The nursing field is a very demanding one; with changes occurring frequently, nurses must face current issues and learn the new trends that rapidly developed. A nurse is essentially someone responsible for advocating and taking care of patients while they undergo illness and recovery, guiding them through difficult times. To comply with this profession’s standards, one must refer to various ethical codes as well as look at the way the field transforms with the flow of time and adjust to the trends.
Ethical Implications of Decision-Making in Nursing Practice
Many issues arise on the topic of ethics, but it is essential for every nurse to know the rules of conduct within their field as they face many ethical dilemmas. Mallari and Tariman (2016) note that these might include lack of resources, patients refusing treatment or disagreeing with caregivers, treatment of patients with decision-making disabilities, nugatory decisions on treatment for terminal patients, guidelines for end-of-life treatment, euthanasia and so on. Thus, nursing practice is inevitably an ethical decision-making practice.
Ethical Codes for the Nursing Practice
Standards to navigate the nursing practice derive from numerous official sources. Namely, as stated by Mallari and Tariman (2016), the Nuremberg Code and Declaration of Helsinki is the document that addresses clinical, scientific, and social value; independent reviews; scientific feasibility; and respect for those who participate in research. Similarly, the International and National Nursing Code of Ethics is widely used among nurses, while The International Code of Ethics for Nurses is a scheme for developing and evaluating the codes of ethics of different countries. Then there are also each country’s individual national ethical codes, which deliver guides in accordance with the country’s cultural and moral norms (Mallari and Tariman, 2016).
Problems Associated with Using Nursing Codes of Ethics
Dominant codes are characterized by several weaknesses that necessitate continuous improvement and consideration of additional factors in decision-making. As Mallari and Tariman (2016) note, the International Code of Ethics cannot possibly be representative of cultural and societal diversity of various countries, which is to be taken into consideration when deciding in a particular country. Moreover, since medical science in nursing are developing rapidly, a nursing ethical code should consider issues arising from technological changes and the advancement scientific knowledge. Thus, nursing organizations are to develop official stances and application guidelines that address ethical perplexities in care practices and research.
Culturally Competent Nursing Care
Some problems emerge in relation to the differentiation between international and national codes, when it comes to the treatment of patients. Generally, as the world is becoming a more and more globalized place, it is interesting to look at the issue of so-called transcultural nursing. Im and Lee (2018) state that it is a phenomenon that is nowadays deemed a significant component of nursing practices and research. Essentially, it is a “specialty created to answer the need for developing a global perspective in the practice of nursing in a world of interdependent nations and people” (Im and Lee, 2018, p.164). Throughout years, various concepts in this field have been proposed and used, such as cultural knowledge, brokerage, sensitivity, and competence. Im and Lee (2018) suggest that continuous efforts are needed to keep developing the theoretical works covering transcultural nursing.
Evolution of the Profession and Nursing Skills
For all intents and purposes, the profession of a nurse has indeed evolved in many aspects. Garcia-Castillo (2016) notes that not only its scope has been enlarged, but also its importance. The profession not only focuses on the simple exercise of technical skills, but also on being actively involved in solving complicated problems that inevitably arise. A wide range of practices that are not limited to hospitals but extend to community facilities is covered, and the roles that a nurse plays are different but global in their essence.
Nursing Practitioner as a Leadership Role
The development and continuous imporvement of the profession and the demands toward the nursing practitioners demonstrates that a nurse is supposed to be a leader. According to Garcia-Castillo (2016), it is critical for nurse leaders to be innovative and creative life-long learners, who are compassionate, supportive, determined, and resilient. Garcia-Castillo (2016) cites the following skills of a leader that are crucial for a modern-day leader of the nursing profession.
Leadership Skills in the Nursing Profession
A nurse leader should have a global way of thinking that combines being open and aware of cultural diversity and the ability to apply oneself within cultural differences while adapting to and accepting them. This enables nurses to respond appropriately to health issues and concerns. A nurse should have technical work knowledge, which means the ability to utilize technologies. Decision-making skills based on experience and evidence are also important. The quality of decisions that the leaders make influences their success or failure as leaders. Problem solutions based on practices and facts that have been tested and endorsed have a higher probability of helping to achieve the desired results. Finally, quality and safety prioritization is essential as it is the ability to keep in mind that the healthcare system still faces errors and remains behind in respect of quality.
Moreover, a nurse should possess political acumen, which is the leaders’ ability to understand and be able to intervene appropriately in processes related to politics. It is expected that leaders will keep control of communication in the organization and act if needed. Highly developed skills of collaboration and team building of a leader signify a leader’s ability to prefer the management focused on building partnerships between the leader and their followers to the bureaucratic one. The ability to balance authenticity and expected outcomes, which is a leader’s way to inspire their subordinates. Finally, the foresight and initiative in response to a healthcare system that is defined by change and chaos is a pivotal leadership skill in nursing.
Research on Leadership in Nursing
Additionally, there are many scholars who have conducted their research on what a leader in the nursing field should be like by applying theories from different fields. For one, Leclerc, Kennedy and Campis (2021) have based their study on a constructivist grounded theory by embedding the exploration of human issues through it in the nursing leadership. It is stated that nurses had no other choice but to borrow leadership theories from the world of business since there are no modern corresponding theories in nursing – or, generally, in healthcare (Leclerc et al., 2021). Constructivist grounded theory helped to understand that there is a distinctive leadership style that nurses have, and their leaders employ.
Characteristics of an Effective Nursing Leader
A definition of a leader can include many different characteristics and qualities. According to Leclerc et al. (2021), the participants of their study consider leader to be a person that one would follow anywhere. A leader is someone who couples accountability with caring about themselves and external focus. A leader is also someone who acknowledges humanity in every member of the team. It is leaders who bring the best out of their team members through training and mentoring. Moreover, leaders are always on the brink of change, comprehending the disorder and innovation, while remembering to provide safe borders for the team’s members to reach their goals. Human-centered leadership is something between the theory and the philosophy, but essentially, it is a movement to unite nursing around a common vision.
Collaboration in Nursing Leadership
It is stated in Issues and Trends in Nursing (2017) that collaboration is highlighted by the American Nurses Association (ANA) in its professional standards, which relate to the expected productivity and behavior of a professional nurse. Collaboration as a professional standard requires that a nurse cooperate with all healthcare team members, including users of health services and other professionals, to promote positive results of patient treatment and care of the highest quality. Collaboration includes leveraging effective group dynamics and conflict resolution to create successful healthcare clusters.
Nurses work with other professionals in healthcare to ensure that the patient receives the highest quality of care. According to Issues and Trends in Nursing (2017), collaboration “promotes autonomy, professionalism, self-confidence, and improved patient outcomes” (p. 163). Nurses who work as leaders of the team can make better outcomes due to sharing information with other professionals. Nurses who are involved in collaboration and problem-solving can use the knowledge gained to improve and provide great customer care.
Communication Strategies in Collaborative Nursing Work
Nurses must have skills of negotiating and making joint decisions. Combination of the necessary clinical skills, possession of knowledge and experience as well as decision-making is the core of a caregiver’s repertoire. It is to note, that in a shared environment, decision-making is the effort of the whole team. Each member of the team must be trustful, respectful, and considerate of others’ opinions and perspectives. Moreover, conflict resolution is another crucial element of collegial work. People may have different perspectives and goals that may not match those of others. In such cases an open mind is to be maintained, respect to the team is to be expressed, the barriers are to be explored, and beliefs are to be discussed to reach a compromise. Nurses are supposed to have to relevant education and skills to solve problems professionally and respectfully.
A 21st century nurse’s role is much broader than that of a simple caregiver. A nurse is someone who must always be on the cutting edge of their profession. They must always perfect their craft – and especially communicative skills to communicate efficiently with both patients and fellow professionals. In addition, they must learn how to be the leader and be ready to take on that role in situations of need or emergency. Moreover, ethical codes are to be referred to in situations of ethical dilemmas. One more important thing is to be respectful and responsive – and then almost any problem can be solved.
Im, E. O., & Lee, Y. (2018). Transcultural nursing: Current trends in theoretical works. Asian Nursing Research, 12(3), 157-165.
Leclerc, L., Kennedy, K., & Campis, S. (2021). Human‐centered leadership in health care: A contemporary nursing leadership theory generated via constructivist grounded theory. Journal of Nursing Management, 29(2), 294-306. Web.
Mallari, M. G. D., & Tariman, J. D. (2016). Ethical frameworks for decision-making in nursing practice and research: An integrative literature review. Journal of Nursing Practice Applications & Reviews of Research, 7(1). Web.