CORE CONCEPT

Ethical Comportment
Ethical component in health care is one of the essential guiding principles directing
nurses to think as nurses. This is the contract that nursing has with society. It is the agreement to
deliver care without harm, to give their best, and have the patients best interest at heart, and
supporting each other in the process so all nurses can understand nursing values and ethics The
Code of Ethics is updated every ten years and with the current changes in health care it is
important to consider the factors impacting the delivery of care ( Morin, 2015). Ethics has many
components. It includes ideas of beneficence, non-maleficence, autonomy, paternalism, Justice,
allocation of resources, informed consent, accountability, confidentiality, self-determination,
fidelity, and veracity (Herrman, 2016). Medicine has the Hippocratic Oath to do no harm. That
is part of their ethics code. Nursing has the Nightingale pledge that forms the beginning ideas of
a personal nursing philosophy that guides behavior (Badzek, 2015).
The changes in healthcare include the use of social media, and informatics taking a front seat.
An aging population is increasing the prevalence of chronic diseases. There is a greater
emphasis on hospice, end-of-life care, and pain relief. Staff report violent behaviors, bullying,
and incivility challenging the safety and quality care of the patient (Morin,2015). The need for
approaches to combat new infectious diseases, advise on genetic engineering, and ask the
innumerable moral, ethical , and legal questions that arise each day are needed. Each nurse deals
with ethics every day she/he lives. The Code of Ethics is useful to all nurses to read and be
familiar with to reinforce the fundamental values and commitments each nurse made to the
community they serve. It also identifies the boundaries of practice and informs about other
responsibilities beyond their patient encounters that are necessary. Learning about the ethical

comportment of nursing practice is one of the key components in the student nurse knowing how
to be a nurse. It also enforces the concept that nurses do their best to care for patients and they
support one another to give safe, quality care. It is the way nursing can stay alive as a
profession. We can all ask the question, when was the last time I reviewed the code of ethics?
There are four core competencies that will be addressed in this paper. The ethics of care, the
ethics of integrity, the ethic of maintaining confidentiality, and the ethic of self-determination as
seen at the end-of life are shown to be helpful in encouraging students to think, and act like a
nurse. The ethical principles to make nursing come alive.

Core Concept Teaching Strategies

CONCEPT: Ethical Comportment
Educational Program: Two Year ADN Program
Competency
Level 1 Competency
Blooms Level: 2, 5

A practitioner who
practices with
integrity

Level 2 Competency
Blooms Level: 2,6

Learner Objective(s)
Teaching Strategies
1.Student will state the
1. Ethical scavenger Hunt
components of the Code of Positive and Negative
Ethics
findings.
2. Student appraise
situations for the right
course of action, and
evaluate situations
critically

1. Student will
understand situation
from other
perspectives

A practitioner who will

transform practice
with caring attitudes

2. Student will develop a

philosophy of caring

Level 3 Competency
Blooms Level: 1, 4

1.Understand the history

of legislation creating
HIPAA

A practitioner who
validates the need for
confidentiality

2. Student will point out

violations of
confidentiality created by
social media.

2. Situations are brought

before students within
clinical and classroom to
determine what is the
right thing to do.

1.Have an assigned
perspective to comment
on a situation
2. Write their personal
philosophy of nursing.

1.Analyze you tube video

demonstrating violations
and discuss how the
outcome can be changed.
Mock trial- person to
trial for violation of
HIPAA
2. One minute paper on

the challenge of using

social media and keeping
confidentiality

Level 4 Competency
Blooms Level: 2,4, 5

A practitioner who
respects selfdetermination as
related to end-of life
decisions

1.Analyze Five Wishes

decision in comparison to
Molst forms
2. Determine how to use
end-of life discussions
readiness for discussion,
and assessment of need.

1.Compare the forms and

discuss impact of level of
care decisions of health
approaches by think-pair
-share
2. Discuss hypothetical
and real-life Case
studies for end-of life
situations

TEACHING STRATEGIES PLAN #1

NAME OF LEARNING
ACTIVITY

Positive and Negative Findings

Learning Activity
Summary

Explain to the students that you want them to be on a

scavenger hunt of ethical events, Write down events that are a
positive finding ( someone being an example) , or someone not
adhering to the code of ethics. Have an ethical theme in postconference identifying the different ethical points evident.
Cognitive (identify level):evaluate

Domain of Learning Affective: organizing

(Blooms Taxonomy
Revised)
Student-Centered
At the completion of this learning activity, the learner will:
Learning Objective(s) have a greater appreciation for ethical comportment in the
clinical setting.
Preparation Required Having a hand out of the summary of the ethical comportments
by Teacher/Facilitator and and reviewing them in pre-conference at clinical. Securing a
Materials Needed
room for post-conference,
Time Allotted
Learning Styles
Addressed by Activity

1 hour discussion, group collaboration

Information presentation: Visual, verbal,
Modality : Visual and verbal
Approach: Active

How is content connected Introduction to the concept of ethical comportment and the
to prior learning?
significance to clinical practice
Reflective Debriefing Post-conference discussion
with Learners (postlearning activity) How will
it be accomplished?

Evaluation of
Measured by the examples that are shared during the
Learning (How will it be discussion. Student self evaluation (Hickman & Wocial, 2013)
accomplished?)
Teacher Reflection

Ethics of integrity maintains competence, and helps with

personal and professional growth. The nurses must assume
(justify choice of learning responsibility for their own growth and actions. Nurses are
activity and good fit for expected to be one of the most reliable professions. Instilling
the identified learning the code of ethics will form their professional standards and
objectives)
critical thinking.

TEACHING STRATEGIES PLAN #2

NAME OF LEARNING The Right Thing To Do
ACTIVITY
Learning Activity
Summary

There are a series of scenarios written on cards and put in a bowl or

hat. The class opens with some information about the code of ethics
and then breaks into a interactive time of someone selecting a
scenario from the container, reading it, and saying what is the right
thing to do
Cognitive (identify level):Apply, Evaluate

Domain of Learning
(Blooms Taxonomy
Revised)

Affective: Organizing, internalizing

Psychomotor: perception

Student-Centered Learning At the completion of this learning activity, the learner will discern
Objective(s)
what action would apply correctly to nursing care situations
Preparation Required by Writing the 8-10 situation s on cards. Preparing information about
Teacher/Facilitator and the Nursing code of ethics and give student s website that are
Materials Needed
informative for this exercise.
Time Allotted

2-3 minutes per situation would allow for a 20-30 minutes exercise

Learning Styles Addressed Information presentation: Verbal

by Activity
Modality: Verbal
Approach: Active, reflective
Understanding: Holistic
How is content connected to It is introducing the Nursing Code of ethics and how it impacts us on
prior learning?
a day to day practical level.
Reflective Debriefing with Ending with time for discussion and questions.
Learners (post-learning
activity) How will it be

accomplished?
Evaluation of Learning The formative evaluation of increased understanding of the concepts.
(How will it be
accomplished?)
Teacher Reflection

This activity fit well with the ethical comportment of integrity and
doing the right thing in ordinary situations as well as larger situations.
(justify choice of learning (WInland-Brown, Lachman, & OConnor Swanson, 2015)
activity and good fit for
the identified learning
objectives)

TEACHING STRATEGIES PLAN #3

NAME OF LEARNING The Six Hats of Caring: Ways of caring
ACTIVITY
Learning Activity
Summary

Breaking up into teams of six, learners will be given a case

study of a person in the acute care setting receiving care. They
will be asked to look at the situation from different levels of
care: Cultural, Spiritual, physical, psychological, Emotional,
Financial. These levels relate to the individuals needs and
incorporating the other areas addressed by health care.
Cognitive (identify level):Knowledge, application and analysis

Domain of Learning Affective: Receiving and responding, looking at valuing care

(Blooms Taxonomy
Psychomotor: participating.
Revised)

Student-Centered
The learner will:1: perceive caring as a choice and a
Learning Objective(s) commitment to care

Preparation Required Making hats with different labels, Selecting a case study for
by Teacher/Facilitator and discussion.
Materials Needed
Time Allotted

15 min for discussion in group

15 min of synthesis in a large group

Learning Styles
Addressed by Activity

Information presentation: auditory

Modality: Visual, verbal
Approach: Active
Understanding: Holistic

How is content connected Build on continued understanding and development of ethics

to prior learning?
comportment
Reflective Debriefing In the synthesis discussion- attempting to identify areas of
with Learners (post- care, using Watson caring theory and elements of caring
learning activity) How will attentiveness, responsibility, competence, and care receiver
it be accomplished?
response.
Evaluation of Learning Applying the concept of care in future assignments.
(How will it be
accomplished?)
Teacher Reflection

Caring uses the nursing process, problem-solving for effective

nursing practice. Caring is a combination of the right attitudes,
(justify choice of learning actions, and knowledge of the patient and their situation. Using
activity and good fit for different Hats" gives caring by nurses multidimensional. It can
the identified learning be a duty or entered into enthusiastically. (Lachman, 2012)
objectives)

TEACHING STRATEGIES PLAN #4

NAME OF LEARNING Personal Nursing Philosophy of Caring
ACTIVITY
Learning Activity
Summary

Given a series of questions and asked to write their own

philosophy of caring. Worked on outside of class. Discussion
in class of what makes caring. Small group discussion with
contributions written in front of class so all contribute.
Cognitive (identify level): analyze, create

Domain of Learning Affective: Characterization

(Blooms Taxonomy
Psychomotor: Fundamental
Revised)

Student-Centered
At the completion of this learning activity, the learner will
Learning Objective(s) incorporate attitudes of caring into role definition of
themselves.
Preparation Required Preparation with questions to help draw out information
by Teacher/Facilitator needed. Present theory of caring for nursing.
and Materials Needed
Time Allotted

Learning Styles
Addressed by Activity

Break up into small groups of 4-6 appoint a spokesperson to

write information in front of class. Small groups 10min ,
10min to assimilate at end. 10min for questions.
Information presentation: Verbal
Modality : Verbal, visual
Approach: Active
Understanding: Holistic

How is content connected Allows for students to identify with the ethic of caring
to prior learning?
Reflective Debriefing They have done the work of describing what caring looks like

with Learners (post- the facilitator can synthesize all the data given and post it for
learning activity) How the students to use as they write their own philosophy due at
will it be accomplished? the end of the week.
Evaluation of
They will write out their own philosophy of caring as a nurse
Learning (How will it and it will be turned in for feedback, Graded on pass/fail
be accomplished?)
basis.
Teacher Reflection This activity helps them assimilate the ethic of caring and how
it can impact their day to day approach to clinical situations
(justify choice of learning and life in general. A personal mission/ vision statement will
activity and good fit for strengthen their professional growth.(Hountras, 2015)
the identified learning
objectives)
TEACHING STRATEGIES PLAN #5
NAME OF LEARNING
ACTIVITY
Learning Activity
Summary

Mock Trial

The students will have index cards with script and rolls of
characters. Rolls are assigned impromptu
Cognitive (identify level): understand, analyze, create

Domain of Learning
(Blooms Taxonomy
Revised)

Affective: Responding
Psychomotor: Perceptual

Student-Centered Learning At the completion of this learning activity, the learner will:be able
Objective(s)
to assimilate the implication of HIPAA to their practice.
Preparation Required by Write out roles and pick out the scenario to be played. Make a
Teacher/Facilitator and simple script that the students have the option to adlib. Optional
Materials Needed
have a speaker from a local hospital on compliance come and speak
Time Allotted

1 hour

Learning Styles Addressed Information presentation : sight, sound

by Activity
Modality; Visual, Kinesthetic
Approach: Actve
Understanding: Sequential
How is content connected to This continues to develop ethical awareness in practice.
prior learning?
Reflective Debriefing with Allowing 5-10 min after the mock trial to discuss issues.
Learners (post-learning
activity) How will it be
accomplished?
Evaluation of Learning Have a student evaluation of this activity, with a scale response
(How will it be
And place for comments of improvement.
accomplished?)
Teacher Reflection

The ethical and legal implications of HIPAA are best seen in a court
of law. Not all violations will be implicated at a legal level but the
(justify choice of learning potential is there and to have a mock trial and think in those terms
activity and good fit for will be to their advantage in the long run.(Lachman, 2013)
the identified learning
objectives)

TEACHING STRATEGIES PLAN # 6

NAME OF LEARNING One minute paper on social media impact
ACTIVITY
Learning Activity
Summary

Pre-class work to find three articles on social media use in the

clinical area and how it was perceived.
Cognitive (identify level):Understand and analyze

Domain of Learning

(Blooms Taxonomy
Revised)

Affective: valuing , internalizing

Psychomotor: Perception

Student-Centered
At the completion of this learning activity, the learner will
Learning Objective(s) understand the critical risk social media puts on
confidentiality.
Preparation Required . Preparation for being aware and able to discuss the issues of
by Teacher/Facilitator social media and the violations of confidentiality. Give a
and Materials Needed scenario for making the critical need for evaluating this
ethical dilemna
Time Allotted

Learning Styles
Addressed by Activity

Pre-class 1-2 hour, Class 1 minute 20min for discussion

afterward.
Presentation: text, writing
Modality: visual
Approach: reflective
Understanding: holistic

How is content connected Ethical issues and nursing student developing his/her
to prior learning?
perception of risks to the safe care of patients. Affects how
they perceive their role as a nurse, and their ability to create a
safe care atmosphere by choosing ethical principles.
Reflective Debriefing During the discussion, and follow-up.
with Learners (postlearning activity) How
will it be accomplished?
Evaluation of
Writing and collecting the one minute papers. Evaluation
Learning (How will it takes place in the discussion and requiring all to comment.
be accomplished?)
There is self-assessment that should occur as well.
Teacher Reflection This activity allows for self-reflection and their own awareness
to be increased as they consider the influence and impact of

(justify choice of learning social media. The well-being and safety of patients are
activity and good fit for jepardized if confidentiality is not maintained (Lachman,
the identified learning 2013).
objectives)
TEACHING STRATEGIES PLAN #7
NAME OF LEARNING Think- pair - share
ACTIVITY
Learning Activity
Summary

Discussion of impact of do -not resuscitate orders, and the

ethical and legal implications of the decision for the patients.
Students receive copies of each of the forms. They pair up with
a peer and have to share their perceptions how they would feel
about this issue if they needed to fill out the forms.End time
with a 10min video, of someone making that decision.
Cognitive (identify level): understand, analyze.

Domain of Learning Affective: Valuing and responding

(Blooms Taxonomy
Revised)
Student-Centered
At the completion of this learning activity, the learner will:be
Learning Objective(s) able to respond to end-of life decisions.
Preparation Required . Obtain copies for each student of Five wishes Document,
by Teacher/Facilitator and Molst form, DNR, Healthcare proxy forms for each student.Be
Materials Needed
aware of differences and impact in different clinical settings.
Which settings may not accept certain forms?
Time Allotted

Learning Styles
Addressed by Activity

Explanation pre-activity 10min. Each person in the pair has

10min to share and then switch. Discussion of difference of
different forms 20min and changes in different settings.
Information presentation; verbal, visual,
Modality: visual and verbal
Approach: Reflective

Understanding: Holistic
How is content connected This expands on their understanding of the ethical issues of
to prior learning?
care. The ethical issues of end-of life will also be applicable on
a personal level. Allow more reflective but calling for action of
a decision in this area.
Reflective Debriefing Debriefing with next post conference to check if they noticed
with Learners (post- their patient code status and or were able to assess their
learning activity) How will readiness to address these questions.
it be accomplished?
Evaluation of Learning Included on a test at the end of the unit. As a test question to
(How will it be
describe the differences in the end-of life forms.
accomplished?)
Teacher Reflection

It allows for each person to address the content and then after
personal application the video to broaden it to the patients they
(justify choice of learning will care for. It is easy to make this a subject that is not
activity and good fit for discussed, by first delving into their own perceptions,
the identified learning preconceived notions; they can apply it to patients.
objectives)
(Lachman, OConnor Swanson, & Winland-Brown, 2015)

TEACHING STRATEGIES PLAN # 8

NAME OF LEARNING
ACTIVITY

End-of life Case study discussion

Learning Activity
Summary

Discussion of impact of care study on do not resuscitate

orders, and the ethical and legal implications of the decision for
the patients
Cognitive (identify level): 5 Evaluate

Domain of Learning
(Blooms Taxonomy
Revised)

Affective: organizing
Psychomotor: Guided response

Student-Centered Learning At the completion of this learning activity, the learner will: be able to
Objective(s)
describe legal and ethical implications for patients at end of life
Preparation Required by Various case studies available. Knowledge and copies of MOLST and
Teacher/Facilitator and DNR form. Video clips of healthcare worker discussion assigned to
Materials Needed
students
Time Allotted

15 min discussion
10min reading case study and working through questions
15min coming together for larger group synthesis
5 min for summarizing

Learning Styles Addressed Information presentation: Sight and verbal

by Activity
Modality: Visual and verbal
Approach: Active and reflective
Understanding : Holistic
How is content connected to Further extends understanding to applying use of the end-of-life
prior learning?

concept to specific case-study

Reflective Debriefing with Debriefing by the group calling out their positive input and
Learners (post-learning negative reaction, writing on a white board.
activity) How will it be
accomplished?
Evaluation of Learning Formative evaluation during discussion. Facilitator will follow
up by summarizing responses online.
(How will it be
accomplished?)
It is a useful activity in getting the students to think of all the
variables that can come into play with living wills, durable
(justify choice of learning powers of attorney, Self-determination act, agency policies,
activity and good fit for state law differences, code of ethics, and nursing practice act.
the identified learning
( Winland-Brown, Lachman, OConnor Swanson, 2015)
objectives)
Teacher Reflection

References
American Nurses Association (2015) Code of Ethics for nurses with interpretive statements,
Silver Springs, MD: Author. Retrieved from
www.nursingworld.org/MainMenuCategories/Ethicsstandards/Resources.
Badzek, L. & Desmond, K. (2015). Issues up close. American Nurse Today, 10(9) 16-17.
Fowler, M.D.M. (2015). Guide to the code of Ethics for Nurses with interpretive statements. (2nd
ed.) Silver Spring, MD: American Nurses Association
Herrman, J.W. (2016). Creative teaching strategies for the nurse educator. (2nd Ed. )
Philadelphia: F.A.Davis Company

Hickman, S.C., Wocial, L.D., (2013). Team-based learning and ethics education in nuring. The
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Hountras, S.C.(2015). What guides your nursing practice? Journal of Christian Nursing.32(3)
179-181.
Lachman, V.D. (2012). Applying the ethics of care to your nursing practice. Medsurg Nursing
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Lachman, V.D. (2013). Social Media: Managing the ethical issues. Medsurg Nursing 22(5) 326
-329.
Lachman, V.D., OConnor Swanson, & Winland-Brown, J., (2015). The new code of ethics for
nurses with interpretive statements (2015): Practical Clinical Application, Part II,
Medsurg Nursing, 24(5). 363-368.
Morin, K.H. (2015). The code of ethics for nurses more relevant than ever. Journal of Nursing
Education, 54(12). 667-668.
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