“What’s love got to do, got to do with it? What’s love, but a secondhand emotion?
What’s love got to do, got to do with it? Who needs a heart when a heart can be broken?”
These lyrics from Tina Turner’s 1984 song pop into my head unbidden from time to time as I review my day or reflect on my nursing practice.
These lines are inevitably followed by a segment of Crazy by Gnarls Barkley, “Ha ha ha, bless your soul. You really think you’re in control.” As I reflect on the possibility that being in control in healthcare is a façade, I’m prompted to remember why I entered and remain in nursing: love. Love for humanity, rooted in recognition of the love that Jesus Christ extended to me, is the template for my nursing practice, which, to my mind, easily encompasses the ideals of nursing.
Recently, I read Grace and Milliken’s Clinical Ethics Handbook for Nurses (2022) along with several other nursing ethics books. I appreciated how different authors grounded ethical terms in moral philosophy and nursing practice to bring clarity to what it means to be a “good” nurse:
Because nursing is one of the healthcare professions that provides an important human service and came into being to meet healthcare needs that were not otherwise met, nursing actions are aimed at providing a benefit (a “good” in ethical terms). Thus, we can assert that the profession is intrinsically ethical in nature. (Milliken & Grace, 2022)
This is a bold statement. When we embrace this truth, we can respond to complex daily challenges. For all nurses, nursing actions are directed by our codes of ethics. Readings from wise nurse ethicists remind me of skills that help us discern what nurses can collectively and individually be responsible for in complex ethical situations. I offer these suggestions as a starting point for navigating complex ethical issues:
- Be realistic about your sphere of influence and expectations. For example, if your work area is often understaffed but you’re not in a position to authorize increased staffing, use all available avenues to advocate for more staff. Leave the outcome and consequences with those in authority for human resources and funding.
- Lean on the values of nursing and your code of ethics as you navigate complex care issues.
- Practice self-reflection to learn about your own values, motivations, and expectations (of self and others). Our personal motives or expectations can blind us to what actions are in the best interests of patient(s).
- Develop self-awareness so you can distinguish and separate emotional from rational responses (but remember, you need both to take effective action). Healthcare settings are rife with emotion which can influence ethical decision-making.
- Develop moral sensitivity. First, increase your ability to recognize and name the values conflicts that cause some vague dis-ease. Then name, discuss, and address everyday ethics to build the foundation for taking both big and small actions to address ethical issues.
- Develop effective communication skills. Emotional responses can contribute to communication that silences problem solving. Gain core skills that help you clearly communicate questions or concerns.
- Practice decisions are not fundamentally based on cost-saving or economic values. The ‘good” in nursing is about benefiting the patient(s) or person(s) in front of you.
When overwhelmed by complex ethical nursing situations, I consider what I’ve learned about taking action. I want to take big, impressive action; most often, though, my actions are small, directed at the person in front of me, rooted in my own experience of Jesus Christ’s love. Fr. Stephen Freeman reminds us how to act: “We turn to Christ and wonder, ‘What should we do?’ The answer, I think, is simple and immediate: Do the good that lies at hand.
Freeman, S. (2020, August 12). Doing the good you can do. Ancient Faith Ministries. https://blogs.ancientfaith.com/glory2godforallthings/2020/08/12/doing-the-good-you-can-do/
Milliken, A., & Grace, P. J. (2022). Developing ethical awareness and ethical sensitivity (pp. 21-33). In P. J. Grace & A. Milliken (Eds.). Clinical ethics handbook for nurses. Springer.
Read the full article by Lynn Musto, PhD, RN, RPN, in the April/June 2023 Ethics column of the Journal of Christian Nursing.
Dr. Musto is an assistant professor in the School of Nursing at Trinity Western University, Langley, BC, Canada. Her scholarship focus is healthcare professionals’ moral agency, moral distress, and maintaining ethical practice.