What is beneficence in nursing?

The four ethical principles of the nursing profession covered by the American Nurses Association’s Code of Ethics include autonomy, justice, nonmaleficence, and one 11-letter word with a simple definition: beneficence. So, what exactly is beneficence in nursing?

Cynda Rushton, RN

Cynda Rushton, PhD, RN, FAAN, the Anne and George Bunting Professor of Clinical Ethics and Nursing at Johns Hopkins University in Baltimore, Maryland, describes it this way: “Beneficence is a big word that only ethics folks use in a sentence,” she joked.

The true definition of beneficence in nursing is something nurses achieve regularly but may not notice. “It’s doing good or benefiting the people we serve,” Rushton continued. “I think nurses are doing it every day.”

Nurses may not realize that through their daily work, beneficence is front and center. Rushton says nurses should take stock of just how much this principle plays a role in the care they provide.

“Nurses use their expertise, their judgment, and their skill to create a sort of safe passage for their patients through the healthcare system,” she said. “Claiming that contribution is really important because nurses spend more time than anyone else with patients. They’re instrumental in being able to help patients realize the benefits that are possible for them.”

In a March 2023 study published in the journal BMC Nursing, nurse researchers from Tabriz University of Medical Sciences in Iran concluded that clarifying beneficence among nurses can lead to increased well-being in patients, reduction in their mortality rate, increased patient satisfaction, and the respect and human dignity of patients.

The intertwined principles

To better understand the role of beneficence in nursing, understanding nonmaleficence is imperative. The ANA defines nonmaleficence as the avoidance or minimization of harm.

For nurses, these two principles are often intertwined. Rushton explains the connection as the relationship between burdens and benefits.

One example is patients undergoing chemotherapy treatments under the guidance of oncology nurses. “We give chemotherapy, and in the short term it makes them very ill,” she said. “But the goal, ultimately, is to eliminate the cancer cells.”

For labor and delivery nurses, this can involve giving medication to induce labor. “You give Pitocin to cause more intense contractions with the goal of a safe (vaginal) delivery, rather than a C-section,” Rushton said. “It’s kind of a dance of being able to hold both of those realities at the same time.”

The tradeoff of benefits versus burdens sometimes is very clear. Other times, it’s not.

“You start down a path of treatment and you realize, ‘Wow, this is not what we thought was going to happen.’ Is it still an ultimate benefit to this person or not?” she said. “I think that’s where nurses struggle a lot.”

When benefits fall short

Watching patients suffer from the burdens of a disease can be overwhelming and make them question whether beneficence is something they are actually exhibiting.

The result can be what some call compassion fatigue. Rushton, however, suggests that term is misnamed. “It’s actually empathy fatigue,” she said. “Scientists have shown that different parts of the brain …read more

Read full article here: nurse.com