Developing Ethical Practice
In any industry, business or work, morality is a sensitive issue that needs to be personally and professionally addressed. Individuals have moral convictions as much as companies have their moral values where usually their corporate culture is based. Thus, t is important for companies to look at their moral background as this will influence the moral values of their employees. Equally, employees should share the right moral values for their company and colleagues.
Yet where before professional development revolved around trainings and educational achievements for a person to be able to propel forward in his career, today professional development embodies different aspects of growth. Apart from training, professional development now requires goal setting, research, action plans, improvements, and a never-ending learning process. Each one is a pre-requisite of the other to qualify that a person is really growing professionally and developing in his chosen industry. Moral values are integral aspects of this. (Litke, 1996)
Before, planning is a job for firm administrators. They dictate where the company is going, and where the people in it go as well. This exemplifies how the values of a company help shape the individual values of the employees. This has widely changed. Effective planning is now a personal decision of the employees. It is now their prerogative. Thus, moral values have now become an individual choice as well. In effect, these individual ethics make up the ethics in which the company dwells in. (Rennekamp, nd)
My educations influenced my ethical upbringing in a variety of ways. Throughout my school years, I had my share of challenges on my moral and ethical values. Specifically, interaction with other students tested my ability to uphold my ethical beliefs. While other students indulge in what can be considered forms of cheating, speaking ill about others, and the likes, I tried my best to avoid doing such. It is undeniable that it is not only once when I experienced such occurrences. There were also times when I failed fighting these temptations. Yet most importantly, those experiences taught me the value of friendship and camaraderie—when it is right and wrong, honesty, dignity, and strength of values.
Education has been a big part of my ethical development. My formal education and training where starting points on the way I performed and moved through my career. I received my professional certification upon passing the licensure examination of Canada in 1991, the same year after receiving my diploma in Associate Arts in Nursing. Also in the same year I was employed as a clinical nurse for the medical respiratory-cardiac unit of a hospital until 1994. After this assignment I received a position as a critical care nurse in an intensive care unit. Until now, I have been handling this type of job for intensive care units while also holding a position as an e-Nurse. All these roles challenge my morality every day. All of these also create new ethical principles to live by.
Yet school was also the one who started on building the foundation for good moral values. Teachers and instructors as well as inspiring mentors who exhibit impressive values and proper ethics in their work and in their classes are the forefront ways in which students like me learned good values. I believe that if students did not learn, then the teachers did not teach. If teachers are able to encourage their students to do and say the right things through deliberate didactic teaching and through practice and good example, then students will have a good moral foundation that they will carry on at work. Luckily, my educational experience provided me this.
At work, moral values are continually put to a test as well. Colleagues who are practicing unethical decisions at work are rampant. Patients and clients may also encourage unethical practices if its end favors them. At these times, the ethics I learned from school, from mentors, and from my colleagues during the times that I was still in school teaches the right thing to do. It takes analysis to decide how to go about the situation, but the bedrock values one learns will always reign.
In the few instances when temptation to do the immoral and unethical was too strong, the inspiration of ethical people at work also helps. When there are people in my side approving of the right action that I want to take, it is easier to choose what is right from wrong. In the same way, when more people choose what is wrong, it is harder to indulge on what is right. It takes rooted values to fight these temptations.
As a nurse, though, it is easy to choose the ethical. Varcoe et al. explains that because nurses are moral agents, their practice of ethics and values become more important than with other professions. (Module 4A, page 7) When a nurse knows this, it is harder for him to choose things that are contrary to what values dictate. Being ethical is always the thing to do.
This expectation on me as a nurse created a culture of moral, ethical, and virtue-driven focus. Thus, I have instilled in me a deep understanding of the values I have to undertake in my role as a nurse and in setting my priorities in and out of my profession. This created an identity that is unique to me, brought about by the many influences that I receive in my practice. Doane proves this. He states that identity emerges from a series of social relations. Thus, people learn their values by listening or telling stories on how one has been moral or immoral in his actions. (Module 4A, page 8, 10)
Doanne states that nurses are relational and narrative beings. Thus, nurses often learn from other people and from outside sources such as literature. He suggests that nurses should pay attention to the relationships that they maintain, the conflicts that they encounter, the feelings that they develop towards every event that they go into, and the values that they engage or disengage in. In their way they develop their role as nurses and become ready for bigger challenges in their practice. They are also encouraged to narrate their experiences to others as it will bring them forward as moral agents. (Module 4A, page 12)
I have proven these true. In fact, many of my values which I learned from work were based on the ethical principles of other people. They were mentors, colleagues, and patients who have shared their stories on how they fought the unethical and upheld their principles. As much as they inspired me and my other colleagues, they also strengthened the values that we already learned in school. They gave the reassurance that doing the right thing is the right thing.
Maintaining good values was also brought about by reflection. Just the same, self-awareness and self-definition became possible through reflection. Reflecting on everyday activities at work are good indications of one’s work values and attitudes. It will also help if a person will be able to watch or listen to recordings of own work performance which will harness an identification of faults—of strong and weak points—where improvements will be available. This is also how I was able to gauge my performance at work and how I enhanced my skills. (Continuous assessment and professional growth, nd)
According to Rennekamp (nd), professional development has several stages. In all these stages there are values inherent to an employee. There is the entry stage, the period when the employee is new to his industry and is still developing the faculties that he needs to sharpen and use in his job. Much of the ethics in this stage come from the school and the family.
The second stage is the colleague stage. This is the point when the entry-level employee has mastered his surroundings and the scope of his job. At this stage the employee is an active part of the problem-solving team and no longer the passive listener or follower. He has also found his way around several ethical standards in the company which he may have adapted. (Rennekamp, nd)
After the colleague stage is the counselor role. Here, the employee takes on a new role as a mentor to others. Leadership roles are prevalent at this stage. Apart from their regular assignments, employees in the counselor stage may take on additional tasks in leading others. They are now sharing their values to others. (Rennekamp, nd)
Finally, there is the advisor stage. In this stage the employee is no longer just an employee but an essential part in strategic planning of organizations. The employee in the advisor stage is more influential and is now a holder of more responsibilities. He also sets standards of practice rather than just encouraging others to do them. (Rennekamp, nd).
Currently, I would presume that I am in the counselor role. I have mastered my job as a critical care nurse and have created networks. I have also established myself as a nurse and have been helping others achieve as well. However, I am in the colleague stage of my e-Nursing and nursing informatics career. I have just entered this role, but I now have taken leadership roles. Despite this difference in my stages in the two job matrices that I am in, I am in the counsellor stage of my moral and ethical life at work. I learn principles every day and teach them as much to others.
There are many factors in which ones moral values are founded. Doane claims that moral identity comes from layers of influences, including the self, others, and the culture or environment in which one is in. Socialization empowers morals and ethics as much as they may disempower them. It is important for a person to have the freedom to choose how he wants to decide about a situation. Ethics cannot be practiced by mechanically teaching employees how to act, speak, or think. It takes proper integration of ethical principles and living by example to enable ethical values to be learned. (Module 4A, page 10)
Overall, ethics is an important part of work in any industry. Where there is no ethics, proper social relations is impossible. It is inevitable to be in situations calling for the unethical practices to be made. However, if the ethical is feasible, then it shall be made.
Ethics is often tested at work. There was a time when a patient who was terminally ill and was diagnosed to have just several days more to live consulted me if she should seek medical intervention for giving her earlier death. She was not in any pain only because she was practically living on pain killers. Despite her medical insurance, she also cannot sustain the monetary requirements of her illness.
The family feels otherwise. They know that every centavo that they are spending is worth it. They are confident that she will survive. She has not told them about her thoughts.
I am personally against euthanasia. Even though there are instances and occasions when it is needed, I prefer the natural way for death. It was painful to hear a patient decide that way. It was not surprising, though. Before the conversation, she has always been complaining about her medicines, her family, her illness, her life, and her finances. She was sharing that her family wants her gone. She wanted to end the pain and the pain killers.
I was not able to help but share this conviction with my patient. I told her that first, she is not in real pain and that even though her pain is only subsided because of pain killers, it should give her hopes of living; secondly, I shared her several things about life that can encourage her to go on. I told her, despite the onset of her disbelief, that there is a right time for everything. I left her room, and I know that she is dismayed.
The patient lived for almost another year. She even managed to be discharged from the hospital. After our conversation, the topic was never raised again. The family never knew about that conversation, nor did the other nurses I was working with. Yet I felt that the attending physician had to know, and so I told him, and to my relief he shared my convictions. He likewise helped the patient recover from the psychological turmoil that was pushing her to the edge. In the end, the patient proved herself wrong.
Becoming a moral agent
The patient’s story impacted my values a lot. When I heard that she died, I felt sad but victorious that I did what I and the physician thought was the right thing. I became a catalyst of her change of mind and heart. I knew I did the right thing because she outlived the deadline that was given to her life by the doctors. Whether she realized that we made the right thing or not did not matter anymore. The heart of the matter is that I was able to win over this morally distressing situation and get out of it the right way.
I was a moral agent, and my moral agency stressed on me that the right thing to do is allow her to live some more. It was my duty to prolong others’ life as much as I could. It would have been an exactly different feeling if I decided otherwise, against my moral principles. Nursing, I subscribe, is a job that entails moral responsibilities.
After this situation, I became extra sensitive to the psychological and emotional needs of the patients especially those with terminal cases. I read about positive psychology and shared my learning to other nurses. I was also able to magnify cues that may lead to the same situation as well.
When I identify them, such as when the patient is verbalizing thoughts that the family wants her gone or that she should not be living anymore, I try to console her and share my thoughts on life and her health. There are times when the patient will lash out on me with disagreement, but this does not make me bend my convictions. I stayed on believing, because of that patient who survived, that when I make the right choices the right things will happen. In the process, my ethics and morality is also nurtured.
Raines assert that there are four antecedents to the occurrence of a moral agency. First is the modeling. In the situation, the patient showed signs of discontent and giving up. She was practically moving away from all other choices but death. Secondly there is the coming of the ethical dilemma. This was when the patient verbalized what she really wanted, which was to cheat on death by ending it earlier. The third stage, the alternatives, caught me in the situation. I was torn between the choice of the patient and my personal ethics; my beliefs or the patient’s beliefs. (Module 4A, page 15)
Lastly, my decision was based on information. I gathered all the facts that I have instilled in me to be able to encourage the patient to live longer and have hope. I believe that all these four antecedents take integral roles in accomplishing an act of moral agency. A moral agent cannot be so if there is no ethical dilemma at hand, posed by modeling of the impending dilemma. Alternatives and information, likewise enabled the solution of the dilemma, thus were equally important. (Module 4A, page 15)
It is likewise important to have alternatives. Raines assert that nurses should consider that there are always alternatives to a situation. This will put them off the pressure to being gullible followers of a single choice which may not be right. In doing so, ethical values may be put in jeopardy. Gathering and giving information, as well, is important. (Module 4A, page 15)
Communication is another important skill in this. I should still try to learn more about communication processes and skills. Growth can be enhanced by being updated with new policies and guidelines in the skills being developed and the work itself. (Continuous assessment and professional growth, nd) I can do this by attending trainings about effective communication skills, effective listening, and customer support. This does not only benefit my communication with patients and their caregivers, it will also give me the ability to communicate with the other members of my team more effectively which in effect will give me more chances to deliver better and ethics-based patient care in behalf of the company, my team, and myself.
Ethics and values should be part of the highly complex goal-setting strategy of a person. They are as important as any other aims. Interestingly, Cooper (nd) states that 87% of people do not have goals. These people were found to have difficulties coping with the demands of their jobs.
They also found it difficult to excel in their fields. In the contrary, 3% of people have clearly defined goals which are written down. These people were found to be achievers, accomplishing their goals and developing in their careers at 50 to 100 percent of the time. While it is not a requirement, employees should write down their ethical and moral resolutions and read them a couple of times periodically. This will instill in them these resolutions.
Through all this process of planning, Rennekamp (nd) instills that flexibility is an important element. While being focused on goals and achievements is important, preparations for unexpected events should be considered. In my personal practice, for instance, I usually encounter many dilemmas that challenge my values. It is hard to please everybody, and the moral thing is not always the good thing to do. There will be times when the unethical may bring the good for the more number of people, and it can be sometimes the right choice.
BCIT Document, Specialty Nursing. 2007. Developing ethical practice. Module 4A.
BCIT Document, Specialty Nursing. 2007. Developing ethical practice. Module 5.
Continuous assessment and professional growth. nd. Retrieved November 4, 2007, from http://www.wested.org/online_pubs/Chapter6.Carlson-Final-Pdf-4.pdf
Cooper, T. nd. An action plan for growth and success. Retrieved November 4, 2007, from http://teachersnetwork.org/NTNY/nychelp/Professional_Development/growth.htm
Litke, C. 1996. Professional growth in changing times: challenges and choices. Retrieved November 4, 2007, from http://www.ucalgary.ca/~cll/resources/litke.html
Rennekamp, R. nd. Professional growth: a guide for professional development. Retrieved November 4, 2007, from http://www.ca.uky.edu/agpsd/stages.htm