Ethics Education for Nurses: Foundations for an Integrated Curriculum

Abstract

uring the past several years, a group of nursing ethics scholars and expert educators embarked on a project to provide structure for ethics education in nursing curricula. The group convened following a recommendation from the 2016 Symposium on Transforming Moral Distress Into Moral Resilience in Nursing to "encourage nursing and ethics orga-nizations to collaborate on identifying the core components of ethics training for faculty and students" (Rushton et al., 2017). This group became the Ethics Education Subcommittee of the American Nurses Association's (ANA) Ethics Advisory Board. The project stemmed from issues identified in ethics and education literature or directly observed by the group in educational and clinical settings. Among the factors were: nurse moral distress related to perception of lack of moral agency (i.e., the ability and motivation to produce a "good"), inconsistent or inadequate ethics preparation across nursing curricula, and lack of direction about who should teach ethics for nursing practice and how it should be taught.Additionally, there are indications that requirements for both nursing ethics and health care ethics are disappearing from nursing's academic accreditation documents across the United States. The critical nature of our work became even more immediate when the American Association of Colleges of Nursing (AACN) proposed forming committees to review and update all levels of The Essentials: Core Competencies for Professional Nursing Education, referred to as the Essentials (AACN, 2021). Although our work was inspired by activities in the United States, a review of the literature revealed similar trends in many other countries.This article describes the process of our work to formulate and articulate a coherent structure for ethics education. This structure would provide a foundation across both levels of nursing curricula addressed in the Essentials (AACN, 2021): entry level, which includes prelicensure and postlicensure degree programs (p. 18); advanced level, which includes advanced nursing practice specialties ("informatics, administration/practice leadership, public health/population health, health policy" [p.

RESPONDER: A qualitative study of ethical issues faced by critical care nurses during the COVID‐19 pandemic

“…Perceived good (high quality) care and good decisions reflected some nurses' ability to overcome moral adversity and address ethical challenges. Nurses would benefit from pre‐ and post‐licensure ethics education that teaches them how to effectively respond to ethical challenges during crisis (and non‐crisis) times and would overcome noted variabilities and deficiencies in nurses' ethics education (Hoskins et al, 2018 ; Robichaux et al, 2022 ).…”

Debates as an Active Learning Strategy to Enhance Students' Knowledge of Ethics in Professional Nursing Practice and Health Care

“…The Provisions of the Code help delineate the responsibilities of the nurse, while the Statements emphasize the application of the Code to clinical practice 6,8. According to Hegge,9 ethics embedded into nursing education gives the student an understanding that the ANA Code of Ethics is in every aspect of health care, and the Code is “a succinct statement of the ethical values, obligations, duties and professional ideals of nurses individually and collectively; the profession's non-negotiable ethical standard; and an expression of nursing's understanding of its commitment to society.”6 (p8) Robichaux et al10 suggest that ethics education should be included in the curricula of prelicensure and postlicensure nursing education, inclusive of advanced practice and doctoral degree programs. They further indicate that using a multimodal approach to teaching ethics is an effective way to improve knowledge and confidence in the ethical principles of the nursing profession.…”

Operationalizing the role of the nurse ethicist: More than a job

“…49 There has been some progress in identifying undergraduate curriculum content; 25 however, this still requires support in practice integration. 50 With the wide variation in ethics education in formal training programs, the gap must be made up in post licensure education. Fortunately, there is evidence to suggest that ethics education beyond formal training likely has the greatest impact on the moral development of nurses.…”