NRP/508 Ethical Decision-Making in Advanced Practice Nursing

In the role of an advanced practice registered nurse (APRN), ethical decision-making is central to providing patient-centered care. The complexity of healthcare environments often places APRNs in situations where ethical dilemmas arise, requiring them to navigate conflicting principles and make decisions that prioritize patient well-being, professional integrity, and ethical standards. This paper explores how the nursing code of ethics and Jean Watson’s Theory of Human Caring can guide APRNs in addressing ethical dilemmas. Additionally, it examines strategies for creating an ethical environment in the workplace to raise awareness among nurses about ethical issues.

Provision of the Nursing Code of Ethics Violated in an Ethical Dilemma

One ethical dilemma that an APRN might face involves the treatment of patients who request procedures that conflict with the nurse’s personal beliefs or professional standards. For example, a patient may request assistance with end-of-life decisions, such as physician-assisted suicide, in a state where it is legal. The APRN might experience a conflict between their duty to respect the patient’s autonomy and their personal or professional values related to preserving life.

In this scenario, Provision 1 of the American Nurses Association (ANA) Code of Ethics would be relevant. This provision emphasizes respect for human dignity and the right of patients to make decisions about their own care. However, it also recognizes that nurses have the right to conscientiously object to participating in procedures that violate their personal or professional ethics (ANA, 2015). If the APRN refuses to assist in the procedure without providing the patient with alternative options, the ethical principle of beneficence—acting in the best interest of the patient—may be violated. The patient’s right to autonomy could be compromised if they are not given the support they need to make informed decisions.

To address this issue using the Code of Ethics, the APRN can engage in open communication with the patient and explain the ethical conflict. It is important for the APRN to ensure that the patient has access to other healthcare professionals who can provide the requested care without compromising the nurse’s personal beliefs. By upholding the patient’s autonomy while respecting their own moral integrity, the APRN can find a balance between professional responsibility and personal ethics.

Creating an Ethical Environment in the Workplace

Creating an ethical environment in the workplace is essential for promoting ethical awareness and fostering open discussions about difficult ethical decisions. As an APRN, one of the strategies to achieve this is to develop and implement ethics training programs that focus on the importance of the Nursing Code of Ethics and its application in everyday practice. Regular training sessions can help nurses recognize ethical dilemmas, understand the ethical principles at play, and apply the appropriate codes of conduct when making decisions.

Additionally, promoting a culture of open communication within the healthcare team is vital for creating an ethical environment. Nurses should feel empowered to voice their concerns without fear of retribution. Establishing ethics committees within the organization provides a formal platform where nurses can bring forward ethical issues, seek guidance, and collaborate on finding solutions to complex ethical dilemmas (Weber, 2011). Through these discussions, nurses can learn from each other’s experiences, share perspectives, and develop a deeper understanding of ethical principles in practice.

In my role as an APRN, I can contribute to creating an ethical environment by leading by example and encouraging my colleagues to follow ethical guidelines. This can be achieved by offering mentorship to new nurses and modeling ethical behavior in decision-making processes. By providing support and guidance to my peers, I can help create an atmosphere where ethical awareness becomes a part of the workplace culture.

Using Watson’s Theory of Human Caring in Ethical Decision-Making

Jean Watson’s Theory of Human Caring provides a valuable framework for APRNs when confronting ethical dilemmas. This theory emphasizes the importance of caring relationships and treating patients as whole beings with physical, emotional, and spiritual needs (Watson, 2008). According to Watson, healthcare professionals should focus on the humanistic aspects of care, fostering trust, empathy, and compassion in patient interactions.

When encountering ethical dilemmas, Watson’s theory can guide the APRN in making decisions that prioritize the patient’s dignity and individuality. For instance, in the case of a patient requesting physician-assisted suicide, the APRN can use Watson’s theory to emphasize the importance of understanding the patient’s emotional and psychological state. By engaging in a caring and empathetic dialogue, the APRN can explore the patient’s feelings, fears, and motivations behind the request. This holistic approach allows the APRN to honor the patient’s experience while navigating the ethical conflict.

Watson’s theory also encourages APRNs to view ethical dilemmas as opportunities to practice reflective judgment. By taking the time to reflect on their personal values, the needs of the patient, and the ethical standards of the profession, APRNs can make thoughtful decisions that align with both professional ethics and compassionate care.

Conclusion

Ethical decision-making is a fundamental aspect of advanced nursing practice, and APRNs must be equipped to navigate complex dilemmas that may arise in their professional roles. The nursing Code of Ethics offers a structured approach for addressing ethical conflicts, ensuring that nurses respect patient autonomy while upholding their own moral integrity. In addition, creating an ethical environment in the workplace through ethics training and open communication can promote ethical awareness and empower nurses to make informed decisions.

Jean Watson’s Theory of Human Caring provides a humanistic perspective that prioritizes compassion, empathy, and holistic care when facing ethical challenges. By applying these principles, APRNs can ensure that their decisions respect the dignity of their patients while maintaining the highest standards of ethical conduct. Ultimately, combining the guidance of the Nursing Code of Ethics and Watson’s caring framework enables APRNs to navigate ethical dilemmas with integrity and compassion, enhancing patient care and fostering a positive work environment.