領導管理之倫理關注

Ethical Issues in Nursing Leadership

社會的變遷造成醫病關係與整體價值觀的改變，然而護理主管具有營造組織倫理文化的責任，以及展現高度倫理判斷的能力。本文由倫理知識建構的角度，檢視廿一世紀護理主管的倫理關注焦點與決策歷程，包括：病人需求、同仁感受，以及組織利益或專業形象間的權衡。倫理困境的決策方法，包括傳統問題解決法、護理過程、道德決策模式與系統性倫理決策法，這些決策方法皆在文中加以闡述。倫理決策沒有一定的標準步驟，護理主管有責任進行多方面努力，連結雇主與部屬、專業人員與病患、工作組織與員工彼此間之信賴，唯有加強倫理困境決策方法的運用，才能夠確保照護品質的執行及減少不當護理醫療措施的發生。

Social transition causes shifts and changes in the relationship between health, professionals and their patients. In their professional capacity, it is important today for nurses to handle ethical dilemmas properly, in a manner that fosters an ethical environment. This article investigates the ethical concerns and decision processes of nurses from a knowledge construction perspective, and examines such issues as patient needs, staff perceptions, organizational benefits, and professional image. The decision making methods commonly used when facing ethical dilemma explored in this study include the traditional problem solving, nursing process, MORAL model, and Murphy's methods. Although decision making for ethical dilemmas is governed by no universal rule, nurses are responsible to try to foster a trusting relationship between employee and employer, health care providers and patients, and the organization and colleagues. When decision making on ethical dilemmas is properly executed quality care will be delivered and malpractice can be reduced.