Rushton says the nation is at a tipping point in health care. With more than 3 million nurses in the United States—the largest segment of the health care workforce—any conversation about impending challenges of caring for aging baby boomers or the advancement of technology is deeply tied to nurses and can lead to new ethical challenges and moral distress. Just because new technology can keep a patient alive, does that mean it’s the right thing to do? How best to allocate limited resources to a growing patient population? How can hospitals continue to deliver quality care for ever more patients when the workforce is not growing at the pace needed to keep up?
Ethics can be the elephant in the room. Nobody wants to talk about it, but it’s not going anywhere. People aren’t always comfortable talking about the deeply held personal values that shape their personal sense of ethics. They fear being judged, or confronting people who see a situation as categorically right or wrong instead of shaded by individual ethical considerations. It’s a gray area in a profession that values black and white, that values precision and decisiveness. Is the bone broken? Does the patient have an infection? Has the tumor spread? What is the dosage? What is the prescribed treatment? “Coming up with the right answer is a huge part of medicine, and when you can’t feel confident that you came up with the right answer, you might think, ‘I just would rather not get into that territory,'” Rushton says.
Moreover, nurses may be too busy to stop and think about some of their frustrations as actually involving ethical dilemmas. “Often, we think about ethics as separate, that thing we do when everything else is done,” Rushton says. “In fact, ethics is part of everything we do. It’s embedded in our choices, in our behavior, in our character, in how we do our work every day. When you think about ethics in that way, it’s important for the foundation of nursing to be grounded in ethical values so that we’ve got a firm foundation to operate from.”
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Johns Hopkins Magazine