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:

Clinical nursing instructors have two primary ethical responsibilities: to ensure a competent nursing workforce by educating students in the physical and psychosocial skills that constitute good nursing care, and to ensure that patients who allow students to care for them receive safe, quality nursing care. Both obligations can usually be met without undue compromise. However, when unit resources are insufficient and can’t easily meet patient needs, the responsibility to educate students may conflict with the unit’s more immediate patient care priorities.

Click the link above to read the article, follow the hypothetical scenario and attempt to apply it to your own experience, and see how the authors finally expand their analysis to take into consideration the potential role played by such persistent systemic issues in nursing as inadequate staffing.

Sometimes, they note, we may need to work to change the system itself—or find ourselves stuck in the same conflicted situation over and over again.

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