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Why APRNs’ Ethical Competency Is Critical in Healthcare: A Closer Look

Ethical Competency of APRNs: The Core of Advanced Practice Nursing

Ethical competency in Advanced Practice Registered Nurses (APRNs) is crucial to their ability to provide high-quality, patient-centered care. Others will judge APRN practice as ethical if the APRN demonstrates observable behaviors that adhere to high ethical standards. Ethical practice is not just a matter of following rules; it requires functioning across four key elements: character, sensitivity, judgment, and motivation (Robinson et al., 2014). APRNs must integrate these components to navigate complex clinical situations with ethical clarity.

Ethical behavior involves more than clinical decision-making. APRNs need to be sensitive to ethical dilemmas, identify the best ethical course of action, and have the motivation and moral strength to act accordingly. Moreover, the ability to empathize and take the perspective of others is essential to moral sensitivity. Clinical expertise alone is not enough to guarantee ethical decision-making; it must be complemented by ethical knowledge and the ability to distinguish clinical from ethical concerns.


Table: Key Aspects of Ethical Competency in APRNs

AspectDescription
CharacterThe integrity, conscientiousness, and strength of the APRN in adhering to ethical standards.
SensitivityThe ability to recognize ethical issues and be empathetic towards others’ perspectives.
JudgmentCombining ethical knowledge with clinical expertise to make sound decisions in morally complex situations.
MotivationThe willingness to pursue ethical actions, even when they are difficult or challenging.
Team CollaborationNavigating power dynamics, communication, and consensus building within interprofessional teams in ethical situations.
Clinical ExpertiseThe integration of medical knowledge and ethical standards to differentiate clinical problems from ethical challenges.

[Reference: Brashers et al., 2019]


Why Ethical Competency Matters for APRNs

Clinical practice often raises complex ethical issues. APRNs are expected to handle these challenges skillfully, balancing the needs of their patients, their teams, and the healthcare system. A key aspect of ethical competency is the ability to make decisions in ethically ambiguous situations, ensuring that the patient’s best interest is always at the center of care.

Ethical involvement grows from clinical expertise. As APRNs become more experienced, they are often required to take on leadership roles, guiding interprofessional teams through difficult situations where ethical dilemmas may arise. Ethical decision-making is therefore considered a core competency for APRNs.


The Four Core Elements of Ethical Competency

1. Character

When thinking about ethical character, we often associate it with virtues like integrity and conscientiousness. An APRN must uphold the highest ethical standards in all professional actions. This means maintaining honesty, transparency, and accountability in clinical practice.

2. Sensitivity

Ethical sensitivity is the ability to identify when a situation involves an ethical issue. It requires empathy, emotional intelligence, and the ability to see things from the patient’s perspective. Without moral sensitivity, an APRN cannot accurately recognize the ethical dimensions of their work.

3. Judgment

Making ethical judgments requires both clinical and ethical expertise. It is crucial for APRNs to distinguish between clinical problems and those that have ethical implications. This understanding helps them decide on the most appropriate course of action in complex clinical environments.

4. Motivation

None of the above elements matter if the APRN lacks the motivation to act ethically. This involves having the courage and resolve to pursue ethical solutions, even when faced with resistance or challenges.


Ethical Competency in Team-Based Care

APRNs often work within interprofessional teams, which can be structured differently based on the healthcare setting. Whether working in rural settings with loosely defined teams or in acute care with more definitive structures, the APRN must have the skills to navigate complex interpersonal dynamics. Ethical competency helps APRNs prevent power struggles, promote effective communication, and lead discussions that result in consensus in ethically challenging situations.

One emerging trend in healthcare is the renewed emphasis on interprofessional care models, which can bring both opportunities and ethical challenges. APRNs must be well-versed in facilitating team communication and consensus, especially when dealing with ethically difficult cases.


Ethical Challenges in Clinical Practice

APRN clinical practice is inherently filled with ethical challenges. From decisions about patient autonomy to balancing cost-effective care with the best possible outcomes, APRNs must consistently apply their ethical knowledge and decision-making skills. The ongoing development of APRN roles means that ethical decision-making will continue to be an evolving competency, shaped by new healthcare models and patient care approaches.

APRNs must also navigate their responsibilities to patients while working within the legal and institutional frameworks of their workplaces. This adds another layer of complexity to their ethical decision-making processes.


Frequently Asked Questions (FAQ)

1. What is ethical competency in APRNs?

Ethical competency in APRNs refers to their ability to consistently demonstrate behaviors that adhere to high ethical standards. This involves functioning effectively in four key areas: character, sensitivity, judgment, and motivation.

2. Why is ethical competency important for APRNs?

Ethical competency is vital for APRNs because they face numerous ethical dilemmas in clinical practice. Their ability to handle these challenges can significantly impact patient care and outcomes.

3. How do APRNs develop ethical competency?

APRNs develop ethical competency through a combination of clinical experience, ethical knowledge, and moral sensitivity. Continued education and practice in ethical decision-making also play a crucial role.

4. What are the key elements of ethical competency?

The key elements of ethical competency include character, sensitivity, judgment, and motivation. Each of these elements contributes to an APRN’s ability to make ethical decisions in practice.

5. How does ethical competency affect interprofessional teamwork?

Ethical competency enables APRNs to navigate team dynamics effectively, prevent power struggles, and lead ethical discussions that result in consensus. It is especially important in interprofessional care models where ethical challenges are common.

6. Can ethical competency be measured?

Ethical competency can be evaluated by observing an APRN’s decision-making processes and their adherence to ethical standards. Ethical decision-making in practice often serves as a key indicator of competency.

7. How does ethical competency influence patient outcomes?

Ethical competency influences patient outcomes by ensuring that care is always centered around the patient’s best interests. This leads to more informed and compassionate care decisions.


This article on Ethical Competency of APRNs outlines how critical this skill set is to the advanced practice nurse’s role, impacting everything from patient care to team collaboration. Understanding and developing ethical competency is crucial for every APRN to succeed in today’s healthcare environment.

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