Dear Ms. Wilson:
I appreciate Tanya M. Wilson's thoughtful response to my ethics column on The Value of Nursing Ethics: What about Nurse Jackie? (July 2009). I agree with Ms. Wilson's statement that television shows such as Nurse Jackie are helping to open up dialogue about important ethical issues that nurses face daily. In the hectic pace of providing nursing care in today's healthcare system, it is important to take time out to reflect on why we make the ethical decisions that we do. Ms. Wilson points out that one question that we should ask is 'Why would nurses (even fictional ones) feel the need to blatantly disregard accepted ethical principles in order to give their patients the care they feel is necessary for their well-being?' She suggests that one answer is the need for healthcare organizations to be more responsive to the ethical dilemmas that nurses face daily and to provide support and guidance within the organization for ethical decision making. Certainly, a single course in ethics that students may take in nursing school cannot provide a thorough understanding of ethical decisions that nurses face in today's complex healthcare environment. Hospitals have committees that focus on protection of patient rights but have not demonstrated the same priority for providing continued guidance for nurses in difficult ethical decisions they frequently face. As Ms. Wilson notes, when unfavorable outcomes occur for their patients, nurses are often assumed to be at fault. It is critical that we implement policies within healthcare organizations that guide nurses in ethical decision making and acknowledge the important role that nurses play in achieving optimal outcomes for their patients. A culture of care, as opposed to a culture of blame, in healthcare organizations is needed to provide the openness needed for nurses to dialogue with each other and with other healthcare professionals to tackle controversial ethical issues that they face in advocating for their patients.
Jeanne M. Sorrell