Nursing Ethics

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    Ethics in nursing should start at the common denominator, the nurse in daily practice.

    If there are any ethical issues in nursing, one that is definitely developing is that our roots are disappearing. As trite as ‘caring’ sounds, it is the cornerstone of our career birth. Too often, now we find ourselves in the position of being little more than waitresses or waiters with medicine [or procedures] and off to the next ‘table’. Ethics in nursing isn’t about the big issues like ending life support, it’s about us as individuals, risking our licenses because of managed care plans that demand staffing ratios at impossible numbers to deliver excellent care. Ethical issues are about corporate executives shaking hands on deals to merge hospitals because they hear “cha-ching” and not because they have ever set foot on 4 East [just an example, not my floor, and never was] to see that the nurses there regularly suck it up because they don’t get dinner breaks. Nevermind that it’s against the law. If they balk about it, they’re not “team players”, right?

    Ethical issues in nursing remain at the common denominator – the nurse him or herself, because we still haven not risen above nurse-on-nurse bullying. It’s a well known, well documented phenomenon, and we need to start to improve our lot in this career by putting a stop to it. Now. There’s nothing cute or funny about the expression “Nurses eat their young”. If we want to be ethical nurses who bring in a generation of supportive people, we teach them what we know, that we are patient, we welcome them to our work environments. Hospitals are corporations now, mostly for profit, not passion - and if we are divided, they will conquer. That means these ethics conversations will remain academic, Powerpoint meetings that boil down to avoiding lawsuits.

    Our nurse managers have the power to lead us in this direction to some extent. They are responsible for creating the atmosphere in which we work, even if they cannot do all staffing we would like. We are the advocates for our patients - our ADON's and DON's should be *our* advocates.

    Their will always be personalities that clash at work - and that's ok. We need to make a committment to do our best learning from our enemies. Yes, I am saying, the nurse that you cannot stand - offer to cover his patient care so he can go eat dinner. These are the actions that forge unity in our ranks, which we so urgently need. This is what a nurse of the highest ethical standard does. When you feel good about what you have done, it trickles down to your performance for your patient.

    In the meantime, we wait for political changes to makes our jobs safer. Nurses – the core of patient care – are our own worst enemy at times, so why should executives, managed care outfits, or even the government listen to our ethical concerns on an individual level? In what other profession do you see this toe-stepping? Does a school district listen when teachers say that a classroom of XX number of children is not safe or practical? They do! Parents of students demand it because they have some knowledge of that system. Patients, on the other hand, are in the dark about patient safety, hospital profit, even their own medicines!
    Do hospitals want us to advocate for our patients? Only to a point. What would the corporate executives say if we encouarged our patients to demand higher staffing ratios because their safety was at risk? We would be fired.

    The bottom line is, if doctorate and graduate level nurses want to take on ethics, forget a thesis on end of life care or bioethics. Start where it really counts, where we really need help: the ethical concerns nursing on a daily basis on an individual level. Help us get these issues out of an academic hall and into legislation -uniformly across the country- that actively prevents a hostile work environment and promotes safety, cameraderie, and motivation to stay in nursing.
    At heart, nurses are nice people. The nice guys and girls shouldn't finish last.
    Last edit by SunnyPupRN on Jun 15, '11 : Reason: Expanding on topic
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    RN, Florida

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  3. by   deneix
    Bravo on your post on nursing ethics! I could not agree more with you on the problems nurses are facing who are working on the floor. It is sad that we no longer have time to talk to our patients and feel rushed when providing education to them. I feel like it is taking me longer and longer to complete my job tasks to live up to the care we are expected to give. There are many days I personally do not feel like I did all that I should have done because I have to worry about the other eight to nine patients I am giving basic care to ie. medication, dressing changes, and answering call lights. If you mention the heavier acuity load to managers (with no decrease in patient load) they deny it and it's all about the money for them. Your post made me feel better just to know that I am not the only one feeling the strain at work. Nurses should not have to continue feeling the strain of possibly losing their license because hospitals/organizations are just worried about their profit. So many articles point to nursing shortages however I do not see a lot of changes occurring for the nurses who are currently on the job dealing with problems.
  4. by   SunnyPupRN
    Thank you
  5. by   camoflower
    My old boss prior to hiring said "they will eat you alive" referring to the seasoned nurses on her post op floor. I was 50 years old and a new nurse. The girls used slang in report and ran to the manager everytime I asked "what?" to critize how I did not know what anything was...sorry, Lapy-Coly? what? - so I was labeled "stupid" for a year and no matter the zillion things I may have done right - they never forgot. So I quit and went to a nursing home - where I got "employee of the month" within 4 months of being there and when I got onto a "seasoned" CNA about her ring in her nose and eyebrow - she turned and said to me "I know how to get rid of nurses like you" (it was in the darn handbook! no facial jewelry.) She told the ADON I was after her job and I began to get written up for stupid things like "med cart parked next to fire door" In all the years of working - I have never worked with such a back stabbing, critical bunch of so called professionals - I am currently UI and shudder at the very thought of returning to work as a nurse. I am still new, I am not stupid, I am not used to mean and cruel women..perhaps its because I'm over 50 - I love nursing, I work circles around other nurses, I smile all the time ("I don't do cheerful" - Debbie Downer)(been there and have heard that) I have never been fired in my life and I am so down about it...all that money wasted in nursing school..and I thought that nursing would be the one thing I could do til I retire. Eating your young - so disrespectful to co-workers - what makes you think that you are so smart?
  6. by   SunnyPupRN
    I'm so glad you are tough enough to stick it out after the abuse you have endured. My question is, what is UI?
  7. by   camoflower
    UI - (ah ha..your thinking UTI? lol) UI = Unemployment Insurance - the ADON got me fired with her so many write-ups, the CEO said she had my back and the DON said oh you can't be fired by the ADON writing you up. The ADON has waay more experience and way more determination and she waited to get me when the time was right.Lesson learned..oh yes, the ADON can and will write you up and get you fired. Well, the CEO quit two weeks after our conversation, and it just so happens that the DON was sick one day (I was alone and was scheduled into work at noon)the evil-mac nasty ADON worked on the newly hired CEO replacement (who hadn't passed her CEO test to be a CEO and who was fired 3 days after firing of me because of my fraudulent write ups) The CEO replacement and the ADON called me into the office upon arrival and simply said "you have a lot of write ups and we just don't need you right now". (I am considered rehirable from the employee handbook) I was so shook up still and told evil mac nasty in front of that new CEO "I hope you are happy now and one more time I will say I do not want your job! Good luck to all of you...and was escorted out like a criminal. I have never been fired in my life. So now, I look for jobs and get sick when i think that I may have to work amoung some people who are not nice. (this ADON has a son in law that was just sent to prison for 2 counts of attempted man slaughter) THE LIE: I never wanted that woman's job but could not convince her that that CNA lied to her. (The CNA's husband blew himself away 7 weeks later..when she said something to get rid of him) The old CEO tore up my 2 weeks notice only 3 weeks prior to my firing. Because she quit 2 weeks later. One night I was forwarned by some "nice" nurses ..they said "quit signing those write ups - you know she is padding your file to get you fired - she thinks your after her job!" They had to convince me that firing was immenent...I felt so stupid. I told them I had numerous meetings with the DON and the ADON (7) to be exact whereas I said repeatedly pleading for her to leave me alone.. "I don't want your job - I love my job". She, the ADON, would sit and just stare at me, with her arms crossed, in her insecurity, saying "where's there's smoke there's fire"...just glaring. The CEO that tore up my letter of resignation and quit working there herself says today "just use my name and number and I'll put in a high recommendation for you anywhere" lol...during my last intervew question that hit my gutt was "does this CEO still work for this retirement home?"" no..she quit" was my reply, he wrote something on the paper, I should have told him PLEASE CALL HER...she will recommend me, that's her home number. It been a week and I really wanted that particular job. I am sick about the whole nursing atmosphere. Stick it out? I am trying but am so dreading the mean spirited staff..I am a very nice person. The people pleaser...but the evil smart mouths ALWAYS ALWAYS find a way to pick on me. I have even talked other nurses, in doctor's offices, and heard the nurses replying to a doc..."no, she is the nice nurse.." I want to find that group to work with ..the nice, smart, caring professionals, doing a super job. Pray for me.
  8. by   SunnyPupRN
    Ouch! Sorry I misunderstood! If it helps, I'm in a similar position. I didn't get fired, but 'forced resignation' over a supposed med error that never happened. No paperwork, nothing to back it up. I followed procedure - I witheld a med from a patient who was seizing, called the appropiate people, etc. [Did they want the med to go down his windpipe?] But politics, politics. Like you said, one little petty little thing after another. Became a battlefield. Now I question my own abilities. My self esteem took a hit, I lost my house because no paycheque. Since I resigned, no unemployment cheque. Now I am scared to work again as a nurse, but have to do something. I'm applying with no offers. Things have to change.
  9. by   camoflower
    Well, I don't feel so bad. I am getting 400 per week unemployement...but rather be working. I have worked so hard for this RN degree and feel so dishearted. Caring and compassion..ha ha?!! I've been a single mom and am used to saving every dollar I can. I am still applying for jobs weekly (which is mundane WORK!) and receiving no offers. Well, this one place, I had a second interview...and they said now the rest of this process is up to human resources calling your refrences and getting back with us. However, my references haven't been called and I am sitting like a bump on a log, because I really wanted this job, and natta. I could stay on unemployment but would rather be working. Heard some news today..that nursing home has received 3 Imm. Jeopardies...once I got fired, they began writing up nurses with "camo has a big lawsuit coming..we have to write you up" so what happened? They are quitting refusing to put up with the psychological and verbal abuse. Hostile crappy ADON began looking for other victims on which to feed upon a reflection of her upbringing. They wonder why nobody wants to work there? One IJ is for lack of nurses ha ha. I heard the little barker barked at a new nurse and she took off her keys and did not say a word - just walked out prior to clocking in. This is a town of about 10,000 word spreads fast that the ADON will lie, treat someone like me unfair, just because she is street smart. Also residents fear her...If a resident complains about her or any of her BFFs she will have a nurse write in their care plans that they are "habitual liers"...that is abuse and fraud. One nurse got fired for mentioning my name and she has a lawsuit pending for discrimination. errrrr what am I doing in this field?!! mean nurses errrr
  10. by   camoflower
    I miss my residents in the nursing home...they never knew. This week I wrote a letter to the CEO of the corporation in St. Louis and will write another letter along with my diary. I knew I was in trouble..(another lession learned) when on the first day of employement the DON says to me "sorry,come back tomorrow...we don't know exactly what you'll be doing". Imagine the pit in my stomach - I'd just left a hospital job, basically umemployed, and "we don't know where we are going to put you". So they gave me a girls job that was on vacation -I got 6 hours training. Twice with one hour training not only did I do my job but did the nursing home med pass. So, to vent my frustrations, I kept up a daily dairy on lessons of becoming a nurse and treading water at this facility. I am counting my blessings to be away from that horrid ADON who only made 1.00 more than I. (how did I know? / someone conveniently left a computer print out of everyone's salary in one of my files)
  11. by   SunnyPupRN
    True enough, true enough. It's like you go through nursing school and they pull a bait and switch on you. Something's gotta give.
  12. by   camoflower
    Pup, you are so right. I have applied for a position that was posted at a hospital 50 miles away and when I got there it was a baited job oppurtunity.."oh that position is filled" "would you like to work on this floor". In my area you catch wind of where you DO NOT want to be employeed - because of either the mean doctors or the managers that have their pets. Nursing, as least around a rural area, is and can be very clanish and clickish. You from a certain town and the majority of the nurses on the floor are from that small town - they can do no wrong. I keep kicking my tail asking myself why did I waste all that money? I opened a photo and there was this hateful girl that acutually kicked my chair and demanded "did you put a battery in that heart monitor?" she was an employee of the month at an hospital - mean ol nurses
  13. by   SunnyPupRN
    Camo, I know all about the small town syndrome. I could tell you a whole bunch of stories, but I would just be echoing the exact stuff you are already telling me. I don't know whether to go back to school and go higher on the totem pole so as not to deal with floor nursing, or what. I'm not thick skinned and this type of abuse gets to me. If I wanted to be shot down all the time, I would have joined the air force and become a pilot.
  14. by   camoflower
    I was not raised to act nor be anything like most of the mentors that I have been around. I have been so perplexed for the past 3 years I can't tell you because of the evil of the nurses. My mentor, during my clinicals during my preseptorship - made me cry..the last day she said to me in front of my peers as she was filling out my report looked up at her friends as said "aah what is your name anyway...I've forgotten". I shook. I was so humiliated after working for free 12 shifts along with her. I went my instructors and complained about her..and they stated "stick with her or find another and redo all 12'll make it. Hang in there". One year after graduation I heard she got FIRED for STEALING narcotics. My next preceptor works at the local tiny hospital and was worse than her on horrible remarks, snippy - ordering me to clean up the bed side pans in front of her peers. I've had them out and out lie about me, I've been written up, laughted at, "the all knowing rolling of the eyes"...I'm just an average sized, short, bubbly, looking for the good in all situations, give me the work I can get it done kinda of gal. I hear "you got to be thick skinned to make it" - for what? the unnecessary smart lip remarks (it seems like the nastier your mouth is ...the more morons follow you) and once they attack you, your alone in a battlefield, nobody wants the bulley to think they like you - out of fear? - and somehow these lord of the liers has a manager hiding behind her back (weak management that hasn't a clue what is going on - the only hear bad crud about new nurses - which in return keeps the manager from seeing their sloppy work and what they haven't done during their shift) I have heard "bite em back!" Let me tell you...when you're not raised like that it would not come naturally...and being mean to anyone on purpose makes me ill. The last bulley at the hospital was a former meth head! (however, the manager saw her raised from knee high and her daddy has lots of money she's been clean for 5 years ) (I sigh) I get those letters "thank you letters" from the families - I read them and then the jealous ones attack. I get thank you letters because I was raised by the golden rule - do unto others - they were raised to "be tough, don't take no lip..only the strongest survive!" I even asked patients "how am I different?" I know I am...they would reply "you treat me like I am human and you are sincere-not fake, you don't come in here yelling some canned speech, I'm not deaf, you do what you say your gonna do, you bring me coffee, you take the time to take me to the restroom without having to call an aid - when I gotta go I gotta go, you explained in detail to my son how his appendectomy would pan out..etc etc. I know from the bottom of my heart that those bullies can't get jobs anywhere else - they are the queen bees where they work, I see their insecurities and jealous bones. At least I can leave and try to get a job somewhere else. I have thought about getting a BN and becoming a manager..then I have really thought about just completely getting out of nursing, but my family keeps pushing, and I love nursing..even though my very first manager words will forever haunt me "they will eat you alive!" I that weak?