Authenticity
Last week, when discussing ethics with prelicensure students, I had my ethics model posted. As always, I spoke to the themes of my study and its representation in my model. I also reviewed some ethical situations that the participants in my study discussed with me. As we spoke about each situation, we examined it through the lens of the themes. A student asked me more about the central framework of authenticity. Today, I want to think about authenticity in response to our discussion about the central framework.
The literature says that an authentic existence consists of three characteristics.
- The person needs to be fully aware of the present moment.
- The person lives in the moment by choosing how to live one’s life.
- The person needs to take responsibility for the choice (Corey, 1982).
The central framework of authenticity refers to remaining true to a person’s
genuineness of character at the very core of their existence. As a nurse, authenticity
is reflected through genuineness in not just who you are as a person but through the decisions made while in the role of the nurse.
An authentic nurse has to
decide between personal values and actions in their role as a nurse. This may result
in tension between the two roles—the person versus the nurse. However, authenticity
needs to remain a centralized goal in accomplishing ethical nursing practice—in light of
advocacy, dignity, humanity, integrity, and leadership when dealing with patients and
their care.
One story, told to me by a nurse, represents the themes of my model and the central framework of authenticity. This nurse relayed a patient encounter to me where a physician told her to drop a nasogastric tube (NGT) on the patient. After explaining the procedure to the patient, the patient refused the procedure. Once the physician knew the patient refused the NGT, they told the nurse to drop the NGT anyway. The nurse had a decision to make. First, the nurse is an advocate for her patient, as the patient always has the right to refuse care. I always tell my students that our job as a nurse is to make sure the patient is fully educated about the situation. Once fully educated, the patient can make an informed decision based upon their preferences. It is not our role to debate the patient's decision.
If we apply the concept of authenticity in this example here, we will follow the three steps written above.
- The person needs to be fully aware of the present moment. In this case, the nurse observes an ethical situation because the physician tells them to drop the NGT despite the patient refusing it.
- The person lives in the moment by choosing how to live one’s life. The nurse processes the situation and decides to honor the patient's wishes. The nurse acts as an advocate for this patient, while respecting their dignity and humanity. The nurse does not drop the NGT as per the patient request.
- The person needs to take responsibility for the choice. The nurse decided on a course of action (not dropping the NGT) for which they are responsible.
I always tell students that we are accountable to our decisions as a nurse, and this concept applies here. We are accountable not just to our decisions or actions a nurse. We are also accountable to the outcomes of those actions - good, bad, or indifferent. I teach my students that our actions as nurses always have consequences for our patients.
I really hope that my ethics model is helpful in deciphering ethical situations while making decisions as to how to conduct yourself as a nurse. Patients depend upon us to help them navigate their situation while remaining true to their beliefs.
As always, I welcome feedback through your comments.
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