Magazine article American Nurse Today

Breathing Life Back into a Medical Ethics Committee: A High-Functioning Committee Cares about Doing What's Right

Magazine article American Nurse Today

Breathing Life Back into a Medical Ethics Committee: A High-Functioning Committee Cares about Doing What's Right

Article excerpt

Organizations pursuing Magnet[R] recognition must ensure the evidence supports the structures in place for frontline nurses to address ethical issues. What's more, the organization's nurses need to have a strong understanding of the American Nurses Association's Code of Ethics for Nurses.

In 2012, the chief nursing officer (CNO) of the University of Pittsburgh Medical Center (UPMC) Passavant, a 400-bed community hospital in Pittsburgh, Pennsylvania, asked the director of nursing (DON) to assess the hospital's ethics committee. The goal: to evaluate the role and value of the current committee and determine how the team contributed to patient care and the nursing and medical staffs. The DON's assessment confirmed that our medical ethics committee wasn't operating at a level that matched the organization's mission, vision, and values. Meeting attendance was low, members showed little energy or enthusiasm for the work, and the committee lacked a purpose and vision. Committee members' consults focused primarily on risk-management issues. Although the literature shows many hospital ethics committees have periods of ebb and flow, our ethics team clearly needed a transformation to become purposeful and high functioning.

Appointed by the CNO to oversee a committee redesign, the DON devised a plan to build an interdisciplinary committee consisting of physicians, nurses, care managers, palliative care staff, and members of the quality and risk department. The literature supports a multidisciplinary team approach. (See UPMC ethics committee members.)

Members of the newly developing committee knew they had to acquire strong leadership and build a solid foundation that would allow it to grow. After implementation of the redesign plan, our newly transformed ethics committee was born.

Acquiring capable leadership

One key to building a strong team is dedicated, capable, and knowledgeable leadership. The director of anesthesia, who was well versed in medicine, medical ethics, business, and law, agreed to serve as the committee's lead physician. The DON, also well educated and knowledgeable in the foundations of medical ethics, was appointed committee chair.

To build a high-quality medical ethics committee, we needed to explore why the committee had been functioning at a suboptimal level. Before the January 2013 inaugural meeting of the new committee, several newly appointed members were asked to conduct a literature search of regulatory requirements to help determine best practices for a medical ethics committee. One of the first needs they identified was for each committee member to define the term ethics, both literally and personally.

We also became aware of other needs, such as:

* education of committee members regarding their role, the foundation of medical ethics, and the role of healthcare providers in providing ethical care and interventions

* education of the healthcare team regarding the role of healthcare providers in providing ethical care and interventions

* selection of a small team of consultants to respond to ethical concerns of patients, families, and the healthcare team

* review of types and frequencies of consults (such as ethics consults) to track their frequency and category. Ethics consults may address such issues as end-of-life care, power of attorney, second-victim concerns, difficult families, and controversial concerns regarding a patient's care.

Early on, the newly configured team needed to create a vision and determine what the ethics committee would signify. They set out to answer many questions, including:

* How many members should the committee have?

* Do we have the right members?

* Do we need additional education?

* Whom would we serve?

* What avenues of communication should we employ?

* Where should we start?

During the discovery phase of restructuring, we learned our organization was a member of the Consortium Ethics Program (CEP), a regional healthcare ethics network in western Pennsylvania. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.