Nursing Education and Mortal Integrity What Is Moral Integrity?
Moral integrity involves knowing what is right and wrong, acting on that knowledge even at a personal cost, clearly communicating that one’s actions are based on ethical principles, and doing so consistently (Laabs, 2007). It is a fundamental concern for every nurse, ensuring a wholeness of character that is free from corrupt influences or motives. For the nursing profession, maintaining moral integrity is crucial in upholding public trust and delivering ethical care.
Implementation of Moral Integrity in Nursing Education
Nursing as a profession is built on a foundation of integrity, values, and a commitment to society. This foundation has been emphasized from the era of Florence Nightingale to the present-day Code of Ethics for Nurses with Interpretive Statements from the American Nurses Association (ANA, 2010). The ANA defines integrity as “essential to professional practice” (p. 7). Despite nursing consistently being rated highly for honesty and ethics (Gallup, 2013), not all nurses’ actions consistently reflect the profession’s foundational principles of high moral integrity. For example, the Ohio Board of Nursing reported over 250 disciplinary actions in the last quarter of 2013 alone (Ohio Board of Nursing, 2013).
Moral integrity is expected of all nurses, even when they face pressure to act otherwise (ANA, 2010). When compelled to compromise their ethical standards, nurses have a responsibility to “express their conscientious objection to participation” (ANA, 2010, p. 20). Given this expectation and the recognition of a decline in moral standards in society, nursing educators are responsible for promoting a high standard of moral integrity in nursing education.
Moral Integrity in a Historical View
The emphasis on moral integrity in nursing education is not new. Greek philosopher Plato believed that the purpose of education was to “form moral character” (Le Vasseur, as cited in Lachman, 2009, p. 7). Similarly, Florence Nightingale advocated for moral courage among nurses (Lachman, 2009). This tradition must continue within the profession to maintain the standards set by previous generations and to meet society’s expectations.
Nurses also have a duty to themselves to maintain their moral integrity. When external forces prevent nurses from acting according to their ethical beliefs, they may experience moral distress, characterized by feelings of “anger, guilt, powerlessness, and frustration” (Laabs, 2007, p. 795), which can lead to burnout. When facing threats to their integrity, nurses must preserve their personal and professional values and accept only those compromises that safeguard their dignity and that of others (ANA, 2010).
Impact of Moral Integrity
Moral integrity is crucial for nurses, requiring them to always do what is right, even at a personal cost. According to Eby et al. (2013), “nursing has been spared the ethical scandals of many other professions, but issues of compromised moral integrity are growing in practice and education” (p. 1). Consistent application of integrity within nursing is essential for the profession to fulfill its duty to the public and maintain trust. Without moral integrity, nursing would lose its status as an ethical profession.
Outcomes of Moral Integrity in Nursing Education
Research indicates a normalization of dishonest behavior among nursing students (Arhin, 2009). Both the character of the student and the environment of the educational institution influence the decision to deviate from acceptable practices (Balik, Sharon, Kelishek, & Tabak, 2010). Faculty often feel a sense of responsibility for educating students about integrity (Rosenkoetter & Milstead, 2010). If this is the case, it underscores the need for creating an institutional context that promotes positive changes in moral integrity (Balik et al., 2010).
Faculty must modify both classroom characteristics and content to instill a sense of value and high moral standards in their students (Balik et al., 2010). However, a concerning pattern has emerged in academic settings. McCabe (2009) reported higher rates of cheating and dishonesty among nursing students compared to other disciplines. The study suggested a correlation between academic dishonesty (e.g., plagiarism, misrepresentation, falsification) and unethical behavior in professional nursing practice.
To address this issue, nursing educators must develop expertise in teaching moral literacy, best practices for promoting moral integrity, and designing classroom experiences that help students deeply understand its importance in nursing practice (Gray, 2008). Educators are crucial in “modeling and developing professional ethics in students” (Gray, 2008, p. 333). More research is needed to explore the concept of moral integrity and identify best practices for teaching it in nursing education. The health of the nursing profession may depend on educators who are the standard-bearers of ethical behavior for future nurses (McCabe, 2009).
Conclusion
Moral integrity is essential for maintaining the ethical standards of nursing practice and upholding public trust. It involves knowing what is right, acting on that knowledge, and doing so consistently, even under pressure. Nursing education plays a critical role in fostering moral integrity, with a focus on instilling high ethical standards, promoting moral courage, and preparing nurses to navigate complex ethical situations. As the profession continues to face challenges related to moral integrity, nursing educators must be at the forefront, modeling and teaching these critical values to ensure a future nursing workforce that embodies the highest ethical standards.