THEROLE OF NURSES AS MORAL AGENTS
TheRole of Nurses as Moral Agents
Oneof the key roles exercised by nurses in modern health institutions ismoral agency. This applies to both nurse leaders and direct carenurses. Forced to exercise this delicate form of agency in anenvironment that is increasingly uncertain and highly complex, nurseshave to find the perfect balance between caring for the patients andoperating within the ANA (American Nursing Association) Code ofEthics (Chiarella & McInnes, 2008). With this, nurses assumeresponsibility for the management of clients and are accountable tothe set authorities in case of any misgiving. Compared to thetraditional nursing role, moral agency is quite at odds. Unlike inthe past, nurses nowadays are faced with the task of not only caringfor patients but also upholding ethical standards in a manner that isrelatively consistent with their care component.
Asoutlined by Chiarella and McInnes (2008), the degree of complexity inmodern medical environments makes it difficult for nurses to maintaintheir moral values, which leads to a state of moral distress. Thisrefers to a state whereby values conflict leading to some sort ofmoral dilemma. Organizational constraints are the major restrainingfactor in this case. In most cases, a nurse will know what themorally right thing to do is when faced with a delicate situationrelating to patient care but organizational norms and rules tend toact as an obstacle in the implementation of these morals.
Descriptionby use of a case study
Aparticular case study is one that relates to whistle blowing as partof nurses’ moral agency. As a nurse, one is strictly bound by theconfidentiality clause. This is as stipulated in the ANA Code ofEthics (Marquis & Huston, 2012). By virtue of being a nurse, itis considered unprofessional and punishable by the rule of law todisclose matters pertaining to a patient’s condition to anybody. Onthe other hand, it is also the nurse’s moral responsibility toshare any vital information connected to the patient’s condition tothe relative authorities even against the patient’s wishes. Thisbrings forth one of the greatest ethical dilemmas in the nursingprofession. A perfect case scenario, in this case, is whereby a 10year old girl was brought in by the uncle in critical condition aftera severe case of sexual molestation. As the nurse in charge, it is myduty to find out what exactly happened to the girl. It is only afterintensely interrogating the uncle that he confirms he is responsiblefor the molestation but asks that I keep this secret. The uncle inquestion is the only guardian the girl has, having being an orphan.As per the healthcare code of conduct, a nurse is expected tomaintain confidentiality as stipulated by the legal guardian. On theother hand, it is the moral duty of any nurse to speak out if theybelieve they are acting in the best interest of the patient. It is aperfect case of greater evil versus lesser evil, with the lesser evilin this case being breaking the confidentiality clause.
Negativeoutcome that may result from failure to exercise the role of morality
Exposureof the victims to further sexual assault in future
Ethicallyspeaking, the safety and well-being of the child should be givenpriority. This is to imply that ignoring the confidentiality clauseand letting the police know of the revelation is the best way to goabout it. In other words, the lesser evil outweighs the greater evil.Failure to speak out will expose the child to further sexual assaultsince there is no assurance that the uncle will not try it next time.
Victimswill suffer lifetime stigma
Failureto report the action will leave the child with a scar for life sinceshe will live knowing that her uncle sexually assaulted her, and hewalked away scot-free. She will not only have to live with the unclebut also the memories. There is no knowing to what extent this mightaffect the child. All these necessitate the need to speak out as anagent of good morals.
Strategiesthat aided to fulfill the role of taking a moral stand
Strategyof incorporate integrity and accountability in medical field
Perrottoand Grossman envision nurses as leaders that should be able toincorporate integrity as well as accountability into the medicalpractice by blending their caring and humane presence with skillfulknowledge based on evidence (2010). This is as depicted in the casestudy above. A nurse should be deeply in touch with his or her humaneintellect to maintain professionalism and ethical accountability. Inthe case above, a nurse should care enough to try and find out moreabout what transpired and caused the 10-year-old girl that much pain.On the other hand, they should be willing to go against all odds tomaintain their ethical standards by reporting the matter to thepolice, regardless of what might happen to the uncle in the long-run. This brings out a set of skills that all top nurses are requiredto master to attain the perfect balance between legality and moralityat their highly complex areas of practice.
Strategyof exhibiting professional and moral courage
Apartfrom a human intellect, nurses should also exhibit professional moralcourage (Chiarella & McInnes, 2008). Not only is this conceptvital to nurses, but also, all managerial bodies within the medicalfraternity. It is one where nurses are at times expected todemonstrate high levels of determination, zeal, and hardiness,towards what is morally right. Acting timid and tender only worsensthe situation in cases such as the one stated above. Any nurse thatfinds himself or herself in the same situation should exhibit highlevels of moral courage such that no kind of threats ororganizational bureaucracy will derail them from reporting the uncleto the police. This kind of hardiness coupled with human intellectand exceptional nursing care skills make for the perfect combinationin a complex nursing world full of both resolvable and irresolvablemoral dilemma.
However,a lot is normally said concerning the role nurses play as moralagents but little is done. This all boils down to the English dialectevolving incredibly over the years, and the once clearly structureddistinctions between words such as ought, must, should, can, will andmay have simply boiled down to ‘interchangeable’. This is to meanthat most hospitals have not clearly stipulated what is morallyexpected of nurses, and if so, no clear follow up structure has beenset (Marquis & Huston, 2012).
Motivationfor the stand taken
Themotivation to take such a stand despite the difficulties in takingsuch a stand, is the love to care for patients, seeing them back totheir normal situation before the incident, happier and satisfiedonce again. The motivations for such should, come from within. In asmuch as rules and policies are essential, nurses should be well awareof their ethical responsibilities towards both the patients and theorganizational policies and know when best to forfeit one in favor ofthe other. Nursing in itself is a caring ethic. The love and care forpatients are motivation enough for any nurse to immensely, push forupholding morals within the relevant health institutions.
Marquis,B. L. & Huston, C. J. (2012). Leadership Roles and managementFunctions in Nursing: Theory and Application. Philadelphia, PA:Lippincott, Williams & Wilkins.
Chiarella,M. & McInnes, E. (2008). Legality, Morality and Reality- The Roleof the Nurse in Manatining Standards of Care. Australian Journal ofAdvanced Nursing, 26(1), 77-83. Retrieved from the Walden librarydatabase.
Olson,D.A. (2009). Are Great Leaders Born, or Are They Made? Frontiers ofHealth Services Management, 26(2), 27-30. Retrieved from the Waldenlibrary database.
Perrotto,A., & Grossman, M. (2010). Ten Ways to the Top. NursingManagement, 41(4), 28-32. Retrieved from the Walden Library database.
Schaffner,J. (2009). Roadmap for Success: The 10-Step Nursing Strategic Plan.The Journal of Nursing Administration, 39(4), 152-155. Retrieved fromthe Walden Library database.