When Professional Organizations Are Out of Sync With the Needs of Nurses

The views expressed in this post are those of the author, and do not represent the views of their employers or affiliated institutions, or of AJN and Wolters Kluwer.

One of the many lessons my veteran father taught me was this: actions tell you what a person believes in, and you should believe people when they show you what they believe. This principle applies not just to individuals, but also to organizations run by groups of like-minded people.

Many of our national nursing advocacy organizations, like the American Nurses Association (ANA), National League for Nursing (NLN), and others have been complacent in many arenas of nursing advocacy for far too long. Nurses are more burned out than ever, bedside nurse wages have stagnated, the costs of both health care and education continue to balloon, and there is an ongoing epidemic of violence against health care professionals and citizens alike. I find myself reflecting upon my own efforts to address any of these issues faced by my fellow nurses or community, and I cannot help but look to the largest and most powerful nursing organizations with disappointment at their inaction on even the most straightforward issues.

When professional organizations fall short.

Sure, nursing organizations are good at issuing reports and recommendations. For example, in 2025 a new version of the ANA Code of Ethics for Nurses was published. Commitment to society and social justice is one of the provisions, including an ethical obligation for both nurses and their professional […]

2026-03-09T11:56:56-04:00March 9th, 2026|Ethics, Nursing, nursing perspective|1 Comment

Nurses Have an Ethical Obligation to Demand Accountability for ICE Violence

The views expressed in this post are those of the authors, and do not represent the views of their employers or affiliated institutions, or of AJN and Wolters Kluwer.

On January 24, 2026, Customs and Border Patrol (CBP) agents in Minneapolis shot and killed Alex Jeffrey Pretti, a 37-year-old nurse who worked in the intensive care unit at the Minneapolis Veterans Affairs Medical Center. Alex died while upholding core nursing values of helping and supporting his community. While standing in opposition to the tactics used by Immigration and Customs Enforcement (ICE) agents in Minneapolis, he was directing traffic and helping a woman being pepper-sprayed by CBP. These actions should not have cost him his life. It is now time for us, fellow nurses and leaders, to follow Alex Pretti’s example by advocating for our communities and upholding the core ethical principles of our discipline, including justice, beneficence, and nonmaleficence.

2026-02-17T14:54:37-05:00February 17th, 2026|Ethics, Nursing, nursing perspective|0 Comments

Cost-Cutting and Nursing: Are We Solving the Wrong Problems?

Courtney Desy, BSN, RN, OCN

Across the country, hospitals are under sustained financial pressure. Margins are thin, reimbursement often fails to cover the cost of care, supply chains remain fragile, and administrative demands continue to grow. Leaders are asked to stabilize organizations while navigating forces largely outside their control.

Those pressures inevitably reach the clinical floor.

In staff meetings, nurses hear familiar refrains: we need to be more efficient, we need to tighten workflows, we need to reduce waste. These requests are rarely made casually or without reason. They reflect real financial strain and genuine concern about sustainability.

But in high-acuity clinical settings—especially oncology—the question isn’t whether efficiency matters. It does.

The question is whether we are starting in the right place.

The Problem with starting at cost-cutting

Nurses are trained to define the problem before proposing solutions. In clinical care, jumping to treatment without understanding the diagnosis is unsafe. Yet in operational decision-making, the process is often reversed.

The implicit starting question becomes:

How do we cut costs?

Once that question is accepted, the solutions are predictable: tighter schedules, compressed staffing, reduced flexibility at the bedside. These approaches may lower expenses in the short term, but they rarely address the forces actually driving financial instability.

From the nursing perspective, […]

The Ethical Use of our Therapeutic Connections with Patients’ Families

“What would you do, doctor?” The family had been explicit in wanting straightforward communication about their child, whose neurological disease had progressed to the point where she was continually seizing, despite every medication the physicians had tried. The seizures were in turn damaging her brain, such that she was minimally responsive to stimuli and was not expected to regain significant awareness of her surroundings.

I held my breath as I anticipated the doctor’s reply. She had spent many hours with this patient and family, and had built trust with the parents.

“As a physician . . . I would transition my child to comfort care and ultimately let her go. But as a mother . . . I would struggle to do this.”

The patient’s mom nodded tearfully. The doctor had given an honest reply, and had still ultimately left the choice to the parents.

I took care of this patient in her final few days of life. The parents were heartbroken but also clear in their decision. We walked them through each step, and made sure they felt supported to the best of our ability, down to their very last goodbye with their child.

******

There is power in the medication and therapies we apply. Fluid […]

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 […]

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