The perioperative nursing culture is made up of many habits that are simply accepted.
“Habits and ethics belong together because of the moral virtue that arises through habit and moral, which is implied in the word ethics” (Lindwall & von Post, 2008, p. 670). Ethics deals with the rightness or wrongness of human behavior. Habits are created by human beings living or working in a particular culture. Culture encompasses experiences, moral concepts, ideas of right and wrong and the habits that are developed as part of a society.A habit is something that is performed frequently or regularly and may be an ethical act that is bad and is frequently repeated and difficult to stop.
Perioperative nursing is a profession that is founded on caring and ethics. The habits of the perioperative nursing culture are a result of demand for asepsis, safety and productivity. The habits of the perioperative nurses are formed by education, basic values and ethics. Nurses’ habits and behavior can and will affect the patient’s sense of well-being (Lindwall & von Post, 2008).
Perioperative nurses are obligated to treat all persons in a just and fair manner with respect and compassion. A perioperative environment where disrespectful behavior is allowed is unethical (Kupperschmidt, 2006). Lindwall and von Post conducted a study looking at habits existing in the perioperative nursing culture. They found that a temporary friendship with patients, showing respect for each other, and finding the time to reflect on ethical questions promote ethical values.
Habits hindering progress include seeing the patient as a surgical case, nurses not acknowledging one another, and not talking about ethics and caring.Habits that will set the tone within the perioperative culture include the existence of a hidden power structure (medical profession deciding norms and values), a weak management allowing informal bosses to steer things unseen, and attempting to achieve more in less time (Lindwall & von Post, 2008). Failure to acknowledge one another is a habit that lays the foundation for an environment that is inhospitable and restrictive. Failing to recognize each other as colleagues is a habit that leads to a toxic environment.A toxic culture where nurses are shunned or made to feel unneeded, unwanted or under-valued is not only unethical but leads to problems retaining adequate staffing.
Failing to show respect for each other adds to this toxic environment (Lindwall & von Post, 2008). Negative, non-supportive, unpleasant, and uncooperative colleagues are key impediments to the ability to find joy in a job. Respondents in one study reported that the most frequent source of verbal abuse was other nurses. The study also noted that disrespectful behavior increases job stress and decreased job satisfaction.
Another study indicated that the lack of respect for the “gift” of self will cause nurses to leave nursing all together. In order for a culture to foster habits promoting ethical values nurses must show respect for each other. The American Nurses Association’s (ANA) Code of Ethics states that professional nurses must treat colleagues with respect. In addition, each professional nurse has an ethical duty to resolve conflicts with colleagues (Kupperschmidt, 2006). The ANA Code of Ethics notes that the responsibility for facilitating an environment of respect rests with both the individual staff nurse and leadership.Provision 6 of the Code notes that the leadership team is responsible for setting standards and managing the environment of care to assure that each staff member is treated fairly and with respect.
Senior leadership is responsible for managing an ethical environment that is conducive to the provision of quality health care consistent with professional standards and values. Adoption and enforcement of a policy of zero tolerance for disrespectful behavior communicates the expectation that all nurses will respect the inherent dignity, worth and uniqueness of every individual. Leaders need to respect employees’ competence and initiative.Nurses feel respected when the managers provide access to information, support and resources, and opportunities for development. Managers and staff nurses need to become competent in confrontational skills, thereby setting an expectation for mutual respect (Kupperschmidt, 2006). Conclusion The formation and maintenance of an ethical environment is a shared responsibility requiring the effort of all individuals in the workplace (Lindwall & VonPost, 2008).
Professional nurses must care enough about their patients, their profession, their colleagues, and themselves to promote respectful behavior.Treating others with professionalism and respect enhances the performance of the health team. Just as nurses have the right not to be abused or harassed in the workplace, they must treat others in the workplace with respect and compassion. Treating others with respect is a nurse’s ethical responsibility.
Respect is the ethical foundation for all employee relations. When all nurses within the perioperative environment assume ethical responsibility for treating others with respect and confronting disrespectful behavior, it is then that the practice of perioperative nursing will be consistent with its professional values (Kupperscmidt, 2006).
