Ethical Principles in Nursing: Tips for Nurse Leaders in Promoting Ethical Practice

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Leadership plays a significant role in developing and maintaining nursing ethics.

For nearly 20 years, nursing has topped Gallup polls as the most honest and ethical profession. Leadership plays a significant role in developing and maintaining nursing ethics. Ethical nurse leaders create work environments that impact employee choices, behaviors, and values.

For nurse leadership and ethical decision making to work concurrently, nurse leaders should review what kind of ethical challenges their staffs typically encounter and determine the best ways to resolve the difficulties. Researchers in the Journal of Medical Ethics and History of Medicine said nurses who practice ethical leadership in their daily actions advance positive behaviors in healthcare.

“Ethical leaders must strive to model and support ethical performance and at the same time be sensitive to moral issues and enhance nurse’s performance by fostering respect for human dignity; thus, they can play an important role in promoting patient safety, increase the capacity to discuss and act upon ethics in daily activities and support the ethical competence of nurses,” researchers said in “Obstacles and problems of ethical leadership from the perspective of nursing leaders: a qualitative content analysis.”

is particularly important for registered nurses (RNs) who are striving to advance their careers. Indeed, among the many requirements of a Doctor of Nursing Practice (DNP) curriculum, including an online DNP program, is understanding and adopting ethical standards for nursing leadership.

Nursing Leaders Promoting Ethics

Before nurse leaders can adapt and implement ethical standards, they must understand the components of ethical decision-making as they apply to the field. The American Nurses Association (ANA) and other nursing leadership organizations outline these basic principles as a baseline for ethical nursing practice:


Nurses must be committed to helping patients and seeking out the best possible healthcare outcomes for them.


Nurses must make sure they are not purposely harming patients in their care. While treatment or procedure can have negative impacts on patients, nurses should not cause intentional harm.


Nurses should be faithful to their promises and responsibility to provide high-quality and safe care.


Nurses must accept personal and professional consequences for their actions.


Truthfulness is a cornerstone in nursing and something patients depend on. Patients should be able to depend on nurses for the truth even if the information is distressing.

Patient autonomy

Patients are entitled to know about all of their treatment options and have the right to make decisions about their healthcare based on their personal beliefs. Patients have the right to refuse treatment or medication. If a patient does not have the capacity to understand the information, the patient’s healthcare power of attorney should be consulted.

In addition to understanding components of ethical decision-making, nurse leaders must be able to help staff nurses handle the implications that arise from poor ethical choices. Failure to address moral distress that results from poor ethical decision-making can wreak havoc on a nursing unit, the nursing workflow production platform Lippincott Solutions said.

“As moral distress on a unit increases, so too does staff turnover and a loss of job satisfaction,” the organization said.

Exemplifying Ethics in Nursing Leadership

To provide staff members with the tools they need to identify personal ethical frameworks, nurse leaders should take these steps:

  1. Identify and discuss the nursing unit’s common ethical dilemmas
  2. Organize an ethics committee or identify ethical champions in everyday life
  3. Develop ethics-friendly policies and procedures
  4. Provide continuing education and training in ethical decision making
  5. Promote open discussions among staff nurses and managers regarding ethical patient care

In addition, recommends that nurse leaders use the problem-solving process to make ethical decision-making easier:

  • Define the problem: Clearly define the ethical dilemma and the circumstances behind it.
  • Collect information: Review published information, professional position papers, codes of ethics, and information about the ethical dilemma.
  • Analyze information: Organize and assess the collected information.
  • Identify solutions: Explore the problem and seek out all possible solutions and alternatives to resolve the dilemma.
  • Choose a single solution: Select the best possible solution. Keep in mind that the best solution might not be the most desirable, but it may follow the most ethical path.
  • Perform solution: Follow through on the chosen solution.
  • Evaluate results: Review the outcome of the situation, how it aligns with the original desired outcome and the overall effectiveness of resolving the dilemma.

In addition to following guidelines and decision-making theories, nurse leaders should trust their well-honed instincts as a result of an advanced RN education.

Duquesne University online DNP students learn about ethics in nursing leadership, including how to apply ethical decision-making to everyday work. The DNP curriculum teaches students how to apply advanced thinking and observation skills to the most challenging ethical dilemmas.

About Duquesne University’s Online DNP Program

Duquesne University’s online DNP program prepares RNs to demonstrate ethical leadership through positive workplace culture and decision-making. Duquesne University, a leader in nursing education, offers three DNP tracks:

  • Clinical Leadership DNP
  • Post-Bachelor’s Executive Nurse Leadership DNP
  • Post-Master’s Executive Nurse Leadership DNP

Duquesne University has been repeatedly recognized as a leader in nursing education, most recently as a “Best Online Graduate Nursing Programs” by U.S. News & World Report. The university’s online DNP program provides one-on-one faculty mentorships and a 100 percent online curriculum. Apply today!


Gallup, Nurses Again Outpace Other Professions for Honesty, Ethics
Journal of Medical Ethics and History of Medicine, Obstacles, and problems of ethical leadership from the perspective of nursing leaders: a qualitative content analysis
Lippincott Solutions, Best Practices for Ethical Nursing Leadership, Ethical Practice: NCLEX-RN