Management Issues and Practices in Nursing

Introduction

As with most other professions, all nursing profession practitioners are bound by rules and regulations that govern how they go about their duties. These rules and regulations are sometimes legally enforceable. Nurses also face numerous ethical issues in the line of duty. While some of these ethical issues are resolved by following the ethical standards and guidelines for nurses, others rely primarily on the nurses’ principles and value system to be solved. These values may sometimes not be in line with the legal obligations of the nurse. Legal standards stipulate what is right or wrong according to the laws of the land whereas ethics are standards for professional behavior. Johnstone (2008) articulates that while ethical standards that hinge on personal beliefs and principles may suffice when caring for a loved one in a home setting, they may not be irrefutable when dealing with strangers in the work environment.

This paper shall set out to give a detailed and conclusive description of an ethics program that should be implemented by nurses as they carry out their day-to-day activities. Personal values and professional ethics that are paramount in the nursing practice shall also be identified and duly outlined. The paper shall also examine the strategic planning that should be utilized by the program coordinator in a bid to ensure that the program yields the desired results. In addition to this, it shall highlight the most appropriate leadership style that should be employed by the coordinator to ensure that the employees work towards achieving the set goals and objectives to be enforced by the program. The various tools and techniques that can be used to facilitate due diligence towards the program shall also be discussed and the methods used to discourage nonconformity addressed. Recommendations shall also be made in regards to how best this program should be maintained to ensure that it works towards the betterment of the organization as well as the workforce.

Program overview

Professional ethics are those ethics that are stipulated by professional nursing bodies e.g. the International Council of Nurses which endorses the international codes of ethics for nurses and the American Nursing Association. They state the expected professional behavior which should be exhibited by a nurse in his/her duties. According to the International code of ethics for nurses, the nurse’s fundamental responsibilities include promotion of health, prevention of illness, restoration of health, and the alleviation of suffering. With such responsibilities, and ethics program plays a pivotal role in ensuring that nurses respect and uphold the sacred right that is life.

Considering the professional manner in which nurses are expected to act, it may be argued that personal ethics should only play a secondary role in the decision-making process of the nurse since they sometimes hold no scientific backing. However, total disregard for one’s belief system may lead to psychological disturbances and hence greatly affect the productivity of the nurse (Nemie, 2009). Therefore due merit should be given to the establishment of an ethics program.

Strategic planning process

David (2006), states that Strategic planning plays a pivotal role in ensuring that an organization focuses on its set goals and objectives. Additionally, he claims that strategic planning acts as guidelines, and as a result, it adds value to the operations being undertaken by the organization. In this case, the best way to ensure that the program is successful would be to divide the whole process into stages. The “Name of the program, Action Plan description, Scope of the action plan, resources required, Start date, Finish date and success measure, and the program manager should be included in an action plan if it is to succeed” (Sabath 2002, p.212). By carefully considering these aspects and setting the time frame required for the full implementation of the program, the employees can adjust their schedules to meet the set goals and objectives. The success measure would be very effective in the monitoring and analyzing processes required in gauging the effectiveness of the program. Therefore, the use of this strategic plan will ensure that the program yields the desired outcome.

Implementation of the program

To ensure that all workers abide by the program requirements, it should be noted that it is a term and condition of employment that all prospective and current employees conform to this program. This must also be reflected in all employment contracts provided by the organization. In addition to this, copies of the program must be made available to all the departments of the organization and the managers of each department must take upon themselves the task of implementing reasonable measures to ensure that all employees identify with its contents. On the same note, any amendments made to the program must at all times be communicated to all employees using the available channels immediately so that the employees can review them and adjust to those changes. The channels available include internal memos, e-mails, and departmental meetings.

The importance of ethics and good conduct cannot be understated and as such, I shall devote the organization’s resources to ensure that both the new and current employees get the necessary training to adapt and maintain the desired standards of conduct and ethics. To do so, all managers are expected to organize seminars that offer different lessons in employee behavior, their roles, and obligations, guidelines to how things ought to be done, and most importantly; customer care.

In addition to this, the management has organized a schedule through which employees will in turn educate each other on the various ethical issues that affect them during their endeavors. This move aims at enhancing team building and teamwork within the organization. This is because such productive interactions provide the employees with an opportunity to learn and apply the same etiquettes when approached with similar situations thereby creating a bond forged under unity (Crisp, potter & Perry 2005).

On the same note, professional ethicists shall be invited every month to offer advice and training concerning nursing ethics and conduct. All employees are expected to attend the lectures without fail. Also, assessments in form of questionnaires shall be distributed to the employees at the end of each month to evaluate their knowledge and understanding of the designed code of ethics and conduct.

Mathieson (2006) asserts that an exemplary leader should ensure that his organization has a sense of purpose and is working towards the achievement of the organizational goals. He/she should also set out to generate and sustain trust between the administration, employees, and clients as the article demonstrate. This will result in the promotion of hope and confidence amongst the organization’s worker force. These qualities heighten the levels of optimism within the organization in times of transition (change) all the while boosting employee’s morale and guaranteeing future success in all organizational endeavors.

As such, Fullan (2007) literates that effective change can only be realized by adopting a change model that smoothly transforms the communication system without compromising the integrity and comfort of the targeted individuals (2007). The ADKAR change model is therefore the most appropriate tool for installing change in this situation. The model was developed by Prosci and was aimed at managing change on an individual level (Blokdijk, 2008). According to Blokdijk, Prosci suggested that there are five stages through which an individual can embrace change. The first one is creating self-awareness of why the change is required and necessary. Secondly is to develop the desire to support and be part of the change. The third stage is gaining knowledge of how to change. Fourthly is to believe in one’s ability to apply new skills and traits and finally input extra effort to sustain the change (reinforcement). As the program coordinator, utilization of these leadership skills will ensure that the employees view the program with optimism and have a smooth transition while adjusting to meet the required standards stipulated in the program.

Evaluation and review

The ethics program is subject to change. In any organization, there are new and differentiated opinions and developments that may affect a proposed course of action. It is therefore always important that each aspect of the organization is designed with some level of flexibility and room for change in case of such circumstances.

As the program coordinator, I have linked up with other department heads in order to establish an ethical committee within the employees whose main purpose shall be to monitor, evaluate and propose amendments to this ethics program. This is very crucial considering that each employee reacts differently to similar situations. Through interviews and open discussions between the management and employees, the committee shall be able to identify areas of strengths or weakness in the program. Additionally, the committee shall offer the employees an opportunity to air their opinion without fear or tension that is always present between employees and their superiors.

The committee shall at any time make amendments to the program to create a sense of fairness and balance in the organization. The decision to do so shall purely be based on the validity and applicability of the grievances or recommendations made by the employees and clients of the organization.

Reporting procedure and ramifications for contravention

Compliance with the ethical program by all staff members in their capacities is compulsory and dishonoring the code or the set rules and regulations shall be harshly handled. To further discourage misconduct and nonconformity to the program, these rules shall be used in the tracking and handling of those employees whose attitudes and behaviors may have detrimental effects on the program.

If an employee discovers or suspects that another staff member is going against the Code, they should immediately report this incident to the management using the available channels so that proper investigations can be initialized.

If a patient or any other interested third party insinuates a course of action that goes against the nursing code of conduct, the employee has to report the matter to the supervising manager who shall advise and devise the most appropriate course of action including termination of the ongoing or future treatments and transactions. If a breach of ethics is found to have transpired, disciplinary measures will be taken which could lead to the suspension or termination of employment, as well as the opening of civil and/or criminal actions.

In cases where an employee is suspected to be involved in any misdemeanor then an investigation shall ensue and only after the investigation should the appropriate leaders decide on the form of punishment that should be applied according to the intensity of the crime. Failure or delay to inform the management of unethical issues is also viewed as a contravention that can result in disciplinary measures.

Employees who are not certain of a course of action should seek advice from their supervisors or program manager. This especially applies to situations where the situation presents an opportunity for conflict of interest. The enforcement of these rules and regulations will ensure that the employees abide by the program and do not even contemplate contravention.

Conclusion

Nursing ethics have become a vital aspect of the management strategies and development of medical organizations across the globe. Data collected indicate that without such ethical standards, patients and the environment would be at the mercy of business merchants who evidently would do anything to make more money. As such, an elaborate and informative discussion has been held in a bid to analyze the importance, impacts, and implementation of a nursing ethics program that can be used to maintain moral standards in terms of quality and behavior of an organization. An analysis has also been carried out on the basis and necessity of ethics in a medical setting and recommendations made on how best these ethics can be implemented and monitored. The establishment of such will with no doubt help make the medical arena an ethical and morally upright place to be even for the generations to come.

References

Blokdijk, G. (2008) Change Management 100 Success Secrets – The Complete Guide to Process, Tools, Software and Training in Organizational Change Management. USA, Lulu.com.

Crisp, J, Potter, P, A. & Perry, G. A. (2005) Potter & Perry’s Fundamentals of Nursing. 2nd ed. Australia, Elsevier Australia.

David, F, R. (2006) Strategic management: concepts and cases. 10th ed. New Jersey, Prentice Hall.

Fullan, M. (2007) The New Meaning of Educational Change. USA, Teachers College.

Johnstone, M, J. (2008) Questioning nursing ethics (ethics & legal). Australian Nursing Journal. 15, p. 19.

Mathieson, F. (2006) Examining the Law and Ethics Surrounding Palliative Care. Primary health care, 16 (4), pp. 19-25.

Nemie, J, K. (2009) Challenges for the Nursing Profession in Malaysia: Evolving Legal and Ethical Standards. Journal of Nursing Law. 13 (2), pp. 54-63.

Sabath, A, M. (2002) Business etiquette: 101 ways to conduct business with charm & savvy. 2nd ed. USA, Career Press.

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