Workplace Safety as an Ethical Imperative in Nursing

“How do we honor the role of the nurse by building systems that reflect the same level of commitment they bring to patient care?”

Workplace violence (WPV) remains a persistent and serious challenge in health care. Nurses, bound by the American Nurses Association (ANA) Code of Ethics to provide compassionate care and prevent harm, experience assaults at significantly higher rates than other health care professionals—a trend that intensified during the COVID-19 pandemic. These experiences are not only harmful; they create a profound ethical conflict by directly undermining professional role obligations and disrupting the alignment between ethical expectations and workplace realities. This misalignment diminishes professional role clarity, fosters cognitive dissonance in nurses’ professional role identity, and ultimately strains their commitment to the nursing profession.

Nurses’ ability to uphold compassion and provide nursing care is compromised when their safety is not protected. The 2025 revision of the Code of Ethics, particularly Provision 5, directly addresses this concern. It affirms what we’ve long known to be true:

“The nurse has moral duties to self as a person of inherent dignity and worth including an expectation of a safe place to work that fosters flourishing, authenticity of self at work, and self-respect through integrity and professional competence.”

This guidance reframes workplace safety—not as a matter of personal resilience or policy—but as an ethical obligation rooted in nursing values and woven into the nursing professional role. It highlights the responsibility of organizations, leaders, and the profession to ensure nurses can […]

Words Matter – Including Those Left Unsaid

Sticks and stones may break my bones, but words can never hurt me.

How often did we as children say these words to those who teased us? Yet we still felt the sting that unkind and malicious words imparted, especially when said by those we trusted. And it didn’t matter if the taunts were untrue—they still hurt.

Words matter—take youth bullying, for example.

Photo by Benjamin Voros/Unsplash

According to the Centers for Disease Control and Prevention, both bullies and targets of bullying are at high risk for depression, anxiety, and suicidal thoughts. And bullying in nursing is a well-known occurrence and a significant factor in why nurses leave their jobs.

Words matter and are especially important when laws and policies are created.

The words codified in legislation—and those words excluded—dictate funding, programs, and who can participate in the programs or provide them.

Words matter and are especially powerful when spoken by public officials who can influence scores of followers to think and act in certain ways.

I often wonder how many fewer people might have died if more of our leaders had embraced rather than denigrated science-based public health practices during the COVID-19 pandemic.

Words matter when they are used to spread false information or denigrate certain […]

Unseen Struggles: When the Pain of Chronic Illness Meets Disbelief

A friend’s desperation.

Photo by Ben Blennerhassett on Unsplash

It was early in the morning when I received a call from my best friend, who was crying and
distraught. She frantically rattled off her symptoms: “My stomach is on fire, I can’t sleep, nothing is relieving the discomfort, and I’m in excruciating pain.” Although she’d been feeling discomfort for the previous two weeks, at first she’d thought the intensity of her current symptoms might be from food poisoning. Given her not always healthy diet, which she and I had discussed in the past, I too at first thought she might have eaten something that set the symptoms off.

“It hurts so badly I don’t think I can take it anymore,” she told me over the phone. “I can’t stop going to the bathroom.”

She said that despite the severity of her pain, her family just thought she was being dramatic. I could sense her desperation as she sobbed over the phone. Even though she did not want to seek medical attention, I begged her to go to the nearest clinic or hospital and told her I’d meet her there.

Crohn’s disease: When nurses doubt a patient’s pain.

In the emergency department (ED) where she […]

Honoring the Personhood of Brain-Dead Patients: A Delicate Approach

A dandelion alone in a field suggests the fragility of life. Photo by RIDVAN AYRIK/ Pexels

In the past month, we had a couple of patients in our pediatric ICU who had suffered tragic neurological injuries and were declared medically brain-dead. In the state of California as in most states, a pronouncement of brain death is equal to a legal pronouncement of death, and the medical team then possesses legal permission to remove mechanical support from the physical body that has remained under intensive care.

In both of these cases in our ICU, the parents struggled to accept the terminal implications of brain death and pushed back to varying degrees for more time to see if their children might still somehow find a way to recover. In these types of cases, the actual moment-by-moment practice of bedside nursing care becomes complicated. How do we honor the personhood of the patient as we provide intensive care for the body prior to removing mechanical support, and at the same time gently help the parents accept that their child has medically died?

The potential for misunderstanding nursing care

The interactions nurses have with family members as we care for their brain-dead child present many opportunities for […]

April Issue Highlights: Nurses’ Views on Substance Users, Decarbonizing Health Care, More

“I was always the strong one, the one with the answers, the one people came to for advice….” – from the April Reflections essay, “Take Off the Mask: Getting Real About Depression, Trauma, and Loss

The April issue of AJN is now live. Here’s what’s new. Some articles may be free only to subscribers.

CE: How to Write an Effective Résumé

In today’s job market, nursing students and new graduate nurses need to develop an employer-focused résumé geared toward a specific job. This article can assist.

Nurses’ Self-Assessed Knowledge, Attitudes, and Educational Needs Regarding Patients with Substance Use Disorder

This research study’s findings indicate that, “in general, hospital nurses have negative attitudes toward patients with substance use disorder” and are in need of empathy-based education.

AJN Reports: Decarbonizing Health Care

Nurses can be involved in solutions to reduce greenhouse gas emissions in the health sector.

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