Ethics is and always will be a difficult and vague topic to define and understand. By its very nature ethics is an area of study to be debated and discussed. Roughly defined ethics is the virtuous and moral values and actions that society finds acceptable or desirable (Northouse, 2016). Ethics is concerned with good or bad and right or wrong. Ethical leadership then is what motivates the leader and how the leader acts (Northouse, 2016). Leaders by definition have influence to some degree to their followers. Leaders then exert some amount of ethical decision making in how they treat and interact with their followers (Northouse, 2016). Leaders also have ethical influence in how they interact with their organization and people that interact with their organization. Take for instance nursing. As a nurse you are a leader to other professions such as certified nurse aids (CAN), monitor technicians, respiratory therapists, etc. A nurse also can be a major influence in the patient’s perception of the organization as a whole. Nurses similarly have to be ethical in their leadership of patients and patient’s families on their journey of recovery.
Nursing as a profession has always had a strong underpinning of being an ethical profession (Tucket, 2015). Nursing is trusted to be such an ethical profession that it has ranked as the number one most ethical profession in the Gallup poll of ethical professions, except for 2001 when firefighters won the honors (Norman, 2016). The fundamental driving force of nursing that is altruism may be dwindling. Recent research has shown that new graduate nurses core values of altruism and empathy are being eroded by the task-related demands of contemporary nursing work (Lamberton, Leana, & Williams, 2015). Additionally, some research suggests that there is a widening gap between age cohorts on the importance of salary as a motivator suggesting future generations of nurses may be less inclined to choose nursing without more attractive career options and rewards (Chenoweth, Merlyn, Jeon, Tait, Duffield, 2014).
This shift away from ethical altruistic motivation is not to say that new graduate nurses are any less ethical than previous generations but what part of the job is emphasized and deemed more critical is shifting (Tucket, 2015). As a nursing student I have experienced this first hand with nursing instructors who are from previous generations of nursing. Their primary prerogative for students is to talk to our patient, learn their entire back story, and do whatever we can do to make them happy. This is a completely valid and important aspect for nurses to keep in mind and integrate into their care. Working as an intern at the local hospital and having the opportunity to follow nurses throughout an entire shift, however, has shown a dramatic shift in priorities. Nursing now is much less about forming a bond and lasting relationship with patients and more about task orientated interventions, charting, and coordination of care. Talking to many nurse in the hospital and they all want to do the best for their patients from an ethical standpoint. Most of them usually do find time to listen to and answer patients concerns, but the whole time the nurse is in the room they are aware of the list of other duties they have to do.
Ethical leadership in nursing has shifted to fulfilling the universal ethical principles in nursing which are autonomy, beneficence, fidelity, justice, nonmaleficence, and veracity (Henry, et al., 2016). Autonomy refers to the nurse allowing the client to make their own decision. Beneficence means that the nurse will provide care that is in the best interest for the patient. Fidelity refers to nurses keeping their promise to the patient about the care that was promised, i.e. if a bath is offered a bath is given. Justice is the fair treatment that is offered. Nonmaleficence is that nurses will do no harm to their patient. Finally, veracity is referring to telling the truth to your patients. These are the core ethical principles guiding patient care (Henry, et al., 2016). The key difference is how altruristic behavior is seen or measured. In prior nursing generations it was the “classic” idea everyone has for a nurse. Someone who is there to be a knight in shining armor and be their best friend in the hospital. Now altruistic acts are boiled down to those core principles that nurses use interventions to act through. Nurses have an extensive list of items to accomplish that as long as those core principles are fulfilled the nurse is acting ethically.
Differences between generations will always exist and those differences might not always mean one is better than the other. Nursing is a profession that is centered on doing what is right for patients that are in poor or struggling health situations. How the ethical leadership of nurses is portrayed in nursing care may differ but should never be forgotten.
References
Chenoweth, L., Merlyn, T., Jeon, Y., Tait, F., & Duffield, C. (2014). Attracting and retaining qualified nurses in aged and dementia care: Outcomes from an australian study. Journal of Nursing Management, 22(2), 234-247. doi:10.1111/jonm.12040
Henry, N. E., McMichael, M., Johnson, J., DiStasi, A., Ball, B. S., & Holman, H. C. (2016). Leadership and Management Review Module (7.0th ed., pp. 47-48). N.p.: Assessment Technologies Institute, LLC.
Lamberton, C. M., Leana, C. R., & Williams, J. M. (2015). Measuring empathetic care: Development and validation of a self-report scale. Journal of Applied Gerontology, 34(8), 1028-1053. doi:10.1177/0733464813507131
Norman, J. (2016, December 16). Americans Rate Healthcare Providers High on Honesty, Ethics. In SOCIAL & POLICY ISSUES. Retrieved November 14, 2018, from https://news.gallup.com/poll/200057/americans-rate-healthcare-providers-high-honesty-ethics.aspx
Northouse, P.G. (2016). Leadership: Theory and practice (7th ed). Los Angeles, CA: Sage.
Tuckett, A. (2015). Speaking with one voice: A study of the values of new nursing graduates and the implications for educators. Nurse Education in Practice, 15(4), 258-264. doi:http://dx.doi.org.ezaccess.libraries.psu.edu/10.1016/j.nepr.2015.02.004