NTI 2016 Moral Courage

We attended an NTI session this morning about moral courage and ethics for the APRN. This is applicable to many nursing specialties The lecture was Sarah Delgado ACNP Clinical Practice Specialist from San Viejo. She brought up some excellent points regarding "ethical creativity" and the ability to troubleshoot very troubling ethical decisions. Utilizing case studies she provided steps to solve complex ethical issues involving withdrawing care from a pediatric patient, discussing DNR status of an elderly ICU patient with multiple comorbidities and general ethical dilemmas.

Critical care is an arena where ethical decisions are often found. As critical care nurses, having a toolbox of skills to add to our orificenal helps to meet our patient care goals

She broke down the decision-making process into a path with several different directions. Looking at practical alternatives she provided a clear solution to even very complex issues.

She pointed out out common pitfalls as well as potential resolutions. Ms Delgado also brought up a team approach in order to provide a united front. Social workers, risk managers, unit managers, nursing staff, families and providers must all be in agreement in order to provide the best solution.

Some of the tips Ms Delgado provided to solve ethical issues

• Know elements that promote ethical dialogue
• Advertise and use your ethics resources
• Utilize interdisciplinary teams
• Mentor and collaborate as a unit
• Voice conflicting views in calm voice
• Open body language

These tips are not all inclusive. Ethics issues are by their nature sometimes quite fluid without a definite answer.

Instead take a proactive approach...

Work toward preventive ethic by being open with staff, patient and families. Work thru the emotion of the situation. Accept your responsibility for resolving the situation before it becomes a problem.

Being proactive is better than being reactive.

How have you handled an ethical situation recently? Have you used any of these techniques?

What resources did you use?

Reference

AACN Ethical Guidelines