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William F. Connell School of Nursing

Nurses' ethical decision making

connell school news

08/02/10



Associate Professor Pamela Grace, along with colleagues at at Massachusetts General Hospital (MGH) and Brigham and Women's Hospital, has been awarded a Health Resources and Services Administration (HRSA) grant to support ethical decision making in staff nurses. The project, entitled the Clinical Ethics Residency For Nurses, brings together clinical and academic healthcare ethics leaders from Massachusetts General Hospital, Brigham and Women's Hospital, and Boston College.

The innovative three-year project aims to increase the number of registered nurses with knowledge, skills, and competencies in clinical ethics. Through the residency, the team hopes to help nurses assume consultative and leadership roles on unit or department-based ethics committees. The project will also facilitate access to clinical ethics resources for vulnerable patients and their families, improving the quality of patient care and outcomes. In addition, the team hopes to enhance nurse retention by providing avenues to address moral distress when nurses face decision-making uncertainty or obstacles to the provision of good patient care.

During each year of the residency, a cadre of 18 nurses selected from staff at MGH and Brigham and Women's Hospitals will be prepared to serve as ethics resources. The program consists of didactic content, simulated learning, and a clinical ethics practicum. About two-thirds of the group will be nurses practicing in staff roles and one-third will be nurses practicing in advanced practice roles. Additionally, one doctorally prepared faculty member per year will be mentored to develop ethics leadership skills to inform curricula in his/her institution.

Ellen Robinson M.S. '83, Ph.D. '97, clinical nurse ethicist at MGH, serves as the project director. Pamela Grace and Martha Jurchak Ph. D. '96, director of clinical ethics at Brigham and Women's Hospital, are project faculty and serve as principal investigators for the respective cooperating institutions. MGH Chaplain and Director of Clinical Pastoral Eduction Angelika Zolfrank and Susan Lee Ph.D. '05, nurse scientist at MGH, are also project team members.

The project became a reality after several years of discussion and collaboration. Grace explains, "For the past 6 years, Dr. Robinson, Dr. Jurchak, and I have collaborated on a one-day interdisciplinary clinical ethics conference. The idea for this project emerged from our ongoing dialog, our collaborative efforts, and a previous MGH education initiative of Dr Robinson's."

"This is an exciting project," states Connell School Dean Susan Gennaro, "and we look forward to continued collaboration and shared expertise with our clinical partners."