Handling Ethical Dilemmas With Care in Oncology Nursing

Welcome to Onc Nurse On Call, the new podcast from Oncology Nursing News, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers (formerly Jackson), DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time.

This week delivers the second part of an interview with ethics expert Katherine Brown-Saltzman, MA, RN, president of Ethics of Caring, the organization behind the National Nursing Ethics Conference (NNEC).

Brown-Saltzman and Jakel emphasized the power of community in ethical dilemmas, as peers can provide a sounding board or support when issues must be confronted.

Ethical concerns can grow into pressing issues, said Brown-Saltzman, when nurses don’t confront the concern early on, comparing these situations to the rapid spread of a forest fire.

“By the time you are outraged, you’re in moral distress,” said Brown-Saltzman. “To bring these issues up early really helps because then you aren’t completely locked down into conflict.”

In these cases, she said that the best thing a nurse can do to intervene early on is to simply ask a question.

“The wisest thing that I learned along the way was instead of pointing the finger…to put a question on the table,” said Brown-Saltzman. “’I’m beginning to have these ethical concerns and wondering, are we approaching this family in the best way?...I’m wondering how we can better approach them with questions about stopping treatment.’”

Understanding how to slow down and process a situation rather than becoming a “deer in the headlights” is just as much of a “real skill” as administering treatment, she said. Brown-Saltzman underscored that education is key to training the next generation of ethical nurses in oncology and beyond.

Educating recent graduates gave her hope, said Brown-Saltzman, because they engaged with ethical dilemmas to a deeper level and considered the various factors that could complicate a patient’s treatment.

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