Naturalism and Beneficence Related to Value Development in Nurses

While there are seventeen standards of nursing practice, the 7th standard will be focused on throughout this paper, which states that the registered nurse practices ethically (American Nurses Association [ANA], 2015). There are many circumstances in which there could be an ethical dilemma. Many challenges arise in the nursing profession that may be related to which option is better, ethical challenges in communication between other healthcare professionals, which treatment plan is more beneficial, challenges between colleagues, etc. (Kristoffersen, Friberg, & Brinchmann, 2016). While a nurse is challenged and pulled into different directions mentally, physically, and emotionally throughout the duration of his or her shift, one thing remains the same: the patient always comes first. There are many theories that give reason and describe how one goes through the decision-making process, however the remainder of this paper focuses on the theory of naturalism paired with the ethical principle of beneficence and how it relates to the value development of a registered nurse.

Naturalism

The theory of naturalism in ethics may be perceived as the moral judgement related to ethics that is dependent on human nature and psychology (Burkhardt & Nathaniel, 2014). This theory states that ethical practices are natural instincts in which all individuals possess, and the thought that just the majority of people will make a similar decision when faced with the same dilemma. In other words, there is a sense of “universality” in judgement regarding moral circumstances (Burkhardt & Nathaniel, 2014). It involves putting oneself in another person’s shoes and showing sympathy and compassion to those in pain, as all people generally have the same desire to feel pleasure and experience happiness. These perceptions of moral judgement are based on individual’s feelings or attitudes. All patients deserve the absolute best from their nurse, and a nurse should make decisions based off of what is morally and ethically right, without any interference. In fact, the very first provision of the Code of Ethics states that the nurse, regardless of the patient’s worth, uniqueness, or attributes, should treat them all with the same compassion and respect as anyone else (Fowler, 2015).

Beneficence

Beneficence is an ethical principle that is much involved in the field of nursing. The principle of beneficence is believed to encompass all aspects of the field of nursing and is applicable in all situations, whether it be care, safety, security, compassion, etc. Beneficence is defined as doing good, and acting in a way that always has the patient’s best interest (Burkhardt & Nathaniel, 2014). It refers to acting in the best ethical, legal and in good practice, especially by professional nurses, for the benefit of the patient and other healthcare professionals. In a simpler phrase, beneficence simply means to do good, always. Under the beneficence umbrella is the idea that a professional nurse will advocate for the patient in all avenues, and to collaborate among the patient, family members, and providers in order to uphold and abide by the scope of nursing ethics, conduct, informed consent, and good practice to ensure quality care for the patient. Naturalism and Beneficence will assist one in developing principled behaviors.

Value Development

Applying these two concepts may at first seem general to a novice nurse, however, over time, a nurse may look back and see how these theories and principles have shaped their practice. When a nurse first learns about these topics in school, it may not seem relevant but when they emerge themselves into the clinical practice, beneficence, especially, is extremely evident. It is important to understand that while a person may have a natural reaction or decision to a circumstance, before one can ethically practice, their personal values must first be identified (Bagnasco, Catania, Aleo, & Sasso, 2014). When a nurse considers the theory of naturalism, he or she may think of this as a natural instinct that was instilled in them years ago. It generally states how a nurse makes a decision based on the fact that it is black or white, and seeing a clear right or wrong choice. When faced with an ethical dilemma, the nurse will be apt and comfortable in making a decision when implementing the principles of beneficence. If they always have the patient’s best interest in mind, the right thing to do should be clear. These two concepts shape nurses over the years or practicing and after time goes by, the novice nurse will become an expert not only in his or her skills but in ethical decision making as well. The values of the nursing practice are evident to the public and according to Provision 9 of the Code of Ethics; nurses are the voice of the profession and are expected to exemplify and set an example of moral and truly good values to their patients and the community (Fowler, 2015).

Application to Patient Care

Beneficence and naturalism can be applied in many aspects of patient care. The patient should always be considered the first priority. This includes the patient’s needs and wishes, but also the family and close friends that are involved in the patient’s care. The nurse will ensure that their main commitment and priority is focused towards the welfare of the patient, as described by the second provision (Fowler, 2015). Additionally, the nurse should always advocate for the patient, practice ethically, ensure informed consent, and give the patient the best care as possible. The nurse should establish a healthy relationship with the patient and create an environment of mutual trust. Additionally, the environment that the nurse creates should also feel safe. Provision 3 in the Code of Ethics states that the patient should always be able to trust that their safety is of the nurse’s highest concerns, that they are taken care of, protected, and that the nurse will be a barrier from any kind of hard that may come their way (Fowler, 2015). The professional registered nurse should exercise their authority and accept responsibility within their scope of practice by taking action and making evidence-based decisions that are all geared towards promoting health and providing optimal and quality care to the consumer, as outlined by Provision 4 of the Code of Ethics (Fowler, 2015). While it is important to have a healthy relationship with the patient, it is even more important to maintain a professional relationship that abides by the standards of nursing. Likewise, the nurse should practice within legal parameters, along with following the privacy and safety laws that have been previously put into place, i.e. HIPAA. All patient information, regardless of importance should be kept confidential and between the patient and appropriate care givers. The registered nurse should also advocate for the patient’s right to make decisions for themselves, practicing autonomy and the right for self-determination – all of which are ‘doing good’ for the patient. It is extremely important that competent patients are fully informed and included in their plan of care. In this regard, the nurse will ensure that all patients, including the appropriate family members and other clinical affiliates are involved when making certain key decisions.

Personal Growth

Like excellent patient care, it is also important for the registered nurse to continue their own education and growth as a medical professional. A nurse should maintain their competence in regard to hands-on skills and ensure continuous development both personally and professionally, allowing oneself to provide the absolute best quality health care services to all recipients. While the medical field is continuously evolving and improving, the nurse must also change with the times, expanding knowledge and gaining experience. In addition to gaining scientific knowledge, it is equally important to engage in personal growth, as how a nurse personally feels and believes, it will impact their decision-making and feelings towards ethical dilemmas and situations that arise on a frequent basis (Vaksalla, & Hashimah, 2015).

Conclusion

When thinking about all of the concepts outlined previously, there is a common theme: the patient. Every nurse will be different in their ways of thinking and behaving, but the theory of naturalism plays a role in all nurses thought process, consciously or unconsciously. It is believed that one will make similar decisions when faced with similar decisions, and that’s where beneficence comes in. The nurse, along with other medical professionals generally all want to do good for the patient. The natural instinct, so to speak, is going to be in the best interest of the patient. Provision one and two of the code of ethics combined with Standard seven regarding practicing ethically apply to nursing in a multiplicity of ways. The patient comes first in all situations, and the nurse should always, without wavering, treat every patient with equal respect and compassion, as they are in their most vulnerable state. Patients should feel safe, secure, like they were treated with dignity, and that their registered nurse was making ethically and morally good decisions on their behalf.

References

1. American Nurses Association (2015). Nursing Scope and Standards of Practice (3rd Ed.). Silver Spring, MD: ANA.
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3. Burkhardt, M., & Nathaniel, A. (4th Ed.). (2014). Ethics & Issues in Contemporary Nursing. Stamford, CT: Cengage Learning.
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