Clinical Practice Domain



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Bold Idea:

To develop and sustain work environments that support ethical nursing practice.

This idea is embedded in the following foundational commitments: 

  • Integrity, respect
  • Commitment to the health and well-being of patients, families, and the public
  • Nurses’ ability to make judgments based on commonly held notions of right and wrong and to be held accountable for the actions that result (moral agency)

In order to develop and sustain these work environments, specific systemic shifts are needed:

Action Plan Steps

These steps below summarize the actions the work group proposed. In some cases, the group recognized potential synergies with activities in other summit domains (nursing education, research, and policy) and with existing, ongoing initiatives.

Short-term actions

  1. Define and describe the problem (See “Resources” for some specific tools), especially where current workplaces are falling short of creating an ethical work environment for nurses
  2. Define and describe the desired future state
  3. Identify or create a set of tools and guidelines for achieving ethical work environments, evaluate them, and create a centralized repository of relevant findings (that is, what already exists and what needs to be developed)
  4. Build a case statement describing the urgency of creating and maintaining ethical work environments for nurses (in terms of cost and value, patient and nurse satisfaction, impact on quality of care) and present it to a broad range of stakeholders, including patient groups, in a summit meeting
  5. Create a communications strategy to bring these issues to the attention of broader publics and policy leaders

Longer-term actions

  1. Continue identifying, developing, evaluating, refining, and disseminating strategies to promote and sustain ethical nursing practice
  2. Create an inter-professional steering committee to develop consensus on the desired future state of ethical nursing practice and draft national guidelines, then obtain endorsement from major professional organizations

We welcome your responses and ideas regarding improving the work environment for nurses’ ethical practice. Feel free to contribute to the discussion here.

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