As Editor-in-Chief of the Journal of Forensic Nursing, I have the privilege of reading all the manuscripts that are submitted for review for publication, and more importantly, compiling the lineup for each issue of the journal. I must admit that this is one of my favorite tasks associated with my role. As I selected the articles for this issue, I was struck by the diversity of topics that forensic nurses are writing about. One would think, that after all the years I have been associated with the JFN, the complexities and uniqueness of forensic nursing in its totality would no longer surprise me, yet I continually find myself in awe of the commitment of forensic nurses to their patients and clients, their profession, and their communities. The authors and articles featured in this issue are no exception.
As I read each article and carefully considered the implications for education, research, and practice, I could not help but reflect on the everyday ethical issues that surely emerge in the care of the vulnerable patients and clients featured in the pages that follow: women with disabilities, strangulation victims, incarcerated persons, forensic psychiatric patients, patients with personality disorders, and sexual assault victims. I also noted how easy it is to use multiple labels to describe the persons being referred to in each of the articles, for example, hepatitis C infection and recently paroled homeless men. These labels are rife with emotional connotations, which led me to wonder whether such labels are indeed informative and helpful, or is the cumulative impact of such labels stigmatizing and harmful? In short, the ethical issues inherent in the care of forensic patients and clients are as varied as the settings in which forensic nurses practice. So, how does one go about exploring such issues? How does one create a moral space where the proverbial question of ethics-"what is the right thing to do?"-can be enacted? (Bergum, 2013).
What is a Moral Community and Why is it Important to Forensic Nurses?
Austin (2007) states that "ethical action takes place in community" (p. 85). Being ethical, however, is not a solitary venture; instead, it is grounded in relationships-the relationship one has with oneself and with and for others, including the relationships with one's patients, clients, colleagues, and practice environments (Aroskar, 1995; Austin, 2007; Bergum, 2013). Webster and Baylis (2000) describe a moral community "as a community in which there is coherence between what a healthcare organization publicly professes to be, and what employees, patients and others both witness and participate in" (p. 228). Rodney, Buckley, Street, Serrano, and Martin (2013) further define a moral community as "a workplace where ethical values are clear and are shared, where ethical values direct action, and where individuals feel safe to be heard" (p. 198).
In crafting moral communities in forensic nursing, forensic nurses, like all nurses, need to "think and talk about the ethics of their practice; that they are encouraged to learn, reflect and share their ethical challenges; and that they will be supported and provided with resources by managers and senior administrators" (Storch, 2007a, p. 569). However, crafting a moral community is not the sole responsibility of those designated in leadership positions; it is the responsibility of every forensic nurse. So what role will you play in crafting a moral community in your workplace? What is the best way to address the everyday ethical issues and concerns common to your unique forensic practice area? How will you ensure that your voice and the voice of your peers will be heard? What resources do you need to enact your membership in your specific moral community? Scott, Marck and Barton (2012) conclude that engaged membership in a moral community results in holistic, ethical, competent, and safe nursing care. As a result, patients and clients, their families, and their communities collectively benefit from the informed contributions of forensic nurses in their specific moral communities. As forensic nurses engage each other and engage their interprofessional colleagues, they collectively draw upon a multitude of nursing and related resources, which enriches their practice and deepens their ethical commitments.
Relevant Resources
When was the last time you looked at the Forensic nursing: Scope and standards of practice (American Nurses Association/International Association of Forensic Nurses, 2009)? What about the International Association of Forensic Nurses (2008) "Vision of Ethical Practice"? You may be pleasantly surprised to see how these documents can both inform and guide forensic nursing as a moral community. The latter, in particular, speaks to forensic nurses' obligations to patients and clients, their responsibilities to the public, their obligations to science, and their dedication to colleagues. However, adherence to standards of practice and visions or codes of ethics alone will not solely promote ethical practice. Instead, such documents are designed to provide forensic nurses with a broad framework; rarely do they address the idiosyncrasies of particular practice settings or specific ethical dilemmas. Rather, they are intended to be used in conjunction with professional judgment within clinical practice, which takes into account such variables as context, theoretical orientation, standards for practice, and culture. In short, adherence to such documents alone does not promote ethical practice. Instead, they provide a springboard or a platform for further education and dialogue regarding matters of concern (Storch, 2007b). Forensic nurses as members of moral communities need to be ongoing participants in this conversation. I look forward to furthering this dialogue.
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