Conceptual Framework and Purpose of the Paper
Virtue ethics has been chosen as the framework to guide the stand to be taken. Virtue ethics recognizes the critical role of moral character, emotions, and experiences in moral judgment (Robichaux & Parsons, 2009). Virtue ethics goes beyond acting in accordance with a certain set of ethical rules into having consistently habitual pattern in acting that way when providing care, interacting with colleagues, and in life (Robichaux & Parsons, 2009). Under virtual ethics, the concern of the nurse is on what kind of the nurse they should be (Day, 2007). The major concepts in virtual ethics are compassion, fidelity, fortitude, veracity, and prudence (Robichaux & Parsons, 2009). The purpose of this paper is to evaluate a moral issue involving the need to have a moral courage (Butts, n. d.), and demonstrate how virtual ethics might have been used to resolve the issue for a desirable outcome. The paper provides a description of the major concepts of virtual ethics, followed by the presentation and analysis of the moral situation. The final part of the paper will show how Guardian personality might play a facilitative role in solving the moral issue. Guardians possess facilitative leadership qualities to act on morally questionable practice, especially if they have moral courage and commitment to the professional standards and code of ethics for nurses.
Compassion may be considered as the cornerstone of health care, especially in the delivery of morally good care. It is an integration of perception, emotional response, and action. Compassion helps determine what nurses do together with their patients with a view of sharing their patient’s burden and enabling them regain and maintain their independence and dignity. As an aspect of moral sensitivity, compassion contributes to enhancing an ethical practice environment. Moral sensitivity enables one to recognize the existence of a moral dilemma. Both compassion and moral sensitivity also involve recognizing and considering beliefs, values, and viewpoints of others (Robichaux & Parsons, 2009).
Fidelity requires nurses to remain faithful to their commitments in order to sustain a benevolent ethical climate in the workplace. The commitment includes nurses’ relationship with patients, nursing peers, nursing unit, and interprofessional team members. The commitments may include loyalty, active concern for others, and giving credit where it is deserved. In order to maintain an ethical climate, the nurse requires moral fortitude, which is the ability to pursue a morally justified course of action (May, Chan, Hodges, & Avolio, 2003). A nurse with a moral fortitude is able to withstand situational pressures and still remain committed to taking the right action. Prudence is the aspect that governs the others. It combines rationale and humane considerations, making it the most complex component of virtue ethics. It refers to making good judgment while considering potential risks or hazards. Nurses with prudence as a skill are able to understand the complexity of situations that call for competing multiple principles, consider benefits and harms, and make careful, rational judgments.
The Moral Situation and the Role of Leadership in Solving the Issue
The moral situation did not involve a nurse, but a member of the health care team at the hospital. Physicians need to wear gloves when examining patients for purposes safety to the patients and the physician. However, this does not seem to be the case always. I recall a situation in which a doctor was examining a patient without gloves. The doctor had examined another patient, still without gloves, and gone to examine the second one. I felt that this was compromising the patient’s safety. As a patient’s advocate, I felt there was a need to confront the administrator concerning this unsafe practice.
In their Code of Ethics for Nurses, the American Nurses Association (ANA) stated that the primary commitment of a nurse as advocate for the patient is to “the health, well-being, and safety of the patient across the life span and in all settings in which healthcare needs are addressed” (ANA, 2011, n. p.). In this light, ANA requires that nurses “take appropriate action regarding any instances of incompetent, unethical, illegal, or impaired practice by any member of healthcare team or health system or any action on the part of others that places the rights or best interests of the patient in jeopardy” (ANA, 2011, n. p.). The moral situation described shows that the actions of the nurses were compromising the rights and best interests of the patients, and therefore, an action needed to be taken. I considered the physician’s practices as signs of impaired practice or incompetence.
It was difficult to confront the issue and speak up. It not clear how the administrator and the doctor would take it. I also felt that the doctor knew what he was doing, since in addition to being a physician, he was more experienced than me. However, I remember that I have responsibility to protect patients. I also have a responsibility to remain faithful to the professional standards, and the very essence of our profession. The issue could be resolved through the framework of virtual ethics and having moral courage. Virtual ethics concepts of compassion, fidelity, prudence, and veracity all pointed to the need to speak up.
As noted the issue involved the need to have moral courage in order to confront and solve it. Moral courage is required when there is fear to be overcome by confronting the issue head on, especially if the issue involves conflicts of the core values and beliefs that the nurse holds. A nurse with a moral courage has the will to speak out and do the right thing, despite the presence of constraints and forces influencing the nurse to do otherwise. Threats might be physical harm, rejection, lose of job, loss of social standing, humiliation, rejection, and ridicule. Despite all these, nurses with moral courage remain faithful to core values, beliefs, or moral conscience. Nurses with moral courage do what they consider as the right thing, which is a way of making a personal sacrifice in order to achieve an inner sense of peace. Morally courageous nurses should be able to admit to misconduct (which could be by self, a colleague, or someone else) in order to rectify the situation and prevent the pain that might be experienced in relation to the misconduct.
Self-assessment using the Kersey Temperament Sorter suggests that my personality and leadership might serve a facilitative role in the solving the moral issue already described. The result of the assessment shows that my personality is Guardian (SJ). Guardians are said to be naturally talented for smooth leadership roles such as supervision. In addition, although guardians are fun to interact with, they take their duties and responsibilities seriously. They are also dependable and trustworthy. These qualities of being serious with duties and responsibility as well as being trustworthy are the ones that must influence me to see the need to confront the moral issue described. The aspects of being dependable and trustworthy associated with Guardians correspond to some aspects of virtual ethics, such as compassion, veracity and fidelity. In addition, guardians honor law and order, and strongly follow rules. These qualities might play a facilitative role in resolving the moral issue. The reason is that I believe in remaining committed to law and the nursing code of ethics. The nursing code of ethics requires all nurses to act on questionable practice. As someone who is committed to following rules such code of ethics, I would act on the moral situation as required by nursing code of ethics. I would confront the administrator about the issue, and expect them to call the doctor to discuss it.
American Nurses Association (ANA). (2011). Provision 3: Code of ethics for nurses with interpretive statements. Retrieved from http://www.nursingworld.org/provision-3
Butts, J. B. (n. d.). Ethics in professional nursing practice. Retrieved from http://www.jblearning.com/samples/0763748986/48986_ch03_pass3.pdf
Day, L. (2007). Foundations of clinical ethics: Disengaged rationalism and internal goods. American Journal of Critical Care, 16(2), 179-183.
May, D. R., Chan, A. Y., Hodges, T. D., & Avolio, B. J. (2003). Developing the moral component of authentic leadership. Organizational Dynamics, 32(3), 247-260.
Robichaux, C., & Parsons, M. L. (2009). An ethical framework for developing and sustaining a healthy workplace. Critical Care Nursing Quarterly, 32(3), 199-207.