I.

FOUNDATION AND PRINCIPLES OF BIOETHICS IN NURSING

II. ETHICAL THEORIES
III. ETHICAL PRINCIPLES AND NURSING
IV. VALUES CLARIFICATION
V. VALUES DEVELOPMENT

VIRTUES IN PROFESSIONAL LIFE: Trustworthiness

TRUST is defined as “a psychological state that determines a person's willingness to be
vulnerable under conditions of risk/uncertainty, and interdependence.”
If patients trust their physicians, then the relationship between them can be a richer and
more meaningful one. The patient is more likely to feel confident and able to disclose
symptoms, helping diagnosis and future care. If public health and community workers are
trusted, not only is it likely that their work will be easier, in that their actions will be respected
and accepted, but their advice will also be sought spontaneously. Trust, can, therefore, be
thought of as something that is of benefit to all: healthcare workers, individuals, and
communities. Trust is, generally, something to be prized and we need to do anything we can to
strengthen it.
VIRTUES IN PROFESSIONAL LIFE: Integrity
Acting with integrity means understanding, accepting, and choosing to live in
accordance with one’s principles, which will include honesty, fairness, and decency. A person of
integrity will consistently demonstrate good character by being free of corruption and hypocrisy.
Integrity is revealed when people act virtuously regardless of circumstance or
consequences. This often requires moral courage. Indeed, integrity is the critical connection
between ethics and moral action.
PROBLEM SOLVING IN THE PROFESSIONAL REALM
a. Nurses’ Relationships with Institutions
In relation to the Nurses’ relationships with Institutions, questions such as “How does the
management take care of its employees?”, “What do you do to follow your institution’s IRR?”
and “What do you feel about the IRR being implemented in your institution?” come to mind.
How these institutions take care and compensate their employees are taken into consideration.
Along with this, if nurses feel like they are valued then they are able to provide the quality care
that the patients deserve
b. Nurses’ Relationships with other Nurses
Nurse-to-nurse relationships are a key component in determining the health of a work
setting. Because of the impact that such relationships can have on patients, health care
organizations, nurses, and the nursing profession, it is imperative to understand how nurses
relate to each other.
Positive nursing relationships are the key to establishing a healthy place of work. Only when
positive nurse-to-nurse relationships are established can healthy work environments be created
and sustained for nurses in the future.

c. Nurses’ Relationships with Physicians

Relations between physicians and nurses are sometimes strained. Physician-nurse
conflict, tension, and stress have been thought to be contributing factors in job
dissatisfaction and burnout for nurses.
Possible Causes Of Conflict:
 Power Imbalance. Physicians commonly experience significant prestige, respect, and
financial success, and in healthcare they enjoy great authority. Their education is among
the highest of any profession, consisting of college, medical or osteopathic school, years
of residency training, and possibly additional fellowship training. In contrast, nursing,
though a highly respected career, does not enjoy as much societal respect or financial
compensation.
 Differing Goals of Medicine and Nursing. The nurse may believe he or she is more
focused on the patient’s state of wellbeing and therefore should have a larger say in
their care. A specialist physician or hospitalist treating a patient in a hospital often sees
the patient less than the nurse assigned to care for that patient; consequently, the nurse
may feel he or she knows the patient’s care needs and what the patient can tolerate
better than does the physician.
 Gender Conflict. All the above factors deserve consideration as causes of conflict
between physicians and nurses. Such factors and the resulting tension and stress can
lead nurses to feel denigrated, disvalued, disrespected, intimidated, and disempowered.
Nurses who feel intimidated or have low self-esteem might be less inclined to point out
errors they perceive a physician to be making.
How To Solve these conflicts?
In solving these conflicts one common recommendation is to improve communication
between physicians and nurses. As the passage goes “Communication is key.” Thus, if there are
some misunderstandings and conflicts, communication between the nurse is physician should
be established to foster idea-sharing and come up with solutions and alternatives to these
problems. Nurses sometimes avoid conflict or are resigned to it, whereas some form of conflict
resolution fostering collaboration and cooperation might help alleviate physician-nurse tensions
and achieve better overall outcomes.
 d. Nurses’ Relationships with Subordinates
Organizational trust is one of the most important issues in human relations that its
importance in organizations is well known. Effective communication and cooperation between
individuals require trust. On the other hand, the quality of a nurse’s trust in his/ her manager
affects the behavior and performance of the nurse.

e. Discrimination and Harassment

Bullying is the ongoing and deliberate misuse of power through repeated verbal, physical,
and/or social behavior that intends to cause physical, social, and/or psychological harm. Bullying
may create a risk to health and safety and may be direct or indirect. Nurse bullying is a systemic,
pervasive problem that begins well before nursing school and continues throughout a nurse's
career. A significant percentage of nurses leave their first job due to the negative behaviors of
their coworkers, and bullying is likely to exacerbate the growing nurse shortage. A bullying
culture contributes to a poor nurse work environment, increased risk to patients, lower patient
satisfaction scores, and greater nurse turnover.
Discrimination is the unjust or prejudicial treatment of different categories of people,
especially on the grounds of race, age, sex, disability, religion, marital status, employment
status, political opinion, or being affected by domestic violence. Discrimination also occurs
within groups and can cause feelings of vulnerability, powerlessness, intimidation, and
humiliation. It is a complex and often controversial concept which occurs in the cliché, illogical,
and generally unconscious beliefs of different ethnic, cultural, or religious groups.
Discrimination at work causes stress, fatigue, demoralization, and loss of commitment in
employees; prevents an organization from achieving its goals; and encourages workplace
conflicts and resignation. Finally, discrimination correlates with vindictiveness, correlation of
duty, irritation, and decline in the quality and quantity of work.
Harassment is any unwelcome or offensive behavior that is repeated or is serious enough to
have a harmful effect or which contains an implied or overt promise or preferential treatment or
an implied or overt threat of detrimental treatment.

Reference/s:
https://journals.lww.com/naqjournal/fulltext/2019/07000/our_own_worst_enemies__the_nurs
e_bullying_epidemic.12.aspx
https://journals.sagepub.com/doi/full/10.1177/09697330211015291