nursing ethics
Live by the code
Do your research on ethics and you will 'do no harm'.
nursing ethics
Helm an ethics team
Successfully lead an ethics committee with the right tools.
nursing ethics
An intense experience for RNs
Care decisions are complicated when it comes to terminally ill kids.
nursing ethics
Address your moral distress
Liaisons support nurses who need to air ethical concerns.
nursing ethics
LGBTQ care up close
The LGBTQ community has special needs requiring special care.
nursing ethics
BSN in 10 changes things
The New York law raises education requirement for RNs.
nursing ethics
There's power in a hug
Babies need to be touched and held in order for them to thrive.
nursing ethics
The ethics of advocacy
Nurses can be forces of change outside of their workplaces.
nursing ethics
When the end of life is near
Patients need nurses more than ever in their final days.
nursing ethics
Call out unsafe practices
Speaking out against a colleague is intimidating, but necessary.
nursing ethics
8 key assumptions
Leaders draft a blueprint that prioritizes nursing ethics.
nursing ethics
Make every day count
A nurse helps a dying patient spend more time with his young daughter.
CE catalog
Learn important ethics lessons by taking these education modules.
nursing ethics
Keep it confidential
Community RNs must follow confidentiality and privacy policies.
nursing ethics
Know the code
Prepare for patient care challenges by learning the Code of Ethics.
nursing ethics
Who's your go-to person?
RNs share whom they turn to when faced with an ethical dilemma.
nursing ethics
How to make ethical decisions
Patient care decisions start with knowing what the patient wants.
nursing ethics
Choose your words wisely
Medical staff taped comments land them in hot water.
nursing ethics
Protect whistleblowers
Whistleblowers can face repercussions without protection.
nursing ethics
FREE CE: Gene testing
Patients can get gene testing kits on the web. But should they?
nursing ethics
A beautiful death
Treat patients as you would want a family member treated at the end.
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When the end of life is near
Patients need nurses more than ever in their final days
Eileen P. Williamson, MSN, RN
Eileen Williamson, MSN, RN, is the former senior vice president and chief nurse executive at OnCourse Learning. Williamson continues to write for and serve in an advisory role.
Early in our nursing education we learned we would have to deal with patient care situations that could be upsetting and stressful at the least, and pose ethical questions and dilemmas at worst.
Given the continued changes and complexities in our healthcare system, most of us have faced such situations. And the possibility of having to face more of them will only increase, especially where care at the end of life is involved.

Patients are living longer and using more healthcare services well into their 80s and 90s, particularly in their final days. Providers are faced with more legal and regulatory agency guidelines and government agencies have increasing oversight of Medicaid and Medicare costs regarding long-term and end-of-life care. Along with all of this there are ongoing mandates to ensure safety and quality; safeguard patient rights; and be cost-effective.
End-of-life care
is complex. In addition to the nutrition, hydration, medication, palliative care and pain management needs patients have, there also are psychological, emotional, spiritual and social needs to be met. Patients who may be dealing with anger, depression, fear or financial worries will need help with insurance, legal decisions, advance directives, wills and more. Their needs and the needs of their families are not always easy to predict and sometimes difficult to fulfill, yet they must be met.
Their needs and the needs of their families are not always easy to predict and sometimes difficult to fulfill, yet they must be met."
— Eileen Williamson, RN

Nurses' vital role in end-of-life care often places them in situations that can cause ethical conundrums. This can happen whenever there’s a conflict between two strongly held principles, or when a choice between so-called “right” and “wrong” is being considered.

Each time we minister to patients in their last days, our belief systems and personal values are tested because we know our care decisions can ameliorate or aggravate suffering or make the dying process better or worse. We have guidelines to assist us, but because we spend more time with patients than any other caregiver group, we most often serve as their confidants, advocates and sources of information. And there’s not always a rule book nearby to help us.
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Individually as nurses and collectively as a profession we’ve spent time exploring ways to prepare for how to deal with these complex issues. Some of us may have reflected on our colleagues’ varying viewpoints regarding what end-of-life care should and should not include. Others may have thought about differences in how life, death or quality of life can be defined. Maybe we’ve examined of our own responses to ethical dilemmas, such as a no-hope prognosis, a patient’s right to refuse care or aggressive attempts to extend life when doing so would only prolong suffering. Do we and our colleagues feel differently or the same about these crucial issues? Even if there are disagreements, we can work together toward greater understanding and agreement on the vital role we play in our patients' final days. And when the end is near, we can provide the special care they need and deserve.
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