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 describe how nurses who practice ethical principles in nursing 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,” a researcher says in “Obstacles and Problems of Ethical Leadership from the Perspective of Nursing Leaders: A Qualitative Content Analysis.”

Practicing ethical nursing leadership is particularly important for registered nurses who are striving to advance their careers. Indeed, among the many requirements of a Doctor of Nursing Practice curriculum is understanding and adopting ethical principles in nursing.

7 Ethical Principles in Nursing

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

1. Benevolence

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

2. Nonmaleficence

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

3. Fidelity

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

4. Accountability

Nurses must accept personal and professional consequences for their actions.

5. Veracity

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.

6. Justice

The principle of justice is integral to the medical field. Healthcare facilities should distribute an equal amount of resources to patients, and nurses should ensure that they provide care according to legal regulations.

7. 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. According to an article published by Lippincott Williams & Wilkins, “As moral distress on a unit increases, so too does staff turnover and a loss of job satisfaction.”

Why Ethics Is Important in Nursing

While ethics play an important role in every field and industry, ethics is especially important in the field of nursing. Nurses interact with patients on a daily basis, assessing their conditions and symptoms, as well as administering their medications. Nurses need to be committed to taking care of patients and ensuring the most effective patient care. Whether operating equipment or helping with treatments, nurses also need to avoid nonmaleficence.

Since nurses can observe patients over time, they should maintain consistent and effective care. Patients rely on their nurses as primary communicators in the medical field, so nurses should exhibit fidelity and veracity, being faithful to and honest with their patients as well as their patients’ families at all times. Whether asking advice from fellow nurses, nurse managers or doctors, registered nurses should have a network of accountability.

One of the most important ethical principles in nursing that nurses should be aware of in their day-to-day jobs is justice. Nurses should make sure that they are doing everything in their ability to serve all their patients in an equitable and effective manner. In the same vein, nurses should also balance thoughtful bedside manner and transparency. While nurses should be empathic toward the conditions of patients, they should also make sure that patients have the autonomy to make their own decisions and should not withhold information from them.

Tips for Ethical Leadership in Healthcare

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

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

Nurse leaders can use the following problem-solving process to make the process of integrating ethical principles in nursing easier:

Defining 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 the Solution

Take the necessary steps to follow through with the chosen solution.

Evaluate Results

Review the outcome of the situation, how it aligns with the original desired outcome and the overall effectiveness to 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 nursing education. Duquesne University’s online Doctor of Nursing (DNP) students learn about leadership and ethical decision making. The DNP curriculum teaches students how to apply advanced thinking and observation skills to the most challenging ethical dilemmas.

Pursue an Online Doctor of Nursing Practice

Duquesne University’s online DNP program prepares registered nurses to demonstrate ethical principles in nursing leadership through positive workplace culture and decision making. Students in the doctoral education program can focus on one of two tracks: Clinical Leadership and Executive Nurse Leadership or Health Care Management. The university’s online DNP program provides one-on-one faculty mentorships and a 100 percent online curriculum.

If you are a registered nurse interested in advancing your career and incorporating ethical principles in nursing, explore how Duquesne University’s online Doctor of Nursing Practice can help you further your nursing career as a leader in the field.

Recommended Readings

DNPs Leading Safety Culture and Advancing National Patient Safety Goals

Leadership Styles and Their Impact on Patient Outcomes

Strategies to Transition to Advanced Nursing



American Nurses Association, “Ethics and Human Rights”

Gallup, “Nurses Again Outpace Other Professions for Honesty, Ethics”

Lippincott Williams & Wilkins, Best Practices for Ethical Nursing Leadership 

National Center for Biotechnology Information, “Nursing Ethical Considerations” 

National Center for Biotechnology Information, “Obstacles and Problems of Ethical Leadership from the Perspective of Nursing Leaders: A Qualitative Content Analysis”, “Nursing Ethics”