I once spent an hour in an ambulatory surgery PACU when interviewing for work at the place. A few minutes into my visit, one of the patients awoke in tears. The PACU RN proceeded to slap the woman across the face. An open-handed, full-face slap. “No crying here!” she snapped.
I was floored, and reported the incident to the clinic’s medical director. This nurse not only assaulted a patient, she did so in full view of a visitor (me). I suspect that if, instead, I had been an instructor from their medical center with students in tow, she would not have behaved differently. And would I have responded differently if students were present? Would I have confronted the nurse while other patients were watching, to make clear to the students that willfully harming a patient can never be tolerated?
Approaches to ethical instruction.
In “Promoting Nursing Students’ Ethical Development in the Clinical Setting” (free until December 13) in the November issue of AJN, Linda Koharchik and colleagues discuss the ways in which we can further students’ understanding of ethical practice—not only in the classroom, but also when we are with them on the clinical units. “These ethical dilemmas,” they write, “present an important opportunity for ethical instruction in the clinical setting.”
Role modeling in clinical instruction.
The authors point out the impact that role modeling by clinical instructors and other experienced nurses can have on students. When we remind a doctor or nurse to don an isolation gown after they’ve neglected to do so, or talk to a nurse (away from the bedside) who inappropriately describes a patient as “drug-seeking” and refuses to administer post-op pain medication, we can model “a morally courageous response to an immoral status quo.” The authors observe:
“One would hope the instructor would stand up for what’s right…but doing so in this situation has the added benefit of providing students with practical ethical instruction.”
But take a moment to read the article, and feel free to let us know your thoughts or experiences.