Abstract
The 2024 nursing ethics conference brought together health and social care professionals, educators, leaders, ethicists and students to share international and interdisciplinary research and scholarship.
Brunel students contributed to the success of the conference by acting as volunteers and reading citations relating to the Human Rights and Nursing Awards. Students from the University of Genoa, Italy, presented their research in parallel sessions.
This Editorial captures the perspectives of students from Brunel University of London and from the University of Genoa. Student reflections are informative and important as they illuminate issues students perceived as most interesting and engaging.
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Reflections from pre-registration students at Brunel University of London
The human rights and nursing awards – celebrating success and transferable insights
The importance of celebrating success and encouraging nurses to strive for excellence through the international nursing awards provided a good contrast to hearing about the challenges that nurses faced. As a Physiotherapy student, I was not aware of the scope of nursing and hearing about ethical challenges in a multinational setting was definitely a highlight. It was clear that although this was a nursing conference, a lot of the issues raised are transferable to all Allied Health Professionals – such as not being able to get the fundamentals right, timing constraints, pressure and the practitioner’s own perspectives. Despite a large focus on being on challenges, the discussions in the breakout sessions and vignettes of the award winners gave a sense of hope. I believe it was largely beneficial to hear about all three award winners as they had very different career paths and worked in different countries, overcoming different issues. Therefore, there was potential to inspire multiple groups of people who attended the awards, especially the students.
Fundamentals of care
The two-day conference began with an excellent exposition by Professor Sarah Banks on care in a ‘crisis’-stricken world. The point that struck me most keenly was how a discourse of crisis leads to suboptimal care being accepted. A lack of trust between patient and care-giver, bullying in the workforce and moral distress are likely to flourish in these conditions. The conference facilitated an interprofessional and international dialogue as to how we move from a framework of reactive care to proactive care. One of the key takeaways was a reflection made by Fiona Timmins that we must focus on the fundamentals of care. This struck me as an important antidote to the crisis narratives. A strong foundation has the potential to build trust, highlight ineffective and unethical practices and ensure that the cornerstones of care are firmly instilled.
Education as a positive force
The significance of education as a mechanism through which real and potential workforce crises could be resolved permeated discussions throughout the conference. Perhaps unsurprisingly, conference delegates, with backgrounds in health and social care and academia, viewed education as a positive force for change in the pursuit of ethically conscious healthcare provision. As has often been the case, education was lauded by many as a conduit for changing wider healthcare values and ethics.
Yet the crises facing nurse education were recognized as barriers to better workforce outcomes more widely. The English example of nurse education evidences a flawed construction on already unstable foundations; falling number of applicants, strained funding for both HEIs and students alike and, arguably, an excessive requirement of 2300 hours of unpaid clinical practice are a few of the mounting obstacles. In the shadow of such practical challenges, engaging students on matters of morals, values and ethics becomes increasingly difficult. As many delegates recognized, resolving workforce crises through education is not merely a matter of instructing students to bear ethics in mind. Rather, we need to teach students to be curious, to engage with the world at large and to think critically about what we do and why we do it.
Ethical competence
The work of the PROMOCON Project presented by an international team of researchers at the conference might be the future of producing morally competent nurses through the engagement of students with a purposively designed Massive Open Online Course (MOOC) exploring the ethical conditions of the profession. We look forward to the 25th international conference to learn of the project’s outcomes. While a perfect strategy for achieving an ethically minded workforce may not yet exist, the passion and commitment of delegates at the conference highlights that this is not yet the time for cynicism on the matter.
Impact of technology and Artificial Intelligence (AI) on care
Wes Streeting, the Secretary of State for Health and Social Care, declared that “the NHS is broken,” and his mission is to save it. One key change he proposes is transitioning the NHS from analogue to digital, an important step as AI rapidly emerges in clinical work. The benefits of using AI in clinical settings seem obvious – automation, and more efficient data processing could help ease the stress and burnout faced by healthcare professionals. Expanding technology in healthcare seems unavoidable, yet the ethical concerns surrounding the use of AI in clinical work remain urgent. These issues must be carefully explored and addressed, with clear principles established to ensure that ethical standards are upheld.
Ramvi et al. 1 identified several challenges posed by technology in healthcare, including the disruption of relationship-based care, the risk of depersonalization and an overemphasis on efficiency and technical processes, which can overshadow the emotional and ethical aspects of care. Additionally, both healthcare professionals and patients may become increasingly vulnerable as their reliance on technology grows. At the 24th International Nursing Ethics Conference, Ellen Ramvi further explored these concerns. She emphasized that the true threat to care is not technology itself, but the structural conditions of scarcity. Furthermore, as long as communication and relationships remain central to care, technology is not opposed to ethical care. Therefore, it is important to create capacity for healthcare professionals to explore ways to balance the benefits of AI with the preservation of human connection in addressing these ethical challenges.
Reflections from PhD students at the University of Genoa
A platform to discuss issues openly
The 2024 International Nursing Ethics Conference addressed the ethical challenges faced by the global healthcare workforce amidst an ongoing care crisis. Central to the discussions were themes of moral distress, burnout and the ethical dilemmas healthcare professionals face when systemic issues hinder their ability to deliver adequate care. The conference underscored the pressing need to re-evaluate ethical frameworks to foster resilience and well-being for caregivers and patients alike. Many professionals find themselves unable to provide necessary care due to institutional constraints, a reality highlighted by participants who shared their experiences at the conference. The Nursing Ethics Conference provided us a platform to discuss these issues openly, offering diverse perspectives on how ethical leadership can mitigate the negative effects of the care crisis and giving us the opportunity to share our position presenting some of the projects we are working on.
Ethical leadership
A significant focus of the conference was the role of ethical leadership in addressing these challenges. Ethical leadership involves nurturing a culture where values like respect, dignity and care are prioritized. As highlighted by keynote speakers, ethical leadership transcends rule-following; it demands emotional and professional support for teams to maintain high standards of care. Presenting our project during a leadership-focused session sparked meaningful discussions about integrating leadership education early in nursing programs, differentiating between managerial and leadership roles, and effectively managing dissent in multidisciplinary teams. Such discussions are vital in preparing future healthcare professionals to navigate complex team dynamics while promoting a culture of ethical leadership.
Moral distress
The theme of moral distress aligns closely with our project on midwifery care, showcasing the interdisciplinary nature of this phenomenon. Moral distress affects not only nurses but also midwives and other healthcare professionals, underscoring the need for holistic, patient-centred care despite systemic barriers. In addition to discussing the severity of moral distress, the conference highlighted potential solutions. Advocates called for systemic changes, including improved staffing ratios, flexible working hours and enhanced mental health support for healthcare workers. One innovative proposal involved establishing ethical reflection groups to create a supportive environment for healthcare professionals to share experiences and tackle ethical dilemmas collectively. One of our presented projects focusing on reducing turnover among newly graduated nurses by ensuring a smooth transition from their bachelor’s degree into professional practice. The team recognizes that an effective transition is crucial for the well-being and professional development of healthcare professionals. By fostering a supportive environment during this critical phase, we aim to enhance job satisfaction and competence, thereby improving patient care and alleviating moral distress in the workforce.
The importance of ethics education
Finally, the conference emphasized the importance of ethics education that extends beyond theoretical knowledge to include practical training in handling real-world dilemmas. This approach will better prepare future healthcare professionals to navigate the complexities of modern healthcare environments with confidence and resilience. We commend the active participation and welcoming atmosphere fostered by the organizers and participants alike. This environment encouraged open dialogue, enabling us to reaffirm our professional identities and reinforcing our commitment to contribute to scientific discourse that adequately addresses the ethical dimensions of our field.