Press Release: U.S. Nursing Leaders Issue Blueprint for 21st Century Nursing Ethics

For Immediate Release

Media contacts:
Danielle Kress
Johns Hopkins School of Nursing; (410) 955-2840

Leah Ramsay
Johns Hopkins Berman Institute of Bioethics; (202) 642-9640

U.S. Nursing Leaders Issue Blueprint for 21st Century Nursing Ethics

In the wake of media focus on the trials and bravery of nurses in the context of the Ebola crisis, leaders in the fields of nursing and clinical ethics have released an unprecedented report on the ethical issues facing the profession, as the American Nursing Association prepares to release a revised Code of Ethics in 2015.

The report captures the discussion at the first National Nursing Ethics Summit, held at Johns Hopkins University in August. Fifty leaders in nursing and ethics gathered to discuss a broad range of timely issues and develop guidance. The report, A Blueprint for 21st Century Nursing Ethics: Report of the National Nursing Summit, is available in full online at It covers issues including weighing personal risk with professional responsibilities and moral courage to expose deficiencies in care, among other topics.

An executive summary of the report is available at:

“This blueprint was in development before the Ebola epidemic really hit the media and certainly before the first U.S. infections, which have since reinforced the critical need for our nation’s healthcare culture to more strongly support ethical principles that enable effective ethical nursing practice,” says Cynda Hylton Rushton, PhD, RN, FAAN, the Bunting Professor of Clinical Ethics at the Johns Hopkins School of Nursing and Berman Institute of Bioethics, and lead organizer of the summit.

The report makes both overarching and specific recommendations in four key areas: Clinical Practice, Nursing Education, Nursing Research, and Nursing Policy. Among the specific recommendations are:

  • Clinical Practice: Create tools and guidelines for achieving ethical work environments, evaluate their use in practice, and make the results easily accessible
  • Education: Develop recommendations for preparing faculty to teach ethics effectively
  • Nursing Research: Develop metrics that enable ethics research projects to identify common outcomes, including improvements in the quality of care, clinical outcomes, costs, and impacts on staff and the work environment
  • Policy: Develop measurement criteria and an evaluation component that could be used to assess workplace culture and moral distress

What does this blueprint mean for nurses on the front line?

“It’s our hope this will serve as a blueprint for cultural change that will more fully support nurses in their daily practice and ultimately improve how healthcare is administered – for patients, their families and nurses,” says Rushton. “We want to start a movement within nursing and our healthcare system to address the ethical challenges embedded in all settings where nurses work.”

On the report’s website, nurses and the public can learn more about ethical challenges and proposed solutions, share personal stories, and endorse the vision statement by signing a pledge.

“This is only a beginning,” says Marion Broom, PhD, RN, FAAN, Dean and Vice Chancellor for Nursing Affairs at Duke University and Associate Vice President for Academic Affairs for Nursing at Duke University Health System. “The next phase is to have these national nursing organizations and partners move the conversation and recommendations forward to their respective constituencies and garner feedback and buy-in. Transformative change will come through innovative clinical practice, education, advocacy and policy.”

At the time of publication, the vision statement has been endorsed by the nation’s largest nursing organizations, representing more than 700,000 nurses:

American Academy of Nursing
American Association of Critical-Care Nurses
American Nurses Association
American Association of Colleges of Nursing
American Organization of Nurse Executives
Association of Women’s Health, Obstetric and Neonatal Nurses
The Center for Practical Bioethics
National League for Nursing
National Student Nurses’ Association
Oncology Nursing Society
Sigma Theta Tau International

An updated list, including individual endorsers, is available at:

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Report Summary:

Full document, A Blueprint for 21st Century Nursing Ethics: Report of the National Nursing Summit:

Additional information on nursing ethics developed by the Nursing Ethics Summit:

“What Keeps Nurses Up at Night” (video, 5:30):

Nursing Ethics Summit website:

#NursingEthics Twitter Chats:

Nursing Ethics Blogs




Is Access to Health Care an Ethical Issue for Nurses?

By Patricia M Davidson, PhD, MEd, RN, FAAN

Core values for nurses include promoting health, preventing illness and alleviating suffering. Does this also include improving access to health care? I would say yes.

Across the world there is an increasing gap between the rich and poor. Interventions across the globe by governments are focusing on improving access to health care.

Apart from the ethical and issues related to a just and civil society, improving health care just makes good economic and political sense. Promoting social participation and health is a good recipe for a harmonious and just world.

Many nurses feel the pain and anguish of individuals unable to access health services either on the basis of factors such as cost or transportation.  But perhaps most distressing is when health care is perceived as unwelcoming, alienating or discriminating.

As a consequence many nurses engage in advocacy for their patients in a range of settings, from the community to the policy table.

Advocating for patients, their families and communities requires courageous leadership as commonly we as nurses face traditional and powerful forces.  Improving access to care requires challenging entrenched patterns and providers of service delivery.

So what does courageous leadership look like?  Wanting to make things better is a great start as well as questioning entrenched beliefs and working together for a negotiated purpose.

To me it is also about having a voice and providing a rationale and justified argument as to why inclusion and participation in society makes good sense to governments and other key stakeholders.

You will never do anything in this world without courage. It is the greatest quality of the mind next to honor – Aristotle


Patricia M Davidson, PhD, MEd, RN, FAAN
Dean & Professor
Johns Hopkins University
School of Nursing

Rushton Delivers Inaugural Ethical Issues in Nursing Lecture

Cynda Hylton Rushton, PhD, RN, FAAN
, the Anne and George L. Bunting Professor of Clinical Ethics and a Professor of Nursing and Pediatrics, delivered the inaugural Gerry Lewis-Jenkins Ethical Issues in Nursing Lecture at the University of Colorado.

Dr. Rushton, an internationally recognized expert in ethics and palliative & end-of-life care, delivered a well-received talk entitled “Transforming Moral Distress into Resilience”. 

 Dr. Rushton is a core faculty member at the Johns Hopkins Berman Institute of Bioethics, and is a professor of nursing with a joint appointment in the Johns Hopkins School of Medicine’s Department of Pediatrics.

This lecture coincides with National Nurses Week, celebrated annually from May 6th through May 12th.  May 12th is the birthday of Florence Nightingale, widely regarded as the founder of modern nursing.

Ms Lewis-Jenkins serves as executive Vice-President of COPIC, the leading medical liability carrier in Colorado.  She entered into the healthcare field as a registered nurse and this endowed lecture provides an outlet to continue her commitment to ethics and nursing education & practices.  The event was cosponsored by the Center for Bioethics and Humanities and the College of Nursing at the University of Colorado, along with COPIC.

Groundbreaking Professorship in Nursing and Bioethics

Johns Hopkins University will dedicate a new endowed professorship, the Anne and George L. Bunting Professor of Clinical Ethics, believed to be the nation’s first joint professorship in nursing and bioethics.

The ceremony to dedicate the professorship and install the inaugural Bunting Professor, Cynda Hylton Rushton, PhD, RN, FAAN, will be Tuesday March 12, 2013 at 4:00 PM in the Alumni Auditorium at the Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Baltimore, MD 21205.

Johns Hopkins University School of Nursing and the Johns Hopkins Berman Institute of Bioethics have jointly established the Bunting Professorship, and Rushton will work collaboratively with faculty and students of both institutions to identify, analyze and attempt to resolve the ethical dilemmas that arise in caring for patients and their families.

Rushton has been with Johns Hopkins for over 20 years, beginning as a Clinical Nurse Specialist in Ethics in 1991.  She was appointed the first Chair of the Maryland State Council of Quality Care at the End of Life and has been recognized as one of Maryland’s Top 100 Women.  In addition to her faculty appointments in the School of Nursing and the Berman Institute since 1995, Rushton has been program director of the Johns Hopkins Children’s Center Harriet Lane Compassionate Care program since 2000.

“We are at a critical juncture in healthcare; the ethical issues that impact patients, their families and clinicians must become part of the national dialogue in order to illuminate ethically sound solutions and cultivate environments where integrity is preserved,” Rushton says. “I feel incredibly fortunate to have this rare opportunity to engage and explore the ethical foundations of nursing in a new and strategic way.”

George L. Bunting is a long-time member of the Berman Institute’s advisory board and a philanthropic supporter of the university. He served as Chairman of Johns Hopkins Health System and Johns Hopkins Hospital from 1994 – 1998 as well as Johns Hopkins Medicine from 1996 – 1998.   Bunting has been integral to the Berman Institute’s growth into one of the world’s largest and most respected centers of bioethics.

“The Berman Institute is absolutely committed to approaching the ethical challenges of clinical practice from an interdisciplinary perspective, and no health professionals are more experienced than nurses in confronting these challenges,” says Ruth R. Faden, director of the Berman Institute.  “The Bunting Professorship is an important addition to our institute, and we are thrilled to have Dr. Rushton, already a valuable member of our faculty, as the inaugural Bunting Professor

Martha N. Hill, dean of the School of Nursing, notes, “This joint, endowed professorship highlights the increasingly important interprofessional role of nursing and bioethics. Dr. Rushton brings to the professorship the expert nursing perspective that is essential to today’s bioethics scholarship and debate and will be required in shaping tomorrow’s healthcare policies.”