Myrna Noel
The profession of nursing like many other professions has its own set of ethics. Articulating the values of nursing and maintaining nursingâs integrity spans across many ethical dilemmas and links all ethical provisions into one. Ethical dilemmas such as chemically impaired nurses, whistle-blowing, and collective bargaining and the professional nurse pose situations to which individual nurses have to contend with on a regular basis.
We live a drug/alcohol oriented society. Most of us are raised observing adults using drugs or alcohol for a variety of occasions and circumstances; celebrations, stress relief, etc. So it is my position that in order to fully address the issue of chemically impaired nurses, the first step is to keep in mind that drug and alcohol use is a socially approved activity and that drug and alcohol use leads to abuse and dependency.
The investment that nurses make to become a nurse and the services that nurses provide lends itself to assisting the chemically impaired nurse to address his or her issues of addiction in a non-judgmental/supportive atmosphere. Referrals to organizations such as Narcotics Anonymous or Alcoholicsâ Anonymous should be made. However, it is also imperative to send a strong message to the nurse that chemical impairment will not be tolerated because it is dangerous! Confronting co-workers (reasonably) and reporting co-workers to immediate supervisors when the suspicion or observance of addiction helps to maintain the integrity of the nursing profession and is the responsibility of each and every nurse in order to maintain patient safety.
Despite the highly detailed, ethical, terminology that is used in many health care organizational mission statements, grave injustices, and just plain wrongdoing occurs. What some may view as human weaknesses results in acts which range from stealing, to cover ups, to murder. Persons who provide health care services such as nurses are in a precarious situation when they come across these violations because on one hand it is their ethical duty to maintain the integrity of the profession and on the other is personal risk. After the appropriate channels are used to alert those in higher level managerial and administrative positions of legal violations, the only other remedy a nurse can resort to many times is whistle-blowing.
The road is tough for whistle-blowers because they are a part of the people they work with. A relationship of trust is often violated and an individual who should be designated as a hero often times is labeled a âsnitchâ or informer. In addition, a whistle-blower can lose their job, get black listed, and suffer professional isolation and ridicule. Indeed, nurses who become whistle-blower must have unwavering resolve, bravery, and commitment to nursing ethics.
The United States like other countries in the Western world has a long history of labor struggle starting with slavery. The labor struggle is essentially a struggle between labor and management or ownership. One of the more stressing issues with the nursing profession in regards to labor unions is the collective bargaining process which many times uses the strategy of âstrikeâ.
From an ethical point of view, collective bargaining in the nursing profession has created a big divide with those who see the process as a benefit to patients because fairer compensated nurses will take better care of patients while on the other hand, some nurses see collective bargaining and labor unions as entities that are for âblue collar workersâ, not professionals such as nurses. In addition, there is also the issue of jeopardizing the safety of patients if nurses go on strike.
There is no easy answer to collective bargaining and the specific dimensions that are played out in the nursing profession. Articulating the values of nursing and maintaining the integrity of the nursing profession support both sides of this issue and because of this there is no easy answer.
In ending, ethical dilemmas in nursing are realities which will continue. The nursing profession must continue to strive for autonomy and come to conclusions to address these dilemmas through a constant review and constant redefining of what it means to be a nurse.
Reference
American Nurses Association. (2001). Code of Ethics for Nurses with Interpretive Statements.
Retrieved from http://www.nursingworld.org/codeofethics
Huston, C. J. (2006). Professional issues in nursing: Challenges & opportunities. Unit 4: Legal
and Ethical Issues, p.293-345. Philadelphia: Lippincott Williams & Wilkins.
