There is no healthcare profession that can be labeled an undemanding one – and especially not that of a nurse. 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 has to refer to various ethical codes and look at how the field transforms with the flow of time and adjusts to the trends.
Ethical Implications of Decision-Making in Nursing Practice
First of all, touching on the subject of ethics, dilemmas arise before nurses nearly daily. Mallari and Tariman (2016) note that those 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.
Standards to navigate this practice are usually derived from numerous sources. According to 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. Various federal and state regulations are deemed to be frameworks for protecting humans. 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 national ethical codes, which deliver guided by a particular country’s cultural and moral norms (Mallari and Tariman, 2016). As one can see, there is a number of documents to refer to.
However, those codes that are reported to be most dominant in terms of models of decision-making in nursing practice are inherently weak in their own regards. First of all, as Mallari and Tariman (2016) note, the International Code of Ethics cannot possibly be representative of the cultural and societal diversity of various countries, which is to be taken into consideration when making a decision in a particular country. Secondly, a code of ethics’ enforcement generally gets to be carried out by a national medical organization rather than by an international one. Nurses have to therefore know what the differences and the similarities between international codes and national codes are and apply only those that are contextually relevant to their practice.
All things considered, since medical sciences and nursing, in particular, are developing rapidly, a nursing ethical code should take into account issues arising from technological changes and advancing scientific knowledge. Mallari and Tariman (2016) propose that nursing organizations are to develop official stances and application guidelines that address ethical perplexities in care practices and research. Nurses, in their turn, are to decide on clinical practice issues within a relevant framework of professional ethics. Being lifelong learners, nursing professionals should seek to continue educating themselves on problems that may arise, alongside being actively involved in the study of emerging ethical issues and in the careful discussion of how to address them.
Culturally Competent Nursing Care Needing Intentional Learning
As has been mentioned above, there might be some problems related 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 as a phenomenon, it arose in the 1950s, and the theory started developing in the 1960s. Since then, it has turned out to be a major nursing field.
Transcultural nursing 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 the years, various concepts in this field have been proposed and used, such as cultural knowledge, brokerage, sensitivity, and competence. The latter especially has been considered by different scholars a substantial element of nursing.
Regarding that, it is interesting to explore what the modern-day trans-cultural nursing trends are. Im and Lee (2018), having explored several theoretical works connected to the subject, found out that current trends are mostly congruent with the ones that have been reported previously. The works that have explored the issues of transcultural nursing defined the objectives of theoretical work used different methods of theorizing and theorizing sources and substantiated the links of this field to nursing practice, hospital policy, and others.
Given its history and definition, trans-cultural nursing has always stood at the forefront of the fight against global change in the phenomenon of nursing. Im and Lee (2018) suggest that continuous efforts are needed to keep developing the theoretical works covering transcultural nursing to reflect the changes taking place and provide culturally appropriate and competent care. It is especially important since the field seems to undergo alterations constantly.
Critical Thinking in Client-Centered Care as Related to Leadership
The profession of a nurse has evolved in many aspects. Garcia-Castillo (2016) notes that not only has its scope 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.
That leads to the logical conclusion that a nurse is supposed to be a leader. According to Garcia-Castillo (2016), nurse leaders must 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. Those are:
- A global way of thinking combines being open and aware of cultural diversity and the ability to apply oneself to cultural differences while adapting to and accepting them. This enables nurses to respond appropriately to health issues and concerns;
- Technical work knowledge, which means the ability to utilize technologies – for example, biometrics, electronic medical records and clinical decision supports as a means of collecting, using, transmitting and storing data concerning the patient as well as nursing care;
- Decision-making skills based on experience and evidence. The quality of the leaders’ decisions influences their success or failure as leaders. Problems solutions based on practices and facts that have been tested and endorsed have a higher probability of helping achieve the desired results;
- Quality and safety prioritization, that is, the ability to keep in mind that the healthcare system still faces errors and remains behind in respect of quality. Thus, the 21st-century leaders are those who are resourceful but tend to ensure the safety and value-laden strategies to improve the situation;
- Political acumen – in other words, the leader’s 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 take action if needed;
- Highly developed skills of collaboration and team-building of a leader. These 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 is a leader’s way of inspiring their subordinates. It is the personal qualities that entice and encourage others to look up to someone;
- The last one is foresight and initiative in response to a healthcare system that is defined by change and chaos. That competence is the essential one that nurses in this day and age should have because it allows them to establish components where change is necessary and to persuade and influence others around to support it. They have to be able to understand the dynamics of the work environment and adapt to them while living and surviving under such circumstances.
Additionally, other scholars 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 nursing leadership. It is stated that nurses had no choice but to borrow leadership theories from the business world since there are no corresponding modern theories in nursing – or, generally, in healthcare (Leclerc et al., 2021). The constructivist grounded theory helped to understand that there is a distinctive leadership style that nurses have and their leaders employ.
It appears that a definition of a leader can include many different characteristics and qualities. According to Leclerc et al. (2021), the participants of their study consider a leader to be a person that one would follow anywhere. A leader couples accountability with care about themselves and their external focus. A leader is also someone who acknowledges humanity in every member of the team but is conscious and expects the same from everyone else. It is leaders who bring the best out of their team members, training and mentoring as part of creating a high bar for work and expecting the team to contribute to that. 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 between the theory and the philosophy, but essentially, it is a movement to unite nursing around a common vision to embody the essence of the field the way it is supposed to be (Leclerc et al., 2021). Though this characteristic may seem a bit romanticized, it is hard to argue that in order to help people passionately, a professional has to be appropriately inspired.
Effective Communication as a Collaborative Team Member While Making Decisions in Nursing Practice
One more aspect in which the nurses’ leadership is to be considered is leadership when working in a group. 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 cooperates with all stakeholders, including users of health services and other professionals, to promote positive results of patient treatment and care of the highest quality. The collaboration includes leveraging effective group dynamics and conflict resolution to create successful healthcare clusters.
In its essence, collaboration is an integral and vital component of success in modern nursing practices. 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 team leaders can achieve better outcomes due to sharing information with other professionals. Nurses who are involved in collaboration and problem-solving are able to use the knowledge gained to improve and provide great customer care.
There are particular qualities that a nurse must possess in order to collaborate successfully. First of all, in order to work together, nurses must have superior communication skills. In addition, trust and respect must be established among those who work in a team. Health professionals should know how to receive constructive criticism professionally, as well as how to express it constructively.
Nurses have to have skills in negotiating and making joint decisions. A 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 team member has to be trustful, respectful, and considerate of others’ opinions and perspectives. One also has to always keep in mind that the patient is a top priority. When remembering that, working together is always doing the right thing.
Conflict resolution is another crucial element of collegial work. Conflicts can easily arise in teamwork. 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 for 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 relevant education and skills to solve problems professionally and respectfully.
In many cases, a nurse can assume a team leader’s role. As Issues and Trends in Nursing (2017) insists, being the focal point for care, nurses are often the best professionals to be an organizer and a leader of teams of health workers to support optimal health outcomes for individuals and populations. All nurses should have the necessary leadership skills to lead teams.
Generally speaking, a 21st-century nurse’s role is much broader than that of a simple caregiver. A nurse must always be on the cutting edge of their profession. They must always perfect their craft – especially communicative skills- to communicate efficiently with patients and fellow professionals. In addition, they have to learn how to be leaders and be ready to take on that role in situations of need or emergency. Moreover, ethical codes are to be referred to in ethical dilemmas. One more important thing is to be respectful and responsive – and then almost any problem can be solved.
Garcia–Castillo, K. (2016). Twenty-first-century leadership in nursing: What must it be?. International Education & Research Journal, 2(5).
Halstead, J.A. & Roux, G. (Eds.) (2017). Issues and trends in nursing. Jones & Bartlett Learning.
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. J Nursing Practice Applications & Reviews of Research , 7(1). Web.