近二十年来，护士在Gallup’s annual poll在最诚实和道德的专业中，超越了医生，学历的老师，甚至是神职人员。而且，随着大流行的继续，公众对护士的看法只得到了改善。
But nursing’s longstanding title as the最值得信赖的职业isn’t by chance.
Since the days of Florence Nightingale, nurses have adhered to strict codes of ethics and guiding principles to ensure every decision they make is in the best interest of the patients they serve. A commitment to ethics in nursing is also a key distinction among hospitals that have earned theMagnet®指定.
But what does ethics in nursing mean, and what does it look like in practice?
《护理道德准则》是什么？
Often considered the original nursing code of ethics, the “Nightingale Pledge” was developed in the late 1890s. This pledge focuses on abstaining from anything “deleterious,” never knowingly administering harmful drugs, elevating the standard of the profession, and acting as a “missioner of health.” For more than 120 years, graduating nursing students have dutifully recited this pledge.
但是，在1950年，美国护士协会（ANA）为护士制定了更正式的道德准则。在过去的几十年中，该文档已经过多次修改，在2015年，ANA添加了九种解释性陈述和规定，以增加额外的清晰度（which can be found here).
此外，ANA在护理方面制定了四个道德原则：
- Respect for Autonomy
护士应确保患者拥有所有必要的信息来决定其医疗服务，并且不应尝试影响他们的选择。 - 非遗憾
护士should never intentionally do harm or act with negligence and always strive to avoid or reduce risks. - Beneficence
护士should act with kindness, charity, and act in ways that benefit others. - Justice
无论患者的社会经济地位，性取向，种族，种族等如何，护士都应该是公平和公正的。
了解道德规范可以帮助护士驾驭其角色的日常复杂性。但是，要使护士成功，他们的雇主为他们的支持至关重要。赚取并保留一些highly sought-after名称，医院通常建立一个道德委员会（包括多个护士），以帮助确保所有护士在ANA的护士道德规范中都受过良好的教育。
Of course, even after years of training and experience, nurses should never be expected to know precisely what to do in every ethical situation. After all, as we’ve experienced in the past year and a half, broad-reaching and unforeseen circumstances can sometimes muddy the waters and force medical professionals to make impossible decisions.
If a nurse experiences a complicated ethical dilemma, they should consult the code of ethics. If they’re still uncertain, they should consult their organization’s ethics committee.
常见的护理中道德困境的例子
护士encounter all sorts of challenges on a regular basis. Here are a few common护理中的道德困境。
- Patients Refusing Treatments
In some cases, and for various reasons, patients may refuse a treatment, medication, or care plan. In these instances, nurses may提供其他信息, but should not attempt to influence or coerce the patient. Ultimately, nurses must accept their patients’ decisions. - 观察同伴中的无能或有害行为
If a nurse sees a fellow member of a care team behaving in a way that’s unethical, inept, or a threat to patient safety, they must report it. Again, consulting the code of ethics or the organization’s ethics committee are options if you are unsure. - 建立边界
在某些最具挑战性和最脆弱的时刻，护士在患者那里。在某些情况下，这可能导致患者对护士提出不切实际的需求或试图跨越专业界限。护士不应超越自己的专业能力，实践范围或护士患者的界限，例如浪漫地参与患者或接受个人礼物。 - 尊重宗教信仰和/或灵性的差异
Some patients hold religious beliefs or spiritual convictions that may impact how they want to be cared for - for example, some religions restrict life-saving interventions. Additionally, some medical interventions may be outside a nurses’ spiritual or religious beliefs. Regardless of the circumstances, nurses are expected to reduce patient suffering and respect patients’ religious beliefs, lifestyles, and value systems. Nurses must respect others’ choices and beliefs even if they don’t condone them.
护理中的道德规范可能很复杂，在某些情况下，感觉就像没有“正确”的答案。但是，通过为护士提供资源和支持，医院可以确保其护理团队对患者的最大利益行事，并取得更好的结果。
要了解有关赚取（并保留）磁铁名称所需的更多信息，请查看我们的电子书，Achieving Nursing Excellence.
