is to discuss the nurse leader's role in ensuring congruence between caring missions and caring practices. Ethical principles are discussed as the foundation necessary for creating an ethical climate for nursing practice. Components of ethical climate are presented and strategies to create a positive ethical climate for nursing practice are provided....

The idea that nurses should be trustworthy seems to be accepted as generally unproblematic. However, being trustworthy as a nurse is complicated because of the diverse range of expectations from patients, relatives, colleagues, managers, peers, professional bodies and the institutions within which nursing takes place. Nurses are often faced with competing demands and an action perceived by some as trustworthy can be seen by others as untrustworthy. In this article some of the reasons for the importance of being trustworthy are (...) offered together with a preliminary discussion about how being a trustworthy nurse is far from straightforward. (shrink)

Good work in nursing is work that is scientifically effective as well as morally and socially responsible. The purpose of this study was to examine variables that sustain good work among entering nurses (with one to five years of experience) and experienced professional nurses despite the obstacles they encounter. In addition to role models and mentors, entering and experienced nurses identified team work, cohesiveness and shared values as levers for good work. These nurses used prioritization, team building and contemplative practices (...) to overcome obstacles. Entering professional nurses tended to avoid conflict in the work setting. Experienced nurses reported forming teams of decision makers who share similar values to resolve conflict. These findings have implications for nurse education and nursing practice. Reflection on the importance of values and virtue in sustaining good work is important. Entering professional nurses should be encouraged to seek positive role models and reflect on the lessons that can be learned from experienced exemplary nurses. (shrink)

The best interests principle is commonly utilized in acute care settings to assist with decision making about life-saving and life-sustaining treatment. This ethical principle demands that the decision maker refers to some conception of quality of life that is relevant to the individual patient. The aim of this article is to describe the factors that are required to be incorporated into an account of quality of life that will provide a morally justifiable basis for making a judgement about the future (...) quality of life, and therefore the best interests, of critically ill patients who are mentally incompetent. This account consists of three major components - pain and suffering, body functioning, and autonomy - and is applicable in situations where very limited information is available to guide decision making. This framework helps to make decisions about the provision of life-saving treatment that are as consistent as possible in all patient situations. (shrink)

The purpose of this article is to discuss an external whistleblowing event that occurred after all internal whistleblowing through the hierarchy of the organization had failed. It is argued that an organization that does not support those that whistle blow because of violation of professional standards is indicative of a failure of organizational ethics. Several ways to build an ethics infrastructure that could reduce the need to resort to external whistleblowing are discussed. A relational ethics approach is presented as a (...) way to eliminate the negative consequences of whistleblowing by fostering an interdependent moral community to address ethical concerns. (shrink)

Ethical issues arise for nurses involved in all phases of clinical trials regardless of whether they are caregivers, research nurses, trial co-ordinators or principal investigators. Potential problem areas centre on nurses’ moral obligation related to methodological issues as well as the notions of beneficence/non-maleficence and autonomy. These ethical concerns can be highly upsetting to nurses if they are not addressed, so it is imperative that they are discussed fully prior to the initiation of a trial. Failure to resolve these issues (...) can place both the conduct and the results of research in jeopardy. (shrink)