Nurses can have critical impact on ethical issues prevalent in healthcare system

For years people have known of the positive impact nurses can have on the physical and mental well-being of their patients. Now, research being done at the UCLA School of Nursing is showing that nurses can have a critical impact on the many ethical issues patients and their caregivers encounter in the growingly complex world of medicine.

"Nurses are in a unique position to work within healthcare teams and influence the course of troubling ethical situations by being sensitive to early indicators of potentially difficult ethical questions," said Carol Pavlish, Ph.D., RN, assistant professor at the UCLA School of Nursing. "Initiating early ethics consultation and intervention can greatly diminish the potential for patient and family suffering as well as for nurses' moral distress."

Pavlish and colleagues will present their findings at the 2011 American Nurses Association National Nursing Ethics Conference on March 24 at the Hilton Los Angeles/Universal City. The two-day meeting focuses on ethical issues prevalent in today's healthcare system and seeks to provide an opportunity for in-depth engagement with these issues.

Pavlish's findings are the result of a research study she conducted in collaboration with the UCLA Healthcare Ethics Center that looked at ethically difficult situations, their risk factors, nurse actions and related outcomes. Most of these situations pertained to end-of-life cases for children and adults. The study has been published in The Journal for Nursing Scholarship.

"Our study showed that unless ethically challenging situations are managed effectively, they often escalate into more complicated issues that erode confidence and result in compromised care," said Pavlish. "Nurses are in a key position to recognize vulnerable patients, advocate on their behalf, and serve as an important liaison between the patient and other members of the caregiving team."

Pavlish said that although the American Nurses Association Code of Ethics provides guidance for nurses' moral actions, many nurses have little knowledge regarding the content of these codes. As a result, many nurses reported "feeling powerless" in the face of ethical conflict, leading Pavlish to believe that further work to develop interventions that strengthen nurses' voices in ethically difficult situations is warranted.