Ethics is one of the most critical aspects of nursing practice across the globe, as every decision that is made by a nurse has some ethical dimensions. Nurses are often faced with conflicting situations or circumstances that result in tension between their roles and personal and professional values. Like other medical professionals, nurses always face ethical dilemmas that are associated with their personal interest and needs versus those of their patients, as well as the community at large. Therefore, to overcome the ethical dilemma, nurses are required to utilize ethical decision-making models. The models ensure that nurses can make the right decisions in ethically conflicting situations, leading to improved care services. Nurses should understand ethical decision-making models and how to utilize them during nursing practices.
Part I
Ethical decision-making models help individuals and organizations to make the best decisions, particularly when they are faced with ethically challenging situations or circumstances. Currently, many such models are utilized in various sectors, including health. However, there are general ethical model criteria that apply to almost all ethical decision-making models or tools. The ethical model criteria for decision-making are based on four major steps. The first major step is the definition of the ethical dilemma (Zeni et al., 2016). To determine the contradicting values or morals and to understand the conflicting situations, individuals or organizations must first define the specific dilemma they are facing. The second major step is the clarification of both personal and professional values involves, especially concerning ethical principles. Personal and professionals values should be defined based on the ethical dilemma situation. Thirdly, individuals should determine alternatives for action. It is essential for a person facing an ethical dilemma to identify possible actions or solutions (Zeni et al., 2016). Finally, a person should choose the best ethical decisions among the available alternatives. An effective ethical decision-making model should reflect real-life situations.
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Ethical model positively impacts nursing decision-making in various ways. Importantly, the model ensures that nurses think critically when they encounter conflicting situations that may hinder health care service delivery ( Dunger, Schnell & Bausewein, 2017) . The model provides a systematic approach in making an ethical decision, resulting in reduce dilemmas and possible errors that can adversely affect service delivery. Also, the ethical model ensures that nurses consider all available alternatives before making the final decision, enhancing the accuracy and relevance of their choices. Thus, the ethical model improves nurses’ decision-making significantly, especially when they face ethical dilemmas in the workplace.
However, nurses still fail to follow ethical practices of patient health information (PHI) protection. The difficulty in identifying ethical or moral dilemmas is one of the major reasons why nurses do not adhere to the required ethical practice standards ( Ebrahimi et al., 2015) . At the same time, nurses cannot easily identify the relevant methods to solve moral dilemmas they face while discharging their duties and responsibilities. Although nurses are aware of their moral responsibilities, a significant number of them can hardly solve their moral dilemmas or challenges due to lack of knowledge, understanding, and experience ( Ebrahimi et al., 2015) . Besides, some of the work environmental challenges prevent nurses from complying with the ethical practice of PHI protection.
Also, nurses' moral values impact the protection of PHI. The way a nurse deals with a problem is closely linked to his or her moral values ( Sari et al., 2018) . Some of the moral values that are linked to the protection of PHI include honesty, valuing other people’s worth, and always doing good. Therefore, a nurse who has appropriate moral values is likely to enhance the protection of PHI. Moral values also determine the actions and behaviors of people, primarily when they are faced with difficult situations.
The main goal of ethical decision-making is to choose the best options among many alternatives, resulting in improve trust, respect, and responsibility ( Sari et al., 2018) . Also, ethical decision-making is aimed at achieving fairness and consistency. Thus, ethical decision-making leads to effective decisions. Individuals can only make ethical decisions conscious, competent, and committed to what they are doing.
Part II
Ethical decision-making requires a person to follow certain steps before arriving at the final decision chronologically. The model has a systematic approach to making ethical decisions. However, my ethical assessment results revealed that I do no systematically make ethical decisions, especially when faced with a moral dilemma. In many cases, I would prefer to make ethical decisions that are in line with my values, even though I would also consider professionals values. At the same time, I would not always take time to identify the ethical dilemma and possible alternatives before making the final decision. Therefore, my ethical practice assessment is not aligned with the ethical model for decision-making. Hence, I should strive to align my personal practice ethical assessment with the ethical models to improve my decision-making abilities.
Also, to improve the effectiveness of an ethical model of decision-making, I would ensure that the model is flexible to specific and real-life situations in life. People face different ethical dilemmas in life that require a different approach to solve. As a result, a universal model cannot solve ethical dilemmas. I would, therefore, recommend a flexible ethical model for decision-making to make it adaptable to various situations.
Conclusion
Nurses face many ethical challenges in their line of duty, which may end up affecting the quality of care services. Hence, to make the best ethical decisions, nurses should rely on ethical decision-making models. At the same time, nurses should ensure that their personal values do not hinder them from making the right decisions. Any decision that is made by a nurse affects the delivery of health care services significantly.
References
Dunger, C., Schnell, M. W., & Bausewein, C. (2017). Nurses' decision-making in ethically relevant clinical situations using the example of breathlessness: study protocol of a reflexive grounded theory integrating Goffman's framework analysis. BMJ Open , 7 (2).
Ebrahimi, H., Nikravesh, M., Oskouie, F., & Ahmadi, F. (2015). Ethical behavior of nurses in decision-making in Iran. Iranian journal of nursing and midwifery research , 20 (1), 147- 154.
Sari, D., Baysal, E., Celik, G. G., & Eser, I. (2018). Ethical Decision-Making Levels of Nursing Students. Pakistan journal of medical sciences , 34 (3), 724-732.
Zeni, T. A., Buckley, M. R., Mumford, M. D., & Griffith, J. A. (2016). Making "sense" of ethical decision making. The Leadership Quarterly, 27 (6), 838–855.
