Nursing Policy Domain


Click to learn about the Nursing Policy Team.

Bold Idea:

Create an ethical health environment through the development of resources, policies, metrics (outcomes), education, training, and research.

The actions of multiple stakeholders will inform, influence, implement, and evaluate the policies (macro & micro level) intended to ensure ethical environments for nursing practice, education, leadership and research.


This idea is embedded in the following foundational commitments:

  • The prime importance of promoting care excellence
  • Civility in the work environment: how we treat each other, respect each other in our differences, work together, and prioritize safety (basic needs)
  • Protection of professional integrity: honoring each other’s values in ways that enhance our work, morale, and self esteem
  • Loyalty: a reciprocal relationship among colleagues and to the organization
  • Collegiality/Collaboration: promotes unity of purpose and builds productive and positive relationships.
  • An ethical health culture embodies fundamental virtues, including justice and courage

To mitigate risks to success, the work group encouraged a number of steps: 1) engaging stakeholders early and keeping them engaged throughout; 2) generating inter-disciplinary support; 3) creating realistic timelines and to-do-lists; 4) providing current data to demonstrate the long-term value of the effort; and 5) creating formal commitments to action with periodic feedback.

The work group discussed systemic factors that need to shift in order for the bold idea to be achieved. These involve moving:

Action Plan Steps

Short-term actions

  1. Continue to secure support for the bold idea from key nursing leaders and indications of what they may contribute; identify missing stakeholders
  2. Identify, compile, and create a centralized, publicly available resource of existing ethics related policies, standards, guidelines, codes of conduct, and best practices influential in creating an ethical culture for nursing
  3. Inventory national and international organizations beyond nursing that are working on ethical cultures and compile what they are learning
  4. Based on these reviews, identify gaps and develop a preliminary framework for policy development
  5. Develop measurement criteria and an evaluation component that could be used to assess workplace culture and moral distress
  6. Create an ethical environment tool and checklist

Longer-term actions

  1. Work toward getting the cultural concepts that emerge embedded in the work of credentialing bodies for nurses
  2. Encourage accreditation bodies like the Joint Commission to include assessment of an organization’s “ethical environment”
  3. Review the standards of other accreditation bodies for settings where nurses work, such as the Public Health Accreditation Board, for the adequacy of their ethics components.
  4. Explore institutional policies within institutions that help or hinder the development of ethical environments, not necessarily nursing-driven (policies regarding whistle-blowing, raising concerns, maintaining a just culture)
  5. Explore the role of ethics committees in promoting “a moral milieu”
  6. Ultimately, consider the impact on nursing of cultural factors beyond health care—for example, social justice.

Your responses and ideas regarding the nursing ethics policy initiative are welcome. Feel free to contribute to the discussion here.

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