In goede handen: verpleegkundige beroepsuitoefening in moreel perspectief

Abstract

In good hands. Nursing practice in a moral perspective. There is much debate about the moral aspects of nursing and the possibilities for moral professionalization. In this study we contribute to the debate by describing the possibilities nurses see for themselves to handle moral problems in patient care. Regarding ethical issues, nurses consider a specific role for themselves as patients advocates, a specific standpoint being based on a nursing domain which they can contribute to multidisciplinary consultation and an ethic of their own, being ethics of care. Analyzing the application of these positions in three pediatric case-study__s reveals that each position offers nurses insufficient support. Advocacy proves to be at odds with team-nursing, the nursing system that is most common. Successful participation in treatment decision-making turns out not to be based on a nursing domain but on a mutual frame of reference with doctors. Although a care-ethical analysis helps to understand the problems that may arise during care and treatment, important problems can not be solved with the aid of care ethics. Elements of all positions are used to construct a new ethical framework that can serve as a fundament for the moral professional practice of nurses and offer assistance to nurses in handling moral problems in patient care.