Authors of the blog:
Dr. Pilar Fuster-Linares
Dr. Leandra Martin Delgado
Dr. Laia Wennberg Capellades
From Universitat Internacional de Catalunya, Barcelona, Spain
The concept of ethical dilemmas has been broadly explored in nursing because of the prevalence of this dilemmas in daily practice (1,2). As nurses we understand the need and importance of having ethical standards in our profession. In 2021, the ICN reviewed and updated the Code of Ethics for Nurses, a statement of the ethical values, responsibilities and professional accountabilities of nurses that defines and guides ethical nursing practice. This document includes the changes that appear in the working environments and the new challenges and dilemmas that have appeared due to the COVID-19 pandemic (3).
Faced with these new elements and in order to show the essence of the ethics of care in the different professional roles, nursing educators must also be updated, not only in the content of the Code of Ethics, but also in the ways in which it is incorporated into nursing curricula.
Although ethical dilemmas are frequent in day-to-day life of the nursing professional, it is difficult for nursing students to identify situations potentially susceptible to be recognized as ethical dilemmas, due to their lack of knowledge of the professional role, their lack of clinical practice or even their lack of autonomy to make decisions in the clinical environment among others (4). For this reason, it is important to work on ethical dilemmas through methodologies that facilitate and stimulate reflection, but that in turn propose situations that students can understand and analyse even if they have not lived them.
Several studies have shown that education through films helps to improve teaching skills and stimulates learner reflection (5,6). Films could be considered as “the audio-visual version of storytelling (….) The cinema experiences act like emotional memories for developing attitudes and keeping them as reflective reference in the daily activities and events” (Blasco, P. et al Journal for Learning through the Arts, v22, n1,2015).
In our case, we incorporate the methodology of reflection through the cinema precisely to offer nurse educators the possibility of experiencing the possibilities of this methodology. We used the film Wit (2001), in which the leading actress Vivian (Emma Thopmson) shares her experience of illness with the viewer, and makes him a participant in her decisions, her experiences and her thoughts. Through the magic of the cinema, Vivian forces us to feel and be moved by her experience, and leads us to reflect on aspects of the nursing profession in a complex situation that is not always evident to us. But above all it allows us to do it from the perspective of the patient and through our own emotion, adding the value of the “experience” to something that priori, could be totally external to us.
This methodology allows us to empathize with the other from the safety of our home, it also allows us to live and relive those moments that cause us more doubt, more surprise or more indignation. We can analyse, dissect and reflect on what we see, but also on what makes us feel what we see, and that part of emotion, adds value to the learning experience, helping to develop concepts and to strongly record elements, in this case of professional ethics.
1- Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An integrative review. Journal of Clinical Nursing, 27(19-20), 3446-3461.
2- Koskimies, E., Koskinen, S., Leino‐Kilpi, H., & Suhonen, R. (2020). The informational privacy of patients in prehospital emergency care—Integrative literature review. Journal of Clinical Nursing, 29(23-24), 4440-4453.
3- Sperling, D. (2021). Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic. Nursing Ethics, 28(1), 9-22.
4- Albert, J. S., Younas, A., & Sana, S. (2020). Nursing students’ ethical dilemmas regarding patient care: An integrative review. Nurse Education Today, 88, 104389.
5- Blasco, P. G., Moreto, G., Blasco, M. G., Levites, M. R., & Janaudis, M. A. (2015). Education through Movies: Improving teaching skills and fostering reflection among students and teachers. Journal for Learning through the Arts, 11(1), n1.
6- Jerrentrup, A., Mueller, T., Glowalla, U., Herder, M., Henrichs, N., Neubauer, A., & Schaefer, J. R. (2018). Teaching medicine with the help of “Dr. House”. PLoS One, 13(3), e0193972