My personal healthcare management philosophy is underpinned by my personal values and ethics. I am a registered nurse and I follow the Code of Conduct (2018) and The Code of Ethics for Nurses in Australia (2018). I am committed to uphold the fundamental rights of people receiving healthcare and to provide and promote quality care for all patients. I help all patients access quality healthcare. I try to provide nursing care with respect and kindness for myself, my work teammates and the patient and their family. The most important thing I have learned working as a nurse is the ethical management of information for the patients’ privacy. I have also found diversity amongst the patients that I nurse and team I work with. So, I have to be aware of my privilege because of my position.
I find that these professional codes relate to patients’ healthcare. I have found healthcare delivery is team-based, integrated and focused on population health. As a nurse manager, I need to consider the organisation of my healthcare team, ward and institution. I also need to focus on population-based considerations of how healthcare is coordinated and delivered. I need to provide ethical management, and sometimes these considerations conflict and are counterintuitive to my patient-centered learning.
I understand ethical management to mean, applying ethical decision-making for the benefit of patients, nurses and healthcare staff and the business operators (Bruning and Baghurst, 2013). I think ethical leadership should aim to improve the communication and relationship between these stakeholders and provide better health outcomes to the patient, better work environment for the healthcare team and decreased cost of healthcare to the organisation (Ho and Pinney, 2016).
I support the concept that nurses in managerial positions have a responsibility to take care of their staff and provide the necessary support for them in ethically problematic situations (Aitamaa et al., 2010). Yet, as a nurse manager I must work to engage ethical decision-making in the patient-healthcare professional relationship, the patient- institution relationship and the healthcare professional-institution relationship by improving the working relationship and trust between these stakeholders. I also need to be aware of ethical implications of organizational decisions and actions on these stakeholders (Silva et al., 2007).
The principals that I have employed to provide myself a foundation and tools to help make ethical decisions are Voges prinicples (2012). Firstly, using beneficence to benefit staff, patients, the organisation and community. I must do this, while meeting the second principle of non-maleficence and bring no harm to these stakeholders. Ethical managers are expected to respect the individuals and their autonomy, and acknowledge their needs and aspirations. The fourth tool is justice. I try to be fair and show unbiased concern when making decisions and promoting stakeholders and population health. I have a responsibility to the community in which the organization functions (Bruning and Baghurst, 2013). A poor relationship between the various stakeholders threatens the organization’s ability to remain functional. So by combining beneficence, non-maleficence, respect and justice, I am able to utilise these foundations to improve the communication and relationship between patients and their families, the healthcare team and the organisation and the community.
I am hoping this course will give me the understanding and courage to act ethically as a nurse unit manager. I know decision-making is complex and influenced by many relationships within the hospital. Yet, if I base my decisions on the ethical process to influence the relationship of patients, healthcare providers and institutions it should improve health outcomes for the patient, a good team environment for the staff and decreased costs for the organisation and community.
References
Aitamaa, E., Leino-Kilpi, H., Puukka, P. and Suhonen, R. (2010). Ethical problems in nursing management: The role of codes of ethics. Nursing Ethics, 17(4): 469-482.
https://doi.org/10.1177/0969733010364896
Bruning, P. and Baghurst, T. (2013). Improving Ethical Decision Making in Health Care Leadership. Businesss and Economics Journal, 4(2): 2151-6219. http://dx.doi.org/10.4172/2151-6219.1000
Ho, A. and Pinney, S. (2016). Redefining ethical leadership in a 21st-century healthcare system. Reflections on Healthcare Leadership Ethics. 29(1): 39-42. doi: 10.1177/0840470415613910
Silva, D.S., Gibson, J.L., Sibbald, R., Connolly, E. and Singer, P.A. (2008). Clinical ethicist’s perspectives on organizational ethics in healthcare organisations. J. Med. Ethics, 34: 320-323. Doi:10.1136/JME.2007.020891
Voges, N.D. (2012). The ethics of mission and margin. Healthc Exec. 27: 30-32.
Nursing and Midwifery Board of Australia. (2018) Code of Conduct for Nurses.