U.S. nursing leaders issue blueprint for 21st century nursing ethics

The report captures the discussion at the first National Nursing Ethics Summit, held at Johns Hopkins University in August. Fifty leaders in nursing and ethics gathered to discuss a broad range of timely issues and develop guidance. The report, A Blueprint for 21st Century Nursing Ethics: Report of the National Nursing Summit, is available in full online at www.bioethicsinstitute.org/nursing-ethics-summit-report. It covers issues including weighing personal risk with professional responsibilities and moral courage to expose deficiencies in care, among other topics.

An executive summary of the report is available at: http://www.bioethicsinstitute.org/wp-content/uploads/2014/09/Executive_summary.pdf

"This blueprint was in development before the Ebola epidemic really hit the media and certainly before the first U.S. infections, which have since reinforced the critical need for our nation's healthcare culture to more strongly support ethical principles that enable effective ethical nursing practice," says Cynda Hylton Rushton, PhD, RN, FAAN, the Bunting Professor of Clinical Ethics at the Johns Hopkins School of Nursing and Berman Institute of Bioethics, and lead organizer of the summit.

The report makes both overarching and specific recommendations in four key areas: Clinical Practice, Nursing Education, Nursing Research, and Nursing Policy. Among the specific recommendations are:

• Clinical Practice: Create tools and guidelines for achieving ethical work environments, evaluate their use in practice, and make the results easily accessible.
• Education: Develop recommendations for preparing faculty to teach ethics effectively
• Nursing Research: Develop metrics that enable ethics research projects to identify common outcomes, including improvements in the quality of care, clinical outcomes, costs, and impacts on staff and the work environment
• Policy: Develop measurement criteria and an evaluation component that could be used to assess workplace culture and moral distress

What does this blueprint mean for nurses on the front line?

"It's our hope this will serve as a blueprint for cultural change that will more fully support nurses in their daily practice and ultimately improve how healthcare is administered -- for patients, their families and nurses," says Rushton. "We want to start a movement within nursing and our healthcare system to address the ethical challenges embedded in all settings where nurses work."

On the report's website, nurses and the public can learn more about ethical challenges and proposed solutions, share personal stories, and endorse the vision of the report by signing a pledge.

"This is only a beginning," says Marion Broom, PhD, RN, FAAN, Dean and Vice Chancellor for Nursing Affairs at Duke University and Associate Vice President for Academic Affairs for Nursing at Duke University Health System. "The next phase is to have these national nursing organizations and partners move the conversation and recommendations forward to their respective constituencies and garner feedback and buy-in. Transformative change will come through innovative clinical practice, education, advocacy and policy."

At the time of publication, the vision statement of the report has been endorsed by the nation's largest nursing organizations, representing more than 700,000 nurses:

• American Academy of Nursing
• American Association of Critical-Care Nurses
• American Nurses Association
• American Association of Colleges of Nursing
• American Organization of Nurse Executives
• Association of Women's Health, Obstetric and Neonatal Nurses
• The Center for Practical Bioethics
• National League for Nursing
• National Student Nurses' Association
• Oncology Nursing Society
• Sigma Theta Tau International

An updated list, including individual endorsers, is available at: http://www.bioethicsinstitute.org/nursing-ethics-summit-report/nursing-ethics-for-the-21st-century-collaborating-partners