Introduction
Nurse leaders practice in challenging environments that can lead to moral distress when a person knows how to perform a morally justified action but cannot do it. Nursing practice is also an area where ethical dilemmas can often arise. The success of resolving ethical dilemmas depends on the personal courage that nurses must show to effectively provide proper care. The 4A’s Framework strategy to reduce stress among healthcare workers can be used to increase moral courage in nurse leaders.
The Sources of Ethical Dilemmas
Ethical dilemmas for nurse leaders can arise when organizational commitment conflicts with the duty to patients and moral distress prevents an appropriate resolution. The primary source of ethical dilemmas is the collision with interpersonal values (Edmonson, 2010). The emotional characteristics of the nursing job provoke constant clashes between people who have their own definitions of right and wrong actions (Edmonson, 2010).
The nature of the profession provokes ethical dilemmas, the growing complexity of healthcare in an environment of limited resources, and constant globalization. At the same time, the vagueness of roles and the distribution of power provoke the suppression of the nurse leader’s personal values (Edmonson, 2010). The result of constantly being confronted with ethically complex issues is moral distress, which can lead to burnout.
Ways for Handling
The main way to effectively resolve emerging ethical dilemmas should be to increase moral courage. This can be done by encouraging expressions of the nursing voice, asserting boundaries, and advocating for patient rights. To withstand moral difficulties, the nurse leader must encourage concern for psychological well-being (Edmonson, 2010). By establishing an ethical framework and focusing on the paramount importance of patient care, the nurse leader can also address dilemmas more effectively (Edmonson, 2010). It is also important to create the ground for developing partnerships to encourage and support medical workers.
The 4A’s concept is a stress reduction model suitable for nursing leaders. It consists of four steps: ask, affirm, assess, and act. The first step allows nurses to find and identify the source of stress (Edmonson, 2010). After this, the nurse leader must confirm responsibility for eliminating moral distress (Hickey, 2022). Once moral distress is confirmed, the nurse leader performs an assessment process based on critical thinking and high skills (Edmonson, 2010). The action involves controlling fear and creating the opportunity and environment for success. The proposed four steps help reduce moral distress for nurses.
Recommendations
Nurse leaders are responsible for creating a nursing culture. They must support medical personnel and help them combat moral distress (Edmonson, 2010). To do this, it is necessary to understand the source of nurses’ current moral distress. Then, the nurse leader is required to create a professional culture and maintain healthy practices. Identifying an appropriate model for increasing personal moral courage and gaining knowledge of ethical theory will reduce moral distress (Edmonson, 2010). The phased implementation of the nurse assistance program will improve the well-being of medical staff and patients.
Conclusion
Due to the nature of their work, nurse leaders often face ethical dilemmas and moral distress. To minimize this adverse psychological effect and keep patient care at a high level, it is necessary to develop nurses’ moral courage. The nurse leader can facilitate this by creating a supportive culture, encouraging personal responsibility, and addressing the source of moral distress in a particular healthcare setting.
References
Edmonson, C. (2010). Moral courage and the nurse leader. Online Journal of Issues in Nursing, 15(3), 1-13. Web.
Hickey, J. (2022). Interventions to reduce nurses’ moral distress in the intensive care unit: An integrative review. Dimensions of Critical Care Nursing, 41(5), 274-280. Web.