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Ethically speaking: Respect is necessary

Sunday June 22, 2014
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Hypothetical case

Amanda is in the 12th month of a 16-month accelerated second degree BSN program. Her life has never been more stressful. Married with twin 3-year-old sons, Amanda is struggling to meet her family and academic responsibilities. Not surprisingly, she is finding herself impatient with everyone — and she is not sure she likes the person she is becoming. Many of her classmates tell her that they’ve “put their families on hold” until getting their BSNs, but how do you put 3-year-olds “on hold”? This semester Amanda is carrying 18 credits, which include two clinical courses — and lots of theory. She must also produce a capstone project, which demonstrates her ability to use research to address a pressing clinical issue.

Scenario 1

Showing up for an evening ED clinical rotation, Amanda gets report from a seasoned ED nurse who tells her, “Tough luck this evening, you’ve got two dillies — don’t expect to learn anything. The man in cubicle three is a homeless drunk who comes in periodically on cold nights for a warm bed and meal. Hold your nose when you go in. Try to get him cleaned up. As for the old bat in cubicle eight, she’s just crazy, and we think her family dumped her here because they needed a break!” Amanda finds her instructor and can’t help loudly voicing her frustration, “What do you think I am — a nursemaid? What am I supposed to learn this evening?”

Scenario 2

The next morning the instructor for the complex problems 2 class expresses her disappointment in the class as she returns the first exam, telling the students that if they don’t study harder they’ll never pass the NCLEX. This is the last straw for Amanda, and she begins to criticize the class, the teacher and the program. Soon many voices have joined hers — all loudly critical and anything but professional.

Professional Nursing Practice

“The Essentials of Baccalaureate Education for Professional Nursing Practice” lists human dignity as one of the five professional values that epitomize the caring, professional nurse. “Human dignity is respect for the inherent worth and uniqueness of individuals and populations. In professional practice, concern for human dignity is reflected when the nurse values and respects all patients and colleagues (AACN, 2008, p. 27).”

In both scenarios there are serious breaches of respect for the inherent worth and uniqueness of individuals. The ED nurse did Amanda a disservice by negatively and unprofessionally predisposing her before she met her patients. As the seasoned nurse, he should have used respectful language to describe these individuals and their needs for nursing care. While repulsion and frustration are natural human responses, professional nurses are expected to rise above these feelings and to summon deep respect for each patient, family and community.

Similarly, Amanda’s instructor needs to reflect on how she communicated her disappointment in the class, and Amanda and her classmates need to rethink their responses. A gripe session can relieve built up pressure, but it also can irreparably poison the learning environment. Civility has become a hot topic in nursing education.

Writing in the National Student Nursing Association journal, Imprint, Susan Luparell (2008) states “the single greatest ramification of incivility is that it steals the joy for who we are and what we do. Nursing is a grand profession, one that is capable of producing much joy in our lives. We should never stop feeling that (AACN, 2008, p. 46)”.

Amanda and her classmates need to reflect on these experiences and try to understand them so that they can learn how to respond differently in the future. Nurses often are in stressful personal and work situations, but these are never excuses for disrespectful and unprofessional conduct.

Sources

American Association of Colleges of Nursing. (2008).

The Essentials of Baccalaureate Education for Professional Nursing Practice. Washington, DC: Author.

Luparett, S. (April/May 2008). Incivility in nursing education. Let’s put an end to it. NSNA Imprint, 42-46.

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Carol Taylor, RN, PhD, professor of nursing, Georgetown University School of Nursing and Health Studies, and senior scholar, Kennedy Institute of Ethics. Post a comment below or email specialty@nurse.com.