By Marion Broome, PhD, RB, FAAN


Case study: At 7 AM in the break room your colleague reveals that she was out until 3 AM partying and is terribly hung over. Her eyes are bloodshot and her appearance is unkempt. This is an overtime shift for her. Assignments on the unit are already tight.


The 3rd provision of the ANA Code of Ethics states: “The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.” Provision 6 of the ANA Code of Ethics says that “The nurse participates in establishing, maintaining, and improving health care environments and conditions of employments conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action.”


How can nurses provide the best quality care if the quality and safety if their practice environments are not in line with this?


What is the relative accountability of the individual and the organization for providing an environment in which each nurse can function to the best of their ability?


Creating a safe environment for patient care is a primary ethical obligation for all clinicians, including nurses.


How do we build capabilities within individual nurses to practice at their full capacity?


How do we support nurses who need to be able to recognize when situations exceed their abilities and capacities, and for other nurses to speak up and out when they see a potential for unsafe care?


Marion Broome, PhD, RN, FAAN,
Distinguished Professor and Dean of the School of Nursing,
Indiana University




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