NEW YORK NURSE: January/February 2010
Q.: As nurses working the 3-11 and 11-7 shifts in the Emergency Room, we often see repeat visitors or “frequent flyers.” These patients may be chronic substance abusers, homeless, or suffer with multiple co-morbidities. The staffing level is usually less than optimal and these patients can be demanding and uncooperative. According to Provision One of the Code of Ethics for Nurses, we should have respect for these patients and treat them as we would any other patient. Isn’t this a bit unreasonable?
A.: Provision One of the Code of Ethics states: “The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by consideration of social or economic status, personal attributes, or the nature of health problems.”
The obligation behind this provision is based on the ideal that we treat everyone as we would want to be treated. Although this isn’t always an easy task, society has come to expect nursing to be a compassionate and accepting profession.
From a personal perspective, this could seem an unrealistic expectation, especially in our current healthcare environment. As individuals in the nursing profession, we bring along a complex array of learned, lived, and acclimated morals, values, and standards – as do our patients. We understand our patients’ rights and autonomy, but are also affected by the restraints of our past thought patterns. Patients often present to us with problems or illnesses that we may perceive as self-created or self-fulfilled. These factors could potentially put us at odds with our commitment and calling to care for those in need, and yet holds us to caring for those who are more vulnerable because of their illnesses.
The Code holds nurses to high standards and stipulates that, as professionals, we must move beyond feelings of anger, resentment, frustration, and blame and “recognize the humanity of others and respond with compassion and respect.” The five interpretative statements of Provision One bring this mandate to light. They reflect that it is a fundamental principle that nurses respect the dignity and free choice of each individual we have a professional relationship with, regardless of the nature of their health problems, and must extend this standard of conduct to our colleagues.
Although it may be a challenge to respond to every patient with the same therapeutic and healing presence, it is our shared responsibility to provide this quality of care to all. Applying ethics to our daily nursing practice may seem an unreasonable expectation, but it is both reachable and expected. Take time to reflect on your own values and on your team’s approach when faced with difficult patients and situations. This process will help you and your colleagues to realize a higher standard of care and satisfaction in your profession.
The American Nurses Association has released the Guide to the Code of Ethics for Nurses: Interpretation and Application to help nurses understand and apply the Code to the present healthcare environment. For more information on the Code of Ethics and the Guide and to purchase, go to www.nursingworld.org.
This is a sample of the questions NYSNA’s experts answer each day. The advice given is specific for the situation described and may not be applicable generally. If you have questions about your own work setting, it is recommended that you contact your NYSNA Nursing Representative or the Education, Practice, and Research Program, 11 Cornell Road, Latham, New York 12110-1499 or call 800-724-NYRN, ext. 282.