護理倫理規範──談護理新手到專家之「盡職」倫理

The Code of Ethics for Nurses: The Ethical Norms of “Fidelity”, From Novice to Expert

近年，專業形象逐漸受到重視，克盡職守常為許多工作崗位提倡首要守則，也成為影響人員專業行為的重要因素。在健康照護體系中，不免會遇到照護倫理困境與議題，時時考驗著專業人員的倫理因應能力與行為表現。本文藉由文獻回顧分析並探討現今規範倫理學與護理規範、倫理行為及實務間的關係，結果發現常規的倫理規範之下，倫理行為規範準則很少被討論。行善原則是行為規範最重要的準則，而盡職 （fidelity）是護理倫理規範中行善原則最重要的行為元素，包含忠誠、公正、真誠、倡言和貢獻等五要素。本文呼應美國護理學會2015年增修的護理倫理規範，強調將倫理規範照護實踐於護理人員照護實務工作上。護理工作強調對個案的專業照護行為，本文說明盡職原則於護理倫理規範照護中的重要性，統整護理人員從新手到專家各階段應具備的「盡職」倫理行為，以作為護理人員實務照護及專業角色發展之參考。

The image of professionals has been taken seriously in recent years. Professional healthcare providers have observed their duty strictly for many jobs codes, which has also affected their behavior. In the healthcare system, ethical dilemmas and issues regularly influence and challenge professional ethical behaviors and the competencies of health professionals. The present article highlights the literature discussions regarding current ethical norms, nursing codes, and professional-practice-related ethical behaviors. The findings indicate that fidelity is an important component of ethical behavior norm that is guided by the ethical principles of beneficence. Five elements of fidelity were identified, including loyalty, fairness, truthfulness, advocacy, and dedication. The 2015 American Nurses Association’s code of nursing ethics emphasizes the ethical behavior of fidelity in nursing practice. The results encourage nurses to apply the guide of fidelity to develop their nursing professional role across their professional nursing career, from the novice to expert level.