ANA Healthy Nurse, Healthy Nation® Blog: The Connection Between Ethics and Nurse Well-Being
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How ethical nursing supports a patient’s health — and your own
According to the American Nurses Association (ANA) Code of Ethics, nurses have a responsibility to advocate for their patients, balancing care plans and treatment options with compassion, dignity, and respect. Patients trust nurses to protect their rights, health, and safety.
Nurses often make high-stakes calls in their daily practice — including life-and-death decisions.
This responsibility may require them to face ethical and moral issues that conflict with their values.
Value Conflicts in Nursing
There are 2 types of conflict that affect a nurse's values: ethical dilemmas and moral distress. An ethical dilemma happens when there are 2 or more solutions to a problem, but neither solution is optimal in the eyes of all parties. This is typically due to a difference in values. A common example is in end-of-life care, when a lifesaving treatment conflicts with a patient’s wishes.
Moral distress happens when external constraints prevent a nurse from providing care that aligns with their personal and/or professional values, principles, and ethics. These constraints may include treatment choices and options, staffing issues, safety concerns, system policies, and other considerations.
Although these types of conflicts are common within the profession, they have a profound impact on a nurse’s well-being when they are unsure of how to handle them.
The Long-Term Impact of Value Conflicts
If left unresolved, value conflicts can be a source of significant stress for nurses, leading to a range of emotional, physical, and mental symptoms. It contributes to nurse burnout and job turnover, which hurts patients, nurses, and — ultimately — the health care system.
Navigating value conflict requires a combination of clinical judgment, moral courage, empathy, and resilience. The good news is there’s a growing awareness of the importance of managing ethical concerns — for both patient and nurse well-being. This has led to a push for greater ethics education that empowers nurses to provide the care they feel their patients need.
The Need for Ethical Guidance in Nursing
According to Kara Curry, MA, RN, HEC-C, more ethics education in nursing can help nurses navigate these conflicts when they arise. Kara is a senior policy and ethics advisor at the American Nurses Association Center for Ethics and Human Rights.
“Ethical challenges are daily occurrences for nurses and happen in all areas of nursing,” Kara says. “However, many nurses lack the language needed to navigate these issues. In nursing school, ethics might be embedded here and there in the overall curriculum, but it doesn’t always get the attention it truly deserves.”
This is where the Code of Ethics for Nurses can help.
The ANA Code of Ethics: A Roadmap for Nurses
The Code of Ethics for Nurses outlines ethical standards for all nurses and offers a clear framework to support decision-making during times of ethical and moral conflict. This helps take the guesswork out of decisions, providing peace of mind and knowledge that nurses are acting in their patients’ best interests, as well as their own.
“The Code is a foundational document grounded in nursing ethics,” Kara says. “It is structured by relationships (nurse-to-patient, nurse-to-colleague, and nurse-to-society.”
This structure enables nurses to determine which provision of the Code applies to their ethical challenge, Kara says, so they can quickly find the guidance they need. It applies to all nurses with varying levels of experience.
“Regardless of their practice setting, nurses can lean on the Code to ensure they are meeting the ethical standard of our profession,” she says.
Organizational Support for Value Conflicts
When health care systems support the core values of ethical nursing, they create healthier, more sustainable work environments that protect against burnout and moral distress.
According to Kara, nurses in larger health care systems often have access to ethics committees and consultation services to help guide them through conflicts. However, nurses in smaller systems or rural areas may not have this level of support. Or a nurse may find themselves in a situation where they’d like some outside guidance.
Kara says ANA’s Center for Ethics and Human Rights can help nurses with questions about ethical challenges. Nurses can contact the Center via email: ethics@ana.org.
Ethical Nursing and Nurse Wellness
Human flourishing in patients, nurses, and society is a new concept highlighted in the latest revision of the Code of Ethics for Nurses. Aligned with nursing ethics, this concept means that in addition to their responsibility to patients, nurses have a responsibility to themselves to advocate for health and wellness.
“The Code includes guidance on the relationship of nurses to themselves,” Kara says. Provision 5 of the Code of Ethics for Nurses states:
“The nurse has moral duties to self as a person of inherent dignity and worth, including an expectation of a safe place to work that fosters flourishing, authenticity of self at work, and self-respect through integrity and professional competence.”
“We have an obligation to take care of ourselves and ensure we receive the same care and nurturing we provide to others,” Kara notes.
A Nurse’s Duty to Self
According to Kara, part of ethical nursing includes giving yourself permission to prioritize your own well-being when needed. This may include stepping away from a role that causes burnout and psychological stress. “It’s OK to stay at the bedside for 30 years, if it nourishes your spirit and well-being,” she says, “It’s also OK to shift to something else if it doesn’t.”
Kara acknowledges that for some nurses, this might feel like a betrayal — but it isn’t. “Nursing, like any career path, evolves differently for each person,” she says. “We also evolve through the different stages of our lives and take on new and different opportunities. These paths toward change and growth should not be ignored.”
Compassion Is the Core of Ethics
Kara notes that above all else, it’s important to remember that compassion, dignity, and respect are the heart of ethical nursing. “Amidst a world facing uncertainty, division, and polarization, we must remain focused on these core values,” she says. “Now, more than ever, we need to translate them throughout all areas of our practice.”
How have you navigated an ethical conflict in your nursing practice? Share your experience in the comments.
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08/06/2025 2:19pm CDT
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