1. Section Editor(s): Alexander, Mary MA, RN, CRNI(R), CAE, FAAN

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Happy National Nurses Week! Each May, we nurses take a moment to reflect on our professional achievements and to celebrate our colleagues. This year, Nurses Week calls attention to ethical nursing practice and its link to quality care.

Mary Alexander, MA, ... - Click to enlarge in new windowMary Alexander, MA, RN, CRNI(R), CAE, FAAN, INS Chief Executive Officer Editor,

In the challenging world that is our profession, ethics is integral to good nursing practice and first-rate care. In recognition of the impact ethical nursing practice has on patient outcomes and the quality of care, the American Nurses Association (ANA) has designated 2015 the Year of Ethics. In January of this year, ANA released an updated version of the Code of Ethics for Nurses with Interpretive Statements for the first time since 2001.1 The revision ensures that the code applies to modern clinical practice and advances in quality and keeps pace with changes in health care.


Nurses make ethical decisions every day; but when we do, we need to ask ourselves why we're choosing a certain course. Are we taking into consideration the patient's and the family's wishes, even if we don't agree with them? Are we observing ethical principles of autonomy, beneficence, nonmaleficence, fidelity, justice, and paternalism?2 Can we make persuasive arguments to back up our decisions?


Nurses are recognized by the public for upholding high ethical standards and are highly trusted as a result. Once again last year, in the annual Gallup poll on honesty and ethical standards in professions, Americans said nurses have the highest honesty and ethical standards, for the 13th straight year. Eighty percent of respondents said nurses have "high" or "very high" standards of honesty and ethics.3


It is, of course, great news that the public recognizes our hard-earned accomplishments, but we can't rest on our laurels. This year, ANA is encouraging health care organizations to participate in educational activities and events that focus on ethics in nursing. We all need to be reminded to think critically about our nursing care and to respect cultural differences and patients' decisions.


Last August, nursing leaders met in Baltimore to discuss "Nursing Ethics for the 21st Century," a gathering sponsored by the Johns Hopkins School of Nursing and Johns Hopkins Berman Institute of Bioethics. Attendees focused on nursing and ethics in 4 areas: clinical practice, research, public policy, and education. The result was a "blueprint" for nursing ethics in the future.4


The blueprint developed common themes in each of the 4 areas as well as plans to move nursing ethics issues forward:


* Clinical practice: Develop and sustain work environments that support ethical nursing practice.


* Nursing education: Promote excellence in nursing ethics education in order to build a strong and diverse health care work force to advance the ethical delivery of health care.


* Nursing research: Develop a research agenda that will lead to a culture of ethical practice in diverse settings that is evidence based and measurable in terms of outcomes and pragmatic considerations.


* Nursing policy: Create an ethical health environment through the development of resources, policies, metrics (outcomes), education, training, and research.4



For the rest of the year, ANA and its partners will work to make the blueprint a reality by disseminating its recommendations, collaborating with other professional nursing organizations to create a dialog with the public about ethics, and implementing many of the blueprint's proposals.


Within our own specialty, infusion nurses encounter ethical dilemmas all the time. From questionable practices of another health care provider, to improper procedures with experimental treatments, to dishonesty in billing practices, we are on alert. And it will only get more complicated as technology advances and resources become limited. The nurse is challenged with weighing professional responsibilities with personal risk. However, remember there are resources you can turn to for guidance. So, in our efforts to promote patient welfare in an ethical manner, What Would You Do?


Mary Alexander, MA, RN, CRNI(R), CAE, FAAN


Mary Alexander




1. American Nurses Association. Code of Ethics for Nurses with Interpretive Statement. Published January 1, 2015. Accessed February 27, 2015. [Context Link]


2. American Nurses Association. Short definitions of ethical principles and theories: familiar words, what do they mean? Accessed March 3, 2015. [Context Link]


3. Americans rate nurses highest on honesty, ethical standards. Published December 18, 2014. Accessed March 2, 2015. [Context Link]


4. Johns Hopkins Berman Institute of Bioethics; Johns Hopkins School of Nursing. A blueprint for 21st century nursing ethics: report of the national nursing summit executive summary. Published November 2014. Accessed March 2, 2015. [Context Link]