Nursing Ethics: Helping Out on the Unit vs. Teaching Nursing Students Crucial Skills

By Jacob Molyneux, AJN senior editor

scalesJust as no two hospital units are exactly alike, rarely are two ethical conflicts exactly alike. There are too many variables, too many human and situational differences. This month’s Ethical Issues column, “Teaching Crucial Knowledge vs. Helping Out on the Unit,” explores potential ethical and practical issues faced by a clinical instructor who must balance the duty to teach essential skills to nursing students against the staff’s need for help in meeting patient care needs.

Will there be an easy, cut-and-dried answer? Probably not. In the course of their analysis of a hypothetical scenario, the authors make the following point:

Because new situations arise all the time, and every situation varies in its ethically relevant aspects, rigid rules often cannot guide ethical action. Instead, analytic skills and transparent negotiation are crucial for resolving conflicts between values as they arise in day-to-day interaction—and for supporting the solutions we choose.

While people skills may be as important as abstract ethical analysis in dealing with real world situations, determining which ethical principles or priorities are coming into conflict may provide us with a certain measure of clarity in our approach. The authors frame the conflict described in the article in the following way:

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Nurses Aren’t Just Healers, They’re Teachers Too: A Patient’s View

Illustration by Jennifer Rodgers. All rights reserved. Illustration by Jennifer Rodgers. All rights reserved.

A teeny red bump had mysteriously appeared on my left index finger. It hurt when I pressed on it. I figured it was nothing. . . .

That’s the start of the June Reflections essay in AJN, “Ms. Lisa and Ms. MRSA,” a patient experience narrative by freelance writer Shannon Harris. As luck would have it, the bump on her finger, it turns out, is not nothing. It’s MRSA.

The diagnosis takes a while. Finally the situation worsens, and surgery is needed. The author takes it all in stride, at least in retrospect:

The third physician stood out to me most. He asked to take a picture of my green and black, staph-infected finger with his iPhone. “Sure. Look at it! I thought this only happened to pirates,” I told him as he snapped away. He glanced at the young, button-nosed nurse standing beside him. “Don’t you want a picture? For your records?” he asked.

She shook her head, squinting and gritting her teeth. “I know. Yuck,” I said. I later shared photos of my infection journey online, to the great wonder and disgust of my friends and family. Before that, though, came surgery.

The author’s tone is light, but the […]

Seeing Potential: The Joys of Teaching Nursing

By Ruth Smillie, MSN, RN, associate professor of nursing at Saint Josephs College, Standish, Maine.

"Buck Up," by zenera / via Flickr. by zenera / via Flickr.

The day I come to class pregnant is one of my favorites. I really hate to be pregnant; I’m 55, grey haired, and way too old to be pregnant. My students are obviously surprised when I waddle in swaybacked with my sudden eight-month pregnancy. They snicker and smile, and then the magic begins.

As each one brings up the “change” they were assigned, I acquire the mask of pregnancy: larger breasts (made from paper bowls), kidney stones and gallstones (collected from outside), more blood volume (once, in a soda bottle), varicose veins (pipe cleaners or string), and so on—all carefully attached to me by duct tape.

I look and feel ridiculous and we all laugh a lot, but that’s not the point. The point is that they remember the changes of pregnancy. Embarrassing as it is, I would do it every day if it helped them learn. I love to teach nursing and it has been an amazing experience.

Students have no idea how incredible they are. Most of mine are just out of high school, young and unaware of their potential. But they have it, and I can […]

Essentials for New Clinical Nursing Instructors, Especially Adjuncts

There are many things it’s helpful to know when you start work as a clinical instructor—and you might not get a lot of orientation first.

By Maureen Shawn Kennedy, AJN editor-in-chief

“So you’ve accepted the contract for your first part-time clinical teaching assignment and you’re wondering where to start in preparing for this new role. Perhaps you’ve been working in an administrative role, away from direct caregiving. Maybe you’ve been active in bedside nursing but have no formal preparation in clinical teaching. If you take the time to prepare for your teaching assignment, you can confidently lead your students through a meaningful clinical experience.”

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