Unit-Based Ethics Rounds: Creating an Ethical Work Culture for Nurses in the Hospital

Abstract

Nurses who work in a hospital setting with seriously ill patients often face ethical dilemmas with no clear solutions but instead difficult choices and uncertainty. Unit-based ethics rounds in the hospital can be tailored to unit specific needs. However, there is a gap in the literature describing how to implement such unit-based rounds. This article describes the experience of nurses who implemented unit-based ethics rounds on one unit using the Integrated Ethics Model as a framework and the feasibility of continuing ethics education into the practice setting. Eight sessions described targeted two of the three Integrated Model’s focus areas: systems and processes, and environment and culture. Seven of the sessions targeted all three foci, and also included decisions and actions. The design of this project maximized exposure to education about ethics in nursing, reflected the unit pace and culture, and has normalized and engaged nurses in ethical thinking and actions. The Integrated Ethics Model provides a feasible framework that can focus unit-based ethics rounds and expand nursing ethics education into practice at the unit level.