Introduction
Non-interprofessional behaviors, including lack of cooperation, carelessness in acts, colleague inquiries, and disintegrating care, impact the nursing profession’s foundation for ethics of care and justice. The frameworks are used mainly by nurses when faced with an ethical problem. While a few professional nurses favor the ethics of justice and consider all patients equally, others are more likely to prioritize their commitment to caregiving ethics. DNP nurses modify the frameworks using a variety of techniques.
For example, a doctor of nursing practice analyzes the moral dilemmas surrounding the patient’s care, the practitioner gathers the information, and then further assesses potential solutions. For a profound comprehension of advanced clinical leadership from an ethical viewpoint, a scholarly assessment of ethics of care vs. ethics of justice approaches and a reflection on the care ethics application tends to be essential.
Description of Ethic of Care versus Ethic of Justice Perspectives
In comparison to EJ, EC can be defined more precisely. EJ refers to a situation in which a moral problem or dilemma is resolved fairly, impartially, and with equality and human rights considered. In other words, it seems to be a legitimate nursing strategy, especially in the American Nurses Association (ANA) Ethics Code’s Provision 3 context.
EJ necessitates considering the ethical duties that a nurse or caregiver has towards the patient and basing judgments on such rights. EJ is considered a reasonably straightforward decision-making instrument that should result in fair and legal conclusions. Yet, this strategy ignores a crucial nursing aspect: the emotional component of providing patient care (Haar, 2020).
EC is closely tied to the caring definition, which tends to be multifaceted and involves both the emotion of empathy and the behavior that is encouraged by it. The primary focus of EC is the “caring relationship,” which assumes a positive, fulfilling, trustworthy, and expert relationship between the caregiver and the person being cared for.
The ANA Code’s first rule, which expressly mandates practicing “with compassion and regard for the inherent dignity” of every patient, is in keeping with EC’s emphasis on respect and relationship. EJ and EC appear comparable in that EC calls for respecting each person’s uniqueness and ensuring an attitude of consideration that should uphold their dignity. EJ, however, lacks the nurses’ attention to the relationship and desire to create this relationship (Carmeli et al., 2017).
Another difference between EJ and EC is that although EC draws on the caregiver’s responsibilities, EJ concentrates on their obligations. It is clear from this that EC does not disallow justice or competence. Instead, it combines the two while adding the relational dimension to the decision-making process. Therefore, EC’s use in healthcare would be anticipated to encompass the benefits of EJ while still providing new ones. Mainly, it would be logical to anticipate a stronger bond of trust between the patient and their nurse and more thoughtful and individualized choices that consider every patient’s unique circumstances and needs (Haar, 2020).
Haahr (2020) uses a case study of a nurse who pushed for more analgesia for a diabetic patient who had undergone a below-the-knee amputation to illustrate EC. The increase was in line with the patient’s request. The choice involved resolving an ethical problem: Article 1 of the ANA Code, which calls for patient empowerment and the safeguarding of their self-determination right, may clash with Provision 3, which calls for protecting the patient’s health.
Haahr (2020) does not go to great lengths about the decision-making process. Yet, it may be presumed that the patient was informed and that the dangers that the doctor was apprehensive about were regarded as relatively minimal as opposed to the patient’s wants and preferences since the nurse could persuade him to amend the order.
The claim made by Haahr (2020) that this case is an illustration of EC can be supported. The decision-making process requires treating the patient as an individual with the right and should be able to decide on his treatment course and frequently reports feeling discomfort. As the nurse also possesses a duty to ensure the patient’s safety and safeguard their health, it is possible that this decision-making process included EJ (i.e., the understanding of the patient’s rights), which might have been insufficient to resolve the conflict on its own.
However, the decision-making process also considered the individual’s feelings of care (trusting their evaluation of the severity of their pain), which led to the act of care provision. As a result, EC can be used as a tool for making decisions or a strategy for solving problems, making it especially beneficial in leadership practice.
Reflection on the Application from an Ethic of Care Perspective
EC expands and extends EJ while incorporating it, making EC more appropriate to DNP leadership and its situations. For instance, Carmeli et al. (2017) noted that EC is partially compatible with nursing because of the tight connection between caring and nursing. In addition, Zolkefli(2019) emphasizes that nursing naturally employs patient-centered approaches and that when compared to EJ, EC changes the emphasis of care from patients’ rights to them as individuals.
Moreover, DNP leadership is distinguished by its focus on patient-centered decision-making (Ingham-Broomfield, 2017). As a result, the EC’s emphasis on the patient and providing for them is consistent with the viewpoint of DNP leaders. Haahr (2020) noted that as EC interactions assume a more remarkable ability to describe patients’ requirements and offer more options for obtaining feedback on that care due to the created trust, EC seems more likely to produce beneficial results.
Indeed, from a purely practical standpoint, EC is focused on improving the bond between patients and their nurses, which is advantageous for the caliber of care and the caliber of the patient’s life. Moreover, providing person-centered, high-quality care is the ultimate goal of DNP leaders; thus, EC seems to be a good fit for them (Prinsloo & Slade, 2017).
In this light, EC, which necessitates ongoing connection development, can be viewed as an operation mode instead of merely a tool for making decisions, and it constitutes an operation mode that tends to be compatible with DNP leadership.
EC has some shortcomings. Making EC-informed decisions is more challenging than EJ-informed ones because the interrelationships complicate the process. Given the example of the dosage increase, it may be inferred that the challenge is accepting extraordinary responsibility for the patient’s well-being regardless of the choice. In the context of EJ, the caregiver might be able to put the patient’s relationship in the background.
However, EC must consider it, which should be more emotionally and mentally challenging (Prinsloo & Slade, 2017). Nonetheless, nurse leaders frequently have specific characteristics that might help with the process, such as being upbeat, visionary, adaptable, and professional. As a result, it would be expected of DNP leaders to be able to use and empower others to use a more complex framework.
Conclusion
DNP leaders might be needed to foster EC in respective settings and give others the tools to use it because nursing leaders can inspire and empower those around them. It should be noted that DNP leaders do not need to hold positions of authority in this situation, indicating that any DNP can get involved in promoting EC, particularly by setting an exemplary example. Yet, more organized strategies for propagating the idea also seem pertinent.
In general, the leadership of DNP and EC appear to have similar views on nursing theory and practice, which should encourage them to support the latter. EJ and EC appear to pertain to healthcare and are consistent with the ANA Code of Ethics; EC tends to be more thorough and closely aligns with the Code. The EJ perspective is present in EC but provides a broader perspective on nursing challenges.
In particular, it expands the duty of nurses to provide care, which is meant to entail both the sentiment of providing care and the act of delivering care, and it necessitates taking into account each patient’s personality and unique set of circumstances. Building mutually beneficial relationships between patients and nurses is the primary strategy EC employs, which is likely to make decision-making more difficult while raising expectations for the standard of care.
A more trustworthy connection necessitates more precise patient needs assessments and in-depth feedback on care, which is an obvious benefit of the strategy. Therefore, the leadership perspectives of EC and DNPs overlap, and DNPs can and should use the tool to guide their decisions.
References
Karlsson, M., & Pennbrant, S. (2020). Ideas of caring in nursing practice. Nursing Philosophy, 21(4), e12325. Web.
Ingham-Broomfield, R. (2017). A nurses’ guide to ethical considerations and the process for ethical approval of nursing research. Australian Journal of Advanced Nursing, The, 35(1), 40-47.
Zolkefli, Y. (2019). Negotiated ethical responsibility: Bruneian nurses’ ethical concerns in nursing practice. Nursing ethics, 26(7-8), 1992-2005. Web.
Carmeli, A., Brammer, S., Gomes, E., & Tarba, S. Y. (2017). An organizational ethic of care and employee involvement in sustainability‐related behaviors: A social identity perspective. Journal of Organizational Behavior, 38(9), 1380-1395. Web.
Haahr, A., Norlyk, A., Martinsen, B., & Dreyer, P. (2020). Nurses experiences of ethical dilemmas: A review. Nursing ethics, 27(1), 258-272. Web.
Prinsloo, P., & Slade, S. (2017). Big data, higher education and learning analytics: Beyond justice, towards an ethics of care. Big data and learning analytics in higher education: Current theory and practice, 109-124. Web.