seniority as others go by a list of whom ever signs up first. As a leader, you are going to use your ethical principles in guiding you to remain fair and unbiased and develop trusting relationships with your staff. You have an obligation as a leader as said above to be able to benefit your staff. Overtime is one of those pieces where you can help improve your staff members life with extra hours. Remaining fair is the biggest obstacle. Creating a system where it is equally distributed is how a leader can do right on behalf of their staff.
Application of Ethical Principles to Own Leadership
As the learner of this assignment I have taken in many new insights after reading many articles on how to work as a fair and trustworthy leader. Currently I work on a 27-bed inpatient psychiatric unit which I possess the title as a night charge nurse. I am faced with many challenges weekly that call for me to make decisions for the unit. For example, my hospital has recently announced that overtime will no longer be accrued by staff unless approved by supervision.
I recently was scheduled to work last Sunday, where I got called letting me know I had a nurse call out and a nursing assistant. Because of the removal of overtime, I was unable to staff the unit accordingly that night. I was in fear of being counseled because overtime is no longer permitted. For the future, I will handle this situation by using the two ethical principles listed throughout the paper, justice and beneficence. The unit is assigned a certain amount of staff for a reason it is what is required.
I will use the ethical principle of justice to justify that to be fair to staff working and to improve function of the unit, I would need to send out a mass message offering overtime in order to work with the amount of staff needed. Regardless of my hospital announcing the removal of overtime I need to do what’s in the best of interest of the patients as well as the staff. By doing so I will also be using the ethical principle beneficence, I have an obligation to promote a safe environment for staff. Good decisions need to be made and that would have been to not work short staffed that night. (Epstein &Turner, 2015)
Conclusion
Ethical principles are important within your scope of practice, and even more important when taking on leadership roles. In nursing, we rely on ethics in order to have a standard of values and morals that we use as guidance towards our patients. Our leaders are also whom we seek guidance from when we are questioning certain aspects within nursing. Having a complete understating of ethics creates an upstanding leader within the field of nursing. Leaders rely on justice in order to make sure that all hospital policy and procedures are being upheld to its highest standard.
Two leadership concerns within healthcare I find are the scheduling and acuity of the staff, as well as the accrual of overtime fairly. I have gained the understating of my moral obligation as a leader to be fair and make good decisions for my staff. I have learned that even in situations where I feel I need to abide by the rules I need to speak up and advocate for my staff. Good decisions need to be made and creating a fair environment is the definitive objective.
References
- Barkhordari-Sharifabad, M., Ashktorab, T., & Atashzadeh-Shoorideh, F. (2017, February 21). Obstacles and problems of ethical leadership from the perspective of nursing leaders: A qualitative content analysis. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5432950/
- Doucette, J. (2013, September). Decision making through the ethics lens: Nursing Management. Retrieved from https://journals.lww.com/nursingmanagement/Citation/2013/09000/Decision_making_through_the_ethics_lens.10.aspx
- Epstein, B., & Turner, M. (2015, May 31). The Nursing Code of Ethics: Its Value, Its History. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26882423
- Flite, C. A., & Harman, L. B. (2013, January). Code of Ethics: Principles for Ethical Leadership. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544144/
- Johnstone, M. (2010, December 10). Nursing and justice as a basic human need. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1466-769X.2010.00459.x
- Kinsinger, F. S. (2009, December). Beneficence and the professional’s moral imperative. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342811/
- Zahedi, F., Sanjari, M., Aala, M., Peymani, M., Aramesh, K., Parsapour, A., . . . Dastgerdi, M. V. (2013, January). The Code of Ethics for Nurses. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712593/
