Establishing ethical boundaries among staff

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Tip of the month

Establishing ethical boundaries among staff 

How often do we hear leadership comment on the lack of ethics in the workplace? We think of ethical actions as those that do well and bring no harm to patients, yet at the staff level, do you see or hear of decisions people are making that raise an eyebrow? 

When you start thinking, “What part of this did they think was okay?” the question of an ethical dilemma presents itself. We see a shift in values and behaviors that for some are justified, while some scenarios are unnoticed.

“The very essence of ethical drift is that it occurs before the seriousness of the dilemma takes shape or before the conflict is even perceived,” says Carol Kleinman, PhD, TN, CNAA.

This “ethical drift” is affecting department morale, staff motivation, and retention. Setting ethical boundaries is an essential role of leadership. Consider these questions to help you approach the next ethical dilemma:

  • What is the identified dilemma? 
  • What nursing value(s) does this conflict with? 
  • Is the conflicting value an organizational, professional, or other value? 
  • Do you have access to an ethics committee or representative? 
  • What outcomes are you looking for?



Kleinman, Carol (2006). “Ethical drift: When good people do bad things.” JONA’s Healthcare Law, Ethics and Regulation. 6 (3), 72–76.



Shelley Cohen, RN, MSN, CEN, Health Resources Unlimited, Adapted with permission.