By Kris TrairatanaBy Kris Trairatana

Learning and Ethics Learning and Ethics Teaching in Nursing Teaching in Nursing

Programs and Programs and Clinical PracticeClinical Practicewith Technologywith Technology

The Florence Nightingale PledgeThe Florence Nightingale Pledge

I solemnly pledge myself before God and presence of this I solemnly pledge myself before God and presence of this assembly; To pass my assembly; To pass my life in puritylife in purity and to practice my and to practice my profession faithfully. profession faithfully.

I will abstain from whatever is deleterious and mischievous and I will abstain from whatever is deleterious and mischievous and will not take or knowingly administer any harmful drug. will not take or knowingly administer any harmful drug.

I will do all in my power to maintain and elevate the I will do all in my power to maintain and elevate the standard of standard of my professionmy profession and will hold in confidence all personal matters and will hold in confidence all personal matters committed to my keeping and family affairs coming to my committed to my keeping and family affairs coming to my knowledge in the practice of my calling. knowledge in the practice of my calling.

With loyalty will I endeavor to aid the physician in his work, and With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.devote myself to the welfare of those committed to my care.

IntroductionIntroduction

Higher education in nursing fieldHigher education in nursing field

is very critical because they are many factors is very critical because they are many factors that make RNs stop continuing study further.that make RNs stop continuing study further.

New alternative is there are many schools all New alternative is there are many schools all over the country offer online class for nursing, over the country offer online class for nursing, BNS, MSN, PhD, and DNPBNS, MSN, PhD, and DNP

Ethics in Nursing is very significant for this Ethics in Nursing is very significant for this field to be concerned.field to be concerned.

BackgroundBackground

Fundamental concept of caring in nursing education Fundamental concept of caring in nursing education is morality and ethics which directly active teaching is morality and ethics which directly active teaching on face-to-face classroom setting.on face-to-face classroom setting.

Classroom setting provide two-way communication Classroom setting provide two-way communication both interactively verbal and nonverbal both interactively verbal and nonverbal communication.communication.

After educational technology has been used in After educational technology has been used in nursing, online class is new option for nursing to nursing, online class is new option for nursing to improve their competency in clinical practice; and improve their competency in clinical practice; and ethics becomes a very huge issue.ethics becomes a very huge issue.

Vision StatementVision Statement

Promote standard nursing care excellence Promote standard nursing care excellence through a community of lifelong learningthrough a community of lifelong learning

Provide a supportive environment that fosters Provide a supportive environment that fosters the educational and develop needs to studentsthe educational and develop needs to students

Cooperate teaching strategies, promotion of Cooperate teaching strategies, promotion of critical thinking skills and use of progressive critical thinking skills and use of progressive technology to decision-making and problem-technology to decision-making and problem-solving to resolutions and dilemmassolving to resolutions and dilemmas

Mission StatementMission Statement

Prepare the highest qualified professionals to meet Prepare the highest qualified professionals to meet the needs of individuals, families, and communitiesthe needs of individuals, families, and communities

Promote and value:Promote and value: Professional development and growth in changing health Professional development and growth in changing health

care environmentcare environment Caring attitude balanced with technical competenceCaring attitude balanced with technical competence Respect for the individualRespect for the individual Excellence in the practice of professionalExcellence in the practice of professional Srtength and joy of diversitySrtength and joy of diversity

GoalsGoals DirectDirect

Encourage professional nursing in practice, moralityEncourage professional nursing in practice, morality Promote values, beliefs and philosophiesPromote values, beliefs and philosophies

IndirectIndirect Support concept of nursing ethics to students to serve patients, other Support concept of nursing ethics to students to serve patients, other

people, and communitypeople, and community Short-termShort-term

Recognize the ethics and morality to practiceRecognize the ethics and morality to practice Amalgamate concept of ethics, philosophy, morality, legislation, Amalgamate concept of ethics, philosophy, morality, legislation,

values, beliefs, and awareness as a wholevalues, beliefs, and awareness as a whole Long-termLong-term

Encourage RNs back to school to contribute more knowledge in Encourage RNs back to school to contribute more knowledge in extensive educationextensive education

Support and explore the researches in nursing ethicsSupport and explore the researches in nursing ethics Shortage of nursing instructors (backup)Shortage of nursing instructors (backup)

Nursing EthicsNursing Ethics(Tschudin, 1992)(Tschudin, 1992)

Ethics between nurses and Ethics between nurses and patientspatients ConfidentialityConfidentiality AdvocacyAdvocacy

Ethics between nurses and Ethics between nurses and doctorsdoctors Nursing autonomyNursing autonomy Making independent Making independent

decisionsdecisions Challenging medical opinion Challenging medical opinion

or treatmentsor treatments Ethics between nurses and Ethics between nurses and

nursesnurses

Ethics between nurses and Ethics between nurses and their employerstheir employers Standards of careStandards of care AccountabilityAccountability Conflict with managersConflict with managers Objection to treatments and Objection to treatments and

policiespolicies Ethics between nurses and Ethics between nurses and

the professionthe profession Political actionPolitical action StrikesStrikes professionalismprofessionalism

Ethical FrameworkEthical Framework Definition of ethics is concerned withDefinition of ethics is concerned with doing good and avoiding harmdoing good and avoiding harm Nursing decisions affect people (patients)Nursing decisions affect people (patients) Nurses thereby have the power to do good or harm to Nurses thereby have the power to do good or harm to

their patients. Possibilities of good or harm depend their patients. Possibilities of good or harm depend partly on factual knowledge and partly on values.partly on factual knowledge and partly on values.

Nursing features includes education, research, and Nursing features includes education, research, and practicepractice

Applying ethics to clinical practiceApplying ethics to clinical practice Ethical direction-personal control rather than Ethical direction-personal control rather than

organizational controlorganizational control

Ethical FrameworkEthical Framework

FactualKnowledge

Definitionof Ethics

Values

Good

Bad

PatientsAnd

Community

Practice

Research

Education

Personal

Code of Ethics for Code of Ethics for TeachingTeaching

Provide a benchmark for interpreting the Provide a benchmark for interpreting the public interest as it deals with conflict and public interest as it deals with conflict and guide the academic enterprise in values-based guide the academic enterprise in values-based decision-makingdecision-making

Values conflict exits in health care situations, Values conflict exits in health care situations, as well as in teaching and learning continuumas well as in teaching and learning continuum

Be reactive or disciplinary, or proactive, Be reactive or disciplinary, or proactive, serving as a guide for our actions and decisionsserving as a guide for our actions and decisions

Education for Education for Internet LearningInternet Learning

Structural guidelines for curriculum and course Structural guidelines for curriculum and course content have been firmly established by schools.content have been firmly established by schools.

Web-learning provides a direct transposition of Web-learning provides a direct transposition of traditional policy have served.traditional policy have served.

School policy defines environment in which decisions School policy defines environment in which decisions are made and extension of reach of standard policy.are made and extension of reach of standard policy.

Arrange of services for quality online learning that Arrange of services for quality online learning that includes orientation, access to the library, technical includes orientation, access to the library, technical support, and activities that promote asupport, and activities that promote a

sense of community.sense of community.

Ethics-Based Internet Ethics-Based Internet for Nursing Educationfor Nursing Education

Nurturing positive ethical behavior for web-based Nurturing positive ethical behavior for web-based learning for nurses is clearly a timely action:learning for nurses is clearly a timely action: FirstFirst-Internet Code of Ethics to guide attitudes and actions-Internet Code of Ethics to guide attitudes and actions SecondSecond-essential ingredient is advocacy with commitment -essential ingredient is advocacy with commitment

from the nursing leadershipfrom the nursing leadership ThirdThird-contribution is publicity about the code and its role -contribution is publicity about the code and its role

in guiding Internet learning and consultationin guiding Internet learning and consultation All steps need charismatic leadership from nurse All steps need charismatic leadership from nurse

teachers.teachers.

Developing Components Developing Components of Ethical Frameworkof Ethical Framework Quality of content on the InternetQuality of content on the Internet

Faulty have to document sourcesFaulty have to document sources Internet is not confidentialInternet is not confidential Schools have to develop methods of outcome assessment, Schools have to develop methods of outcome assessment,

differ from traditional classroom settingdiffer from traditional classroom setting Policy on student dataPolicy on student data

Faculty need to identify what types of student information Faculty need to identify what types of student information are needed and for what purposeare needed and for what purpose

Purpose of Internet-learning is to draw together students Purpose of Internet-learning is to draw together students from diverse geographic regions.from diverse geographic regions.

Schools have to control purposes for which student-based Schools have to control purposes for which student-based Internet information is used.Internet information is used.

Developing Components of Developing Components of Ethical Framework (Cont.)Ethical Framework (Cont.) Informed consent and confidentialityInformed consent and confidentiality

Ethical principle of respect patient’s Ethical principle of respect patient’s confidentialityconfidentiality

Update and confirmation of consentUpdate and confirmation of consent Conflict of interestConflict of interest

Quality and cost in managed care settingsQuality and cost in managed care settings Quality and speed (time of peer review)Quality and speed (time of peer review)

ImplementationImplementation

The basic assumption is to enhance practice of The basic assumption is to enhance practice of professional nursing care:professional nursing care:

Significance of changeSignificance of change is quality of nursing is quality of nursing knowledge and skill practice, professionalism, knowledge and skill practice, professionalism, nursing ethics, and humanistic concernnursing ethics, and humanistic concern

CBAMCBAM supports professional development and supports professional development and explains the process of change theory, method and explains the process of change theory, method and process of transition, receivers (students), and process of transition, receivers (students), and feedback (assignments, comments, and survey)feedback (assignments, comments, and survey)

EvaluationEvaluation

CIPPCIPP: outcomes of plan, back to the course : outcomes of plan, back to the course objective, educational method, learning objective, educational method, learning activities, analysis of informationactivities, analysis of information ContextContext: large picture of program: large picture of program InputInput: human, material resources: human, material resources ProcessProcess: materials, teaching-learning method, : materials, teaching-learning method,

educational technology (feedback, comment, and educational technology (feedback, comment, and survey)survey)

ProductProduct: outcomes from receivers: outcomes from receivers

RecommendationRecommendation

Academic ComponentAcademic Component Human resourceHuman resource Material resourceMaterial resource Experience resource: teaching strategy and Experience resource: teaching strategy and

technologytechnology IndividualsIndividuals CommunityCommunity

ConclusionConclusion

Nursing Program

Traditional Setting

Online Setting

Online and EthicalTeaching in Nursing Program

PersonalValues

Learners

EducationalTechnology

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