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Ethics for Charge Nurses in Frontline Leadership

This is an excerpt from Charge Nurse Leader Program Builder.

Like your practice, your frontline leadership requires that you adhere to ethical principles (ANA, 2015). There is value added when you practice within your professional code of ethics and abide by policies, facility ethics guidelines, and legal standards, such as employee confidentiality. You often serve as advocate, negotiator, protector, preceptor, and counselor to team members, patients, and families. Additionally, you help new staff members settle into their new roles and positions and may preceptor or mentor students completing clinical assignments on your unit.

A code of ethics is a set of principles of conduct within an organization that guides decision-making and behavior (Makaroff, Storch, Pauly, & Newton, 2014). Applying ethical, legal, and policy rules is essential to the safe, effective nursing practice and leadership. Most ethics codes specify that members conduct themselves honestly, fairly, competently, and justly.

Ethics exercise: This exercise will help you consider some of these potential ethical questions and principles you may encounter as a frontline leader and ways to anticipate them with proactive problem solving (Gantt, 2014):

  • Read your specialty practice or profession’s code of ethics: What issues are discussed? What was the outcome? What might be done differently?
  • Draw on personal, practical, lived experiences: What about a situation or question was troubling? Review the Choice and Awareness Model and consider how it might apply to the ethics of the discussion or situation. This model offers one approach for ethical decision-making and working through ethical dilemmas. What other models have you used?
  • Look through books and journals on ethics that include situations testing personal or professional values, beliefs, or morals in how to perform work or interact with co-workers, colleagues, or customers/clients/patients. How do these examples fit situations you encountered during a preceptorship or mentorship? How will your decisions be affected by the ethical choices made by those in the books or journals?

Clinical Nurse Leaders, partners in quality improvement

Quality within any healthcare system depends on improving patient outcomes, which rely on continual nursing professional development and overall improvements in system performance. One of your most important resources for managing such improvements is the Clinical Nurse Leader (CNL). This clinician is a Master’s prepared Advanced Generalist nurse who builds quality measures in patient care outcomes and implements evidence-based practice principles at the clinical point of care and service. These outcomes align with the facility’s goals and strategic plan and can positively impact patient care processes.

 

For example, when working with a CNL, you can align the care team with strategic performance goals. CNLs and the Quality Systems team are important resources for strategic planning for quality and performance improvement (objectives, priorities, expectations, deliverables, and timelines). Working together, you can establish an infrastructure for engaging and motivating staff and other team members to work toward achieving improved patient care outcomes within the organization’s measures of performance. CPI only happens when everyone engages to improve management of operations and care delivery.

 

As the context of healthcare environments continually evolves and changes, your role becomes more complex and demanding. However, these growing challenges offer expanding opportunities for developing partnerships with your nurse manager, CNLs, and interprofessional team members to improve quality, practice, and competency in managing unit operations and coordinating patient care. By taking of advantage of these opportunities, you can help create a unit culture of safety, quality, and practice excellence.

Source: The Effective Charge Nurse Handbook