ABSTRACT
This first-person narrative describes some of the barriers to caring well for patients at the intersection of human trafficking and substance use disorder. I canvass some of the ethical considerations regarding these patients' autonomy and call for establishing and using evidence-based practice to manage these complex scenarios.
Subject(s)
Evidence-Based Nursing/ethics , Human Trafficking/ethics , Human Trafficking/psychology , Personal Autonomy , Substance-Related Disorders/nursing , Substance-Related Disorders/psychology , Survivors/psychology , Adult , Female , Humans , Nurse-Patient Relations , Nursing Staff, Hospital/psychology , United States , Young AdultABSTRACT
THE DRAFT Nursing and Midwifery Council (NMC) code of conduct sets out how nurses should behave and should be the document to inspire nurses towards excellence. In reality, it falls rather short of that and seems, at times, to be lengthy, repetitive, rather obscure, bland and agree to a low benchmark of performance.
Subject(s)
Benchmarking , Ethics, Nursing , Nurse's Role , Nurses, Pediatric , Benchmarking/ethics , Evidence-Based Nursing/ethics , Female , Humans , Nurses, Pediatric/ethics , Precision Medicine/ethics , Precision Medicine/nursing , Pregnancy , United KingdomSubject(s)
Ethics Committees, Research/organization & administration , Evidence-Based Nursing/organization & administration , Nursing Research/organization & administration , Quality Improvement/organization & administration , Evidence-Based Nursing/ethics , Human Experimentation/ethics , Human Experimentation/standards , Humans , Nursing Research/ethics , Nursing Research/standards , Research Subjects , United StatesSubject(s)
Breakthrough Pain/nursing , Personal Autonomy , Aged , Aged, 80 and over , Ageism/ethics , Ageism/psychology , Ethics, Nursing , Evidence-Based Nursing/ethics , Geriatric Assessment , Humans , Palliative Care/ethics , Patient Education as Topic/ethics , Patient Participation , SwitzerlandABSTRACT
Ethical issues relating to infant relinquishment, caring for culturally diverse women, the importance of shared power between women and their caregivers, and the provision of evidence-based practice versus reliance on obstetric conveniences are addressed in this article. Respectful care of women relinquishing their infants including use of appropriate language demonstrates moral and ethical nursing practice; providing cultural competent care of multilinguistic, multicultural, and multiethnic childbearing women and their families is an ethical imperative. Nurses practicing ethically will foster adoption of best practices on perinatal and neonatal units, and generate a clearly articulated vision of woman and family centered organizational culture. In ethical terms, this demonstrates respect for others as well as beneficence. Promoting the use of ethical nursing practice and evidence-based practice requires that nurses identify change agents, those who are champions and facilitators of evidence-based practice, and then reward such innovators and make sure that clinical guidelines be developed based on best practices.
Subject(s)
Adoption , Cultural Diversity , Culturally Competent Care/ethics , Ethics, Nursing , Evidence-Based Nursing/ethics , Neonatal Nursing/ethics , Obstetric Nursing/ethics , Adult , Education, Nursing, Continuing , Female , Humans , Male , Nurse's Role , Nurse-Patient Relations , PregnancyABSTRACT
We examine problems resulting from the narrow empirical focus associated with evidence-based nursing, including the deleterious influence of vested interests, disattention to patients' experiences, underestimation of the importance of social processes, lack of an individualized research perspective, marginalization of other forms of knowledge, and the undermining of patients' autonomy. Addressing each problem in turn, we argue that inclusion of patients at all stages of evidence-based practice can counter or ameliorate these problems. While we concede that patient involvement is not a complete solution to the problem of empiricism, it is the most effective means available to defend nursing values.
Subject(s)
Empirical Research , Evidence-Based Nursing/ethics , Nursing Research/ethics , Patient Participation , Social Values , Humans , Morals , Personal Autonomy , Social Responsibility , United KingdomSubject(s)
Ethics, Research , Evidence-Based Medicine/education , Evidence-Based Medicine/ethics , Evidence-Based Nursing/ethics , Midwifery/education , Midwifery/ethics , Delivery, Obstetric/nursing , Evidence-Based Nursing/organization & administration , Humans , Nursing Methodology Research/ethics , Practice Guidelines as TopicSubject(s)
Child Advocacy/standards , Human Experimentation/standards , Nurse Practitioners/organization & administration , Nursing Research/organization & administration , Pediatric Nursing/organization & administration , Child , Child Advocacy/ethics , Child Advocacy/legislation & jurisprudence , Confidentiality/ethics , Confidentiality/legislation & jurisprudence , Ethics Committees, Research/ethics , Ethics Committees, Research/organization & administration , Evidence-Based Nursing/ethics , Evidence-Based Nursing/organization & administration , Human Experimentation/ethics , Human Experimentation/legislation & jurisprudence , Humans , Minors/legislation & jurisprudence , Nurse Practitioners/ethics , Nurse's Role , Nursing Research/ethics , Parental Consent/ethics , Parental Consent/legislation & jurisprudence , Pediatric Nursing/ethics , Safety Management/ethics , Safety Management/organization & administrationABSTRACT
This article reconsiders the fundamental patterns of knowing in nursing in light of the challenge of narrow empirics in the form of evidence-based practice. Objections to the dominance of evidence-based practice are reviewed, and the reasons for it are examined. It is argued that it is partially the result of weaknesses in the alternative patterns of ethical, personal, and esthetic knowing, the ineffability of which compromises accountability. This ineffability can be countered only by introducing a wider form of empirics than countenanced by evidence-based practice into all patterns of knowing, to demonstrate their salience and to make their use in practice transparent.
Subject(s)
Evidence-Based Nursing/organization & administration , Knowledge , Models, Nursing , Nursing Process/organization & administration , Nursing Research/organization & administration , Empathy , Empirical Research , Esthetics , Evidence-Based Nursing/ethics , Humans , Nurse's Role/psychology , Nurse-Patient Relations , Nursing Process/ethics , Philosophy, Nursing , Postmodernism , Research Design , ScienceABSTRACT
Evidence-based practice (EBP) has become a dominant epistemology in nursing education, and has devalued the complex interpersonal components of mental health nursing. A curriculum for mental health nursing, which values the personhood of service users, should focus on those processes that promote recovery within a therapeutic relationship committed to collaboration and respect for diversity. These relationships become possible where the preparation of mental health nurses for practice includes an examination of self in terms of beliefs and values and their consequences on others. The combination of action and reflection in praxis provides a means by which self-examination and professional obligation can be examined in order to construct a moral identity, which is responsive to the needs of people with mental health problems. Praxis is more than a means of reflecting on practice: it draws together skill, practice knowledge, attitudinal style, and moral reasoning. For this reason, ethical values have a vital role to play in the development of contemporary nursing praxis.