Patient Advocacy
Patient advocacy requires nurses to support and protect their patients. Nurses often find themselves in ethically questionable situations that conflict with their personal and professional morals. Sometimes, speaking out for the patient requires them to demonstrate moral courage—for instance, in the face of conflicting loyalties, in highly charged conflict situations, or when the patient’s rights are being violated. This article provides an overview of moral courage, defines important terms, examines barriers to moral courage, discusses strategies for developing moral courage, reviews peer support and organizational cultures that support moral courage, and discusses whistleblowing.
Defining key terms
Moral courage is the willingness to stand up for and act according to one’s ethical beliefs when moral principles are threatened, regardless of the perceived or actual risks (such as stress, anxiety, isolation from colleagues, or threats to employment). Moral distress occurs when nurses feel powerless to act after witnessing improper behavior, if organizational constraints make doing the right thing difficult or impossible.
Ultimately, these situations challenge one’s sense of virtue, which involves acting in accordance with one’s moral and ethical principles. Moral courage is a virtue and needs to be developed (as does emotional intelligence) to determine when action is required. Thus, moral courage is linked to virtue ethics, which emphasizes the role of character rather than doing one’s duty to bring about good consequences. Virtue ethics appreciates that conflicts occur and that more than just moral wisdom is needed to ensure a moral outcome.
Case scenario: Susan’s dilemma
The following scenario illustrates the moral distress a nurse may experience when her patient advocacy meets resistance or her moral courage is challenged. It also describes effective management strategies to help nurses resolve these problems.
Julie, age 45, works in a telemetry
Defining key terms
Moral courage is the willingness to stand up for and act according to one’s ethical beliefs when moral principles are threatened, regardless of the perceived or actual risks (such as stress, anxiety, isolation from colleagues, or threats to employment). Moral distress occurs when nurses feel powerless to act after witnessing improper behavior, if organizational constraints make doing the right thing difficult or impossible.
Ultimately, these situations challenge one’s sense of virtue, which involves acting in accordance with one’s moral and ethical principles. Moral courage is a virtue and needs to be developed (as does emotional intelligence) to determine when action is required. Thus, moral courage is linked to virtue ethics, which emphasizes the role of character rather than doing one’s duty to bring about good consequences. Virtue ethics appreciates that conflicts occur and that more than just moral wisdom is needed to ensure a moral outcome.
Case scenario: Susan’s dilemma
The following scenario illustrates the moral distress a nurse may experience when her patient advocacy meets resistance or her moral courage is challenged. It also describes effective management strategies to help nurses resolve these problems.
Julie, age 45, works in a telemetry