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Practical Ethics for Nurses and Nursing Students: A Short Reference Manual FREE TO VIEW

Janet Stebleton
Chest. 2003;124(1):418-419. doi:10.1378/chest.124.1.418-a
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Published online


By Kathryn Schroeter, RN, MS, MA; Arthur Derse, JD, MD; Charles Junkerman, MD; and David Schiedermayer, MD. Hagerstown, MD: University Publishing Group, Inc, 2002; 112 pages; $7.95

This short reference manual contains a brief overview of the most common ethical issues that nurses and nursing students might experience. The authors are well-qualified to present this information, as they are all involved in the Bioethics Department at the Medical College of Wisconsin. The lead author is a registered nurse on the Bioethics Department clinical faculty and also serves as Surgical Services Education Coordinator at Froedtert Hospital. The other three authors are physicians who are also on the Bioethics Department faculty (one is a Professor Emeritus and one is also a lawyer).

The format is that of a compact, portable, paperback reference book, measuring 5 by 7 inches and containing 112 pages. The contents are divided into XXVII topics (yes, they are listed using Roman numerals), and each topic is covered in 2 to 5 pages, including the references. The topics tend to fall into three broad categories. First are those topics that encompass general or background subjects such as Professional Responsibilities (of nurses), Legal Issues, Ethics and Managed Care, Ethics Consultation, and Bioethics: Theories and Principles. The second and largest category includes about 14 fairly specific topics involving straightforward legal restrictions and definitions. These include such subjects as Informed Consent, Organ Donation, Advance Directives, and Research, among others. The last category contains seven areas that are somewhat less well-defined legally and that pertain more specifically to nurses, such as Patient Advocacy, The Difficult Patient, and specific areas of practice such as pediatric, obstetric, and psychiatric nursing.

The main strength of this manual lies in the ability of the authors to take exquisitely complex (and, I might add, at times controversial) subject matter and, for the most part, condense the information into manageable and comprehensible reference points. The concept of this book is useful, and the first author was able to maintain the necessary brevity. I particularly liked the underlying concept of “looking up” an ethics topic and being able to read about the aspects that were most pertinent to the matter.

There were a few weaknesses that were apparent. The material should have been organized in a more logical fashion, perhaps using a few chapter headings and listing the appropriate topics under them. The order of the topics also seemed to be random. Given that one of the specific objectives of the manual was to be succinct, it would have been helpful to list some pertinent recommended readings for the reader who may be interested in further pursuing a particular topic. The topics were noticeably unevenly written, and, unfortunately, some of the topics most pertinent to nursing were among the weakest. Some examples included the first topic, “Professional Responsibilities,” which should have established the framework for the whole book. Instead, it rambles on with lists of nursing ethical duties (the American Nurses Association code of ethics), Nurses’ Rights, Nurses’ Duties, What Nurses Should Know, Patients as Individuals, Patient’s Rights, Fundamental Goals of Healthcare, and Moral Decision Making. This was by far the weakest topic, but should have been the strongest. At the risk of appearing politically incorrect, the topic entitled “Cultural Competence” might have been included only to be politically correct. The first precept of the American Nurses Association code of ethics states: “The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual… ” This would encompass all differences, not just cultural. Finally, the topic “The Future of Ethics in Nursing: Implications for Nurse Managers” seemed a little out of place in a book written for nurses and nursing students.

Overall, this is a handy little reference book that includes the major ethical issues that are common to nursing practice at this time. It could benefit greatly, however, by better organization of the subject matter and more consistency in the topic coverage and formatting. It would seem to be most useful for beginning nursing students to be made aware of ethics as a part of their professional practice.




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