Alice Battista, RN
Divisional Director, Mission Services
Our Lady of the Lake Regional Medical Center
Baton Rouge, LA
[email protected]
Nurses have a sacred relationship with their patients and families. In today's health care environment, nurses are the primary bedside caregiver providing approximately 90 percent of the patient care (Cohen & Bartholomew, 2008). This unique relationship calls the nurse to provide holistic, compassionate, professional care that involves critical thinking, respect, listening, and clinical competence. Due to the very nature of this relationship, nurses frequently encounter ethical dilemmas such as requests for non-beneficial care, refusal of treatment, truth telling, and quality of life versus length of life. These situations can be challenging, unsettling, frustrating, and even distressing for nurses. At the same time, nurses need to be able to collaborate with patients, families, and other health care professionals to achieve successful resolution of these dilemmas in order for the nurse to provide high quality care and promote positive patient outcomes. For nurses working in Catholic health care facilities, the American Nurses Association (ANA) Code of Ethics, the Ethical and Religious Directives for Catholic Health Care Services (ERDs), along with the organization's mission, vision and values, as well as policies and practices, provide a framework for nurses to use in ethical analysis and decision making.
The ANA Code of Ethics for Nurses reminds nurses that they have a commitment to the health, well-being, and safety of their patients across the life span and in all settings where health care needs are addressed. The ANA Code of Ethics for Nurses has its foundation in the Nightingale Pledge, written in 1893, which required that nurses be devoted to the welfare of those in their care. Today's Code of Ethics serves nurses with these purposes: (1) it is a succinct statement of the ethical obligations and duties of every individual who enters the nursing profession; (2) it is the profession's nonnegotiable ethical standard; (3) it is an expression of nursing's own understanding of its commitment to society (Fowler, 2008). The Code of Ethics has nine provisions: provisions one through three describe the primary values and obligations of the nurse, provisions four through six address duty and loyalty, and provisions seven through nine address aspects of duties beyond patient encounters.
The ERDs, published by the Unites States Conference of Catholic Bishops, are grounded in Jesus' challenge "to go and do likewise," namely to carry on his healing ministry in the world as well as in the Catholic/Christian tradition's commitment to respect for the dignity of all persons. As noted in the Preamble, the ERDs serve two purposes: (1) to reaffirm the ethical standards of behavior in health care that flow from our belief in the dignity of the human person, and (2) to provide authoritative guidance on moral issues that face Catholic health care today (Preamble, United States Conference of Catholic Bishops, 2009). Through the ERDs, nurses are reminded that Catholic health care is a continuation of God's life-giving and healing work and that the ministry they provide is grounded in dignity, mutual respect, trust and honesty. Healthcare is complex and with the increase in technology and life-sustaining therapy, nurses are experiencing ethical dilemmas on a frequent basis. It is challenging for nurses to provide high quality, safe, effective care when faced with ethical dilemmas. It is also challenging to educate nurses on the Code of Ethics and the ERDs, as well as support them when ethical dilemmas arise. To help address these challenges, a crosswalk between the Code of Ethics, the ERDs, and the Franciscan Missionaries of Our Lady Health System's (FMOL) mission, vision, values, practices and polices was developed with assistance from CHA ethicists. This crosswalk is posted in every nurses' station to serve as a ready resource to guide nurses in ethical decision making.
PDF of the Crosswalk
ANA Code of Ethics for Nurses© (2001) By American Nurses Association. Reprinted with permission. All rights reserved.
Nurses have been called to the nursing profession to use the knowledge gained in training, the skills acquired through experience, the passion to care for patients, and to make a significant difference in the lives of our patients. With today's changing and evolving health care environment, this crosswalk aids nurses in upholding their professional and organizational standards while advocating for their patients and collaborating with the multidisciplinary team to provide safe care that is in the patient's best interest.
References:
Cohen, S. & Bartholomew, K. (2008). Our image, our choice: Perspectives on shaping, empowering and elevating the nursing profession. Marblehead, MA: HCPro, Inc.
Cohen, S. & Bartholomew, K. (2008). Shaping up the image of nursing: Your ethical and professional role. Marblehead, MA: HCPro, Inc.
Fowler, M. (eds.) (2008). Guide to the Code of Ethics for Nurses: Interpretation and application. Silver Spring, MD: American Nurses Association
United States Conference of Catholic Bishops (2009). Ethical and Religious Directives for Catholic Health Care Services (5th Ed.) Washington DC: USCCB Publishing Services
Copyright © 2010 CHA. Permission granted to CHA-member organizations and Saint Louis University to copy and distribute for educational purposes. For reprint permission, contact Betty Crosby or call (314) 253-3490.