What does Integrity mean?
To combine into a unified whole
What are the components of Integrity?
- Moral autonomy
- Fidelity
- Steadfastness
- Wholeness
Moral autonomy:
- We make choices to reject authority, and to make decisions on behalf of ourselves and patients
- We can refuse certain tasks:
EX. refuse to administer certain medications, refuse to restrain a patient
*Patient autonomy is different than nurse autonomy - We need to understand the choices to make good ones
Fidelity (Faithfulness):
- The use of promises and telling the truth
- It includes the promises we make to our patients; specifically the TR
- We promise to follow the code of ethics and provide safe ethical care*
The code of ethics is our promise to the public*
Steadfastness/Resolute (the ability to withstand pressure):
It involves time management and stress management*
- Time management means prioritizing the important
- Stress management is included when time managing and should be a priority in itself
Wholeness:
- We have many different roles (student, friend, partner, child)
- We need to be the same moral person in ALL the roles**
EX. Don’t steal because you wouldn’t do it to a friend
Don’t be racist/homophobic because you wouldn’t do it to your partner - When you’re at work, you’re not at home, and when you’re home, you’re not at work
Why is accountability important?
Because when we make mistakes and admit fault, we grow as a moral individual
- It is harder to be accountable for your actions when things go wrong*
What is a moral dilemma?
- It is a situation in which you don’t know what to do*
It isn’t a huge problem for RPNs, we have the resources for these
What is moral distress?
- It is a situation in which you know what to do, but you’re kept from doing the right thing
- This is a large struggle for RPNs because HC makes it difficult for nurses to do the right thing (lack of resources, lack of time, rigid protocols)
There are physical and emotional consequences with this*
What is moral residue?
- It is the aftermath of moral distress
- You feel like a failure because you cannot do the right thing*
This impacts health (lack of sleep, poor digestion, headaches) (bursting into tears, getting angry, poor affect regulation)
What is moral courage?
The ability to bounce back from moral distress and moral residue
HOW? By making the system change!
What is moral injury?
- It is a loss of trust when authority/leaders/peers act in a way that VIOLATES ethical expectations*
EX.
Stigma - lack of respect by the Dr. or other nurses
Patient Liberty - restricting the patient that you know doesn’t need restrictions
Racism - treating the patient differently based on their appearance - Witnessing this causes injury to self*
What fixes moral distress and moral injury ?
- It cannot be fixed the same way burnout is*
It can only be fixed by LARGE SYSTEMIC CHANGE
WE NEED TO BE THE CHANGE
