Translating ethical theory into practical nursing care

Within healthcare, ethics form the guide for many of the actions nurses take, and their decisions on treatment options. Ethics are the foundation upon which trust, empathy, and professionalism are built. However, going from understanding theoretical ethical principles to seamlessly translating them into practical patient care is a complex and sometimes daunting challenge. 

This article explores how theoretical ethics meet the realities of clinical settings. With a focus on empowering nurses, particularly those in online educational programs, we delve into innovative strategies and approaches that help with the seamless transition from ethical theory to ethical action. This equips nursing students with the knowledge, tools, and insights needed to bridge the gap between theory and practice, ensuring that their actions always respond to the highest ethical standards, to enhance patient care and the overall quality of healthcare delivery.

Understanding theoretical ethical practice

Every choice made in nursing can impact patients’ wellbeing and outcomes. To understand the practical application of ethics in nursing, it is essential to comprehend the theoretical foundations of ethical practices and how these can be applied to nursing.

Nursing ethics take inspiration from several philosophical and ethical theories to provide a framework for ethical decision making. Deontological ethics focuses on moral duties and principles. Nurses adhering to deontological principles will make decisions based on their obligations and the inherent rights or wrongs of an action, regardless of the consequences. For example, respecting patient confidentiality is an ethical duty. 

However, utilitarianism focuses on the possible outcomes. This ethical theory conceives that actions producing the greatest overall happiness or minimizing harm are the right actions to take. Nurses applying utilitarianism consider the outcomes and consequences of their actions when making ethical choices, aiming to maximize benefits for the patient or society. 

In the instance of respecting patient confidentiality, nurses may need to break this occasionally. The outcome should benefit the patient or those around them. There are rules and guidance for doing this, such as if the individual is a serious risk to themselves or others. In all cases, the rules should always be followed carefully.

Virtue ethics would focus on the character and virtues of the nurse rather than specific rules or consequences. Nurses practicing virtue ethics would demonstrate traits such as compassion, honesty, and empathy, which guide their ethical decision making.

Most nurses or aspiring nurses find they already follow some of these ethics without giving them much thought. A direct entry nursing program, such as the course offered by Elmhurst University, will help students develop and build on these existing values. The programs allow online study and make it possible to transition from another career to nursing. They also provide work placements, so nursing students will be able to put everything they learn into practice, including ethical theories. 

The role of ethical frameworks in decision making

Ethical frameworks provide nurses with structured guidelines for ethical decision making. They help nurses evaluate complex situations, prioritize ethical principles, and determine the most ethical course of action. There are several commonly utilized ethical frameworks in nursing.

The American Nurses Association (ANA) Code of Ethics for Nurses serves as a foundational document, guiding nursing practice with nine provisions that outline ethical responsibilities and professional behavior for nurses. These focus on the boundaries of loyalty and duty, provide a detailed description of expected duties that go beyond directly dealing with patients, and make it easier to understand the values and commitment expected from nurses.

Nurses also tend to apply the principles of Beauchamp and Childress, particularly in decision making. This covers four ethical principles, which are autonomy, beneficence, non-maleficence, and justice. 

Theoretical vs. practical ethics and key differences

There are several differences between theoretical ethics, where students learn about the ethics required in nursing, and practical ethics, which involve using this knowledge in real-world healthcare settings.

Until one puts any theory to the test in a practical setting, it is impossible to have a full understanding of how the ethics can be challenged by the complexities and uncertainties of clinical practice. Theoretical ethics often deal with idealized ethical dilemmas, while practical ethics confront messy and imperfect situations encountered in healthcare settings. This is why work placements are so valuable. Students get to put knowledge to use, under the guidance of highly experienced mentors.

Practical ethics can also require nurses to navigate situations where ethical principles may conflict with their own competing values. When this happens, they must find a balance and put their own values aside as much as possible, to make ethically defensible choices.

It is essential for nurses to understand these differences and how to make the right ethical decisions in a clinical setting. This knowledge provides the groundwork for the strategies and approaches they use in practical settings.

Incorporating ethical education into online nursing programs

As the world of education continues to evolve, online learning has emerged as a powerful platform for learning about nursing ethics, offering unique advantages that complement traditional classroom-based instruction.

Online nursing programs attract a diverse group of students from various geographic locations and backgrounds, and at different life stages. This diversity enriches ethical discussions by bringing together a wider range of perspectives and experiences than one might get in a brick university. Many students are studying towards a second career, so the range of professional backgrounds adds to the diversity. It creates a more inclusive and comprehensive understanding of ethical issues in healthcare.

Online courses specifically covering ethics often employ case-based learning, where students analyze real or hypothetical ethical dilemmas. These cases challenge students to apply theoretical ethical principles to practical situations, enhancing their critical thinking and decision-making skills.

Virtual classrooms allow for the opportunity to take part in interactive discussions and role-play scenarios. This enables students to engage in ethical debates, simulate ethical dilemmas, and practice communication and negotiation skills. These activities promote active learning and reflection.

Virtual nursing programs are great for encouraging students to dissect complex situations, identify ethical issues, and develop reasoned solutions. This analytical approach prepares students to confront ethical challenges in clinical practice.

Translating ethical theory into practical care

Ethical theory is crucial, but ethical competency lies in its effective application to real-world nursing practice. This involves strategies and practices that nurses can employ to bridge the gap between theory and practical care.

Encouraging nurses to maintain reflective journals allows them to regularly examine their own actions and ethical decision-making processes. Nurses can identify areas where their ethical practice can be improved. Self-assessment tools, such as decision-making frameworks, help nurses critically evaluate how their actions match ethical principles and values, allowing for personal growth.

Dilemmas often require input from different perspectives. Nurses actively collaborate with other healthcare professionals, including physicians, social workers, and administrators. They can make use of the access they have to medical professionals with different outlooks. This can help them address complex concerns. Interprofessional teams can offer a broader range of insights and ethical expertise, resulting in more comprehensive and ethically sound decisions.

Hospitals and healthcare organizations have committees or consultants dedicated to addressing complex ethical issues. Nurses can consult with them when faced with challenging ethical decisions. These committees can provide guidance, mediate discussions, and offer recommendations to ensure ethical dilemmas are handled with care and expertise.

It also helps to stay informed on ethical standards. The field of healthcare ethics is constantly evolving over time. Making a commitment to ongoing education and staying up to date with changes in frameworks and regulations is crucial. This involves attending workshops, seminars, and conferences focused on healthcare ethics, as well as regularly checking updates from professional organizations like the American Nurses Association or international bodies like the World Health Organization (WHO).

Building ethical competence in clinical placements

Nursing students can actively engage with real-world case studies during their clinical placements. This hands-on approach encourages students to analyze ethical dilemmas within the context of patient care, applying theoretical ethics to practical situations. By actively participating in ethical discussions and decision-making processes, students develop critical thinking skills and ethical sensitivity.

They also learn from the experienced nurses they work alongside. These seasoned professionals can guide students through challenges — sharing their insights, knowledge, and practical wisdom. Mentorship provides a valuable support system for students as they navigate the ethical complexities of healthcare. This observational approach to learning also allows students to witness ethical principles put into action. Clinical placements play a vital role in shaping the ethical competence of nursing students. These experiences enrich their educational journey and contribute to their long-term effectiveness as healthcare professionals.

Ethical nursing practice and patient satisfaction share an inseparable connection, deeply influencing the patient experience within healthcare settings. When nurses prioritize principles such as respect for autonomy, non-maleficence, beneficence, and justice, they establish trust and rapport with their patients. Patients who feel heard, respected, and involved in their care are more likely to report higher levels of satisfaction. 

Ethical communication, informed consent, and a commitment to patient-centered care all contribute to improved patient experiences. Additionally, when ethical dilemmas are managed transparently and with sensitivity, patients and their families are more likely to understand and accept the choices made regarding their care. This builds a sense of partnership between patients and healthcare providers, enhancing overall satisfaction and facilitating better health outcomes.

By adhering to ethical principles, nurses ensure that the care they provide is both safe and effective. For example, the principle of non-maleficence requires nurses to minimize harm to patients, preventing medical errors and adverse events. The commitment to beneficence drives nurses to actively look for ways to enhance patient wellbeing, resulting in more comprehensive and patient-centric care plans. 

Ethical nursing practice also includes advocating patients’ rights, which can lead to timely interventions and the prevention of complications. Ultimately, when nurses consistently uphold these high standards, they contribute to the overall quality of care, reduce healthcare disparities, and promote better health outcomes for patients, effectively fulfilling the core mission of the nursing profession. It helps to see all this in a practical setting, as even the most comprehensive coursebooks or online courses can only provide the groundwork for practical nursing experience.

Challenges and barriers

Translating ethical theory into practical nursing care is not always easy, especially for newcomers. One common obstacle is the complexity and ambiguity of ethical dilemmas encountered in healthcare. Nurses often face situations where ethical principles may conflict, making it difficult to determine the most ethical course of action. Additionally, time constraints and high patient volumes can put pressure on nurses, leaving limited room for in-depth ethical reflection. Another challenge is the potential disconnect between theoretical ethics — learned in the classroom — and the practical realities of clinical settings.

However, the good news is that identifying and addressing these barriers gets easier with experience.

To overcome these challenges and promote the effective translation of ethics into nursing practice, several strategies can be used. Firstly, nurses should take advantage of the ongoing education and training that healthcare institutes provide. This training equips them with the tools and resources to make the right choices. Alongside other methods already mentioned, such as mentorship, interdisciplinary collaboration, and education, challenges can be overcome.

Final Thoughts

In the nursing industry, bridging the gap between theoretical ethics and practical care is more than just a professional aspiration — it is essential. This can be achieved by empowering nursing students to navigate the complexities of healthcare with integrity and compassion, applying ethical principles to every patient interaction. Ethically grounded nursing contributes to the larger picture within healthcare, creating trust, improving patient outcomes, and generally elevating the quality of care provided by healthcare institutions. Well-informed nursing practice resonates far beyond the bedside, shaping the future of healthcare into one marked by unwavering ethical commitment and exceptional patient-centered care.

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