Nursing Management

Think of and identify a timely issue that requires you to perform the role of moral agent or
advocate to improve a situation (e.g., speaking or acting on behalf of a vulnerable patient,
the need for appropriate staffing, a colleague being treated unfairly).
What are the potential outcomes if you do not execute that role?
What skills, dispositions, and/or strategies would help you to fulfill this role?
Finally, consider the values and principles that guide the nursing profession; the
organization’s mission, vision, and values; the leadership and management competencies
addressed in this course; and your own values and reasons for entering the profession.
What motivation do you see for taking a stand on an important issue even when it is
difficult to do so?
Write a 3- to 4-page paper that addresses the following:
Describe your role as a moral agent or advocate for a specific issue in your work
environment or an organization with which you are familiar.
Explain one or more negative outcomes that may result if this role is not fulfilled.
Analyze the skills, dispositions, and/or strategies that would help you to fulfill this role.
Explain your motivation for taking a stand even when it is difficult to do so.
Use current resources. Potential resources are:
Chiarella, M., & McInnes, E. (2008). Legality, morality and reality – The role of the nurse
in maintaining standards of care. Australian Journal of Advanced Nursing, 26(1), 77-83.
Johansen, M. L. (2012). Performance potential. Keeping the peace: Conflict management
strategies for nurse managers. Nursing Management, 43(2), 50-54.

Taking a Stand

Nurses experience a wide array of ethical challenges and this make them take on the role
of moral agents or advocates. Hence, it is greatly important that a nurse has sufficient knowledge
on the proper ethical decisions whenever ethical situations come up. As a result, nurses are able
to deliver equitable and quality health care to patients. Gutierrez (2009) asserts that every health
care institution has an obligation of promoting ethically proficient environments.

Issue in the nursing work environment

A patient had suffered from leukemia for an extensively long period during which she
was in and out of the hospital. During one of the admissions, the patient informed the family of
his decision that he preferred not to undergo further active resuscitation in case his condition

deteriorated. His argument was that he had endured severe suffering. The family agreed to this
decision as they were also greatly affected by the patient’s suffering. According to the nursing
team, the patient was easy to be cared for and lovely. He was informed of his rights as a
healthcare recipient, which made him voice his decision to the team as well.
The above description is evidence of the moral dilemmas involved in nursing. In
particular, the dilemma concerns the moral right of a patient to refuse treatment. On the same
note, the nursing team has a role of ensuring quality care to all patients. As far as the patient and
nursing team are involved, this situation brings about intense moral conflict since there is a
concern for the impacts of equality right (Gutierrez, 2009). Normally, a nurse is obligated
morally to promote the well-being and health of patients. In accomplishing this, there is a need
for the nurse to ensure that there is a balance between how she understands the preferences of the
patient and her professional expertise and knowledge. According to a nurse’s profession, she is
supposed to work collaboratively with patients. As a result, she is able to help, advise, guide, and
educate patients. As a result, patients are able to make proper and responsible decisions in regard
to their health.

The roles of a moral advocate or agent

As a moral agent, a nurse is obligated to consider the patient’s cultural background, social
circumstances, and health status when assessing him (Mallik, 2011). On the same note, a nurse
should consider the strategies that the patient used while making his decision. However, the
nurse has to abide by the ethical and legal framework of her practice and personal convictions. It
is the obligation of a nurse as a moral advocate to promote the ultimate good in her decision
making and practice by promoting quality patient health (Rn & Rn, 2010). Apart from upholding
to ethical, moral, and legal traditions of the profession, a nurse should not discriminate a patient

on any basis including race, conviction, color, and religion. In regard to this case, the nursing
team is supposed to demonstrate the virtues of honesty, caring, respect, and trustworthiness
(Mallik, 2011).
After consideration of the facts in the case, a nurse should then act as a virtuous moral
agent. In doing this, it is important that the nurse is aware and considers the emotions that the
case evoked in her. Being aware of the emotions a patient’s decisions evoke ensures that a nurse
is able to illuminate and deepen the understanding of the situation’s moral nature and
significance as well as the assessment (Corley, 2010).

Negative outcomes if a nurse fails to act as a moral agent

Failure for a nurse to act as a moral advocate results to a several impacts. The patient
health is likely to deteriorate or worsen as a result of inadequate assessment as a result of failing
to consider the circumstances surrounding the situation. Health deterioration leads to
complications or death. If a nurse does not act as a moral advocate, she always suffers from
anxiety because of the nagging though that the patient is likely to die unnecessarily. Furthermore,
there might be the worry that the nurse makes decisions that bring about uncalled for distrust and
worry to her important others (Rn & Rn, 2010). Besides, the nurse feels that the patient is likely
to pay no attention to her professional health promotion role.
Strategies, skills, and dispositions

Successful nurse moral agents possess wide knowledge and information of their career.
For instance, a nurse should possess information that value for life and the possibility for
recovery are the major arguments that nurses offer against patient resuscitation.
A nurse should acknowledge the challenges she is likely to face when advocating for the
rights of a patient and how to react to them. Some of the challenges include the assumption that

unethical actions are acceptable, group thinking that disregards independent thinking, nurses’
lack of concern where they lack moral courage to enhance patient rights, and organizational
culture; nurses should be keen on promoting an ethical culture as well as preaching its profit to
other professionals (Gutierrez, 2009).
Affective and objective information are essential when assessing whether a situation
needs more exploration. Utilizing these requires moral courage. A nurse should have a keen
concern for moral obligation by taking time to consider the moral values and ethical principles
being compromised. Lindahl and Sandman (2012) notes that issues that prevent moral courage
should be addressed. In this regard, cognitive strategies for emotional control as well as risk-
aversion management should be used. Possible actions and potent adverse repercussions should
be regarded. There is also a need to avoid apprehension and overreflection, which are stumbling
blocks. Assertiveness and negotiation skills demonstrate expression and action.


According to Corley (2010), acting as a moral agent is ethical and as a result, a nurse is
fully contented with herself, outcomes, and career. Although the nursing profession requires
nurses to act ethically, a nurse has an individual role of promoting morals in her career and


Acting as a moral advocate requires a nurse to argue for the patient’s behalf. However,
the nurse should abide by the institution’s and nursing guidelines. Failure to make ethical
decisions results to many negative consequences. So as to implement decisions effectively, a
nurse should have a special set of strategies, skills, and dispositions.



Corley, M. C. (2010). Nurse moral distress: a proposed theory and research agenda. Nursing
ethics, 9(6), 636-650.
Gutierrez, K. M. (2009). Critical care nurses’ perceptions of and responses to moral distress.
Dimensions of Critical Care Nursing, 24(5), 229-241.
Lindahl, B., & Sandman, P. O. (2012). The role of advocacy in critical care nursing: a caring
response to another. Intensive and Critical Care Nursing, 14(4), 179-186.
Mallik, M. (2011). Advocacy in nursing- a review of the literature. Journal of Advanced
Nursing, 25(1), 130-138.
Rn, D. S. H., & Rn, K. F. (2010). Moral distress, advocacy and burnout: Theorizing the
relationships. International Journal of Nursing Practice, 5(1), 8-13.

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