Moral Integrity and Moral Courage: Can You Teach It?

Recent reports in the news media suggest that American society is becoming increasingly engulfed in a culture of moral depravity; however, there is still a high expectation for moral integrity in the profession of nursing. Nursing has a firm foundation of values and codes reflecting high moral integrity and obligations to society. The professional, social, and personal responsibility and accountability for nursing practice have been emphasized, from Florence Nightingale (¹⁸⁶⁰ ) to the International Council of Nurses' Code of Ethics for Nurses (²⁰⁰⁶ ) and the American Nurses Association's (^{ANA, 2010} ) Code of Ethics for Nurses with Interpretive Statement .

Although nursing consistently receives top scores on surveys that rate moral behavior among the professions (^{Jones, 2011} ; ^{Wilk & Bowllan, 2011} ), nurses bring an array of value systems into the profession that do not consistently reflect the high standards of moral integrity on which the profession was founded. Practicing RNs are increasingly demonstrating that the moral foundation of practice is eroding. The meeting minutes of state boards of nursing reveal an alarming number of disciplinary actions reflecting a loss of moral compass (e.g., ^{Indiana State Board of Nursing, 2011} ; ^{Ohio Board of Nursing, 2011} , as two state boards served by the geographical area of this study). The American Association of Critical Care Nurses (²⁰⁰⁸ ) acknowledged, "Moral distress is a serious problem in nursing. It results in significant physical and emotional stress, which contributes to nurses' feelings of loss of integrity and dissatisfaction with their work environment" (p. 1).

A similar pattern has been noted in nursing academic arenas. McCabe (²⁰⁰⁹ ) reported a higher rate of cheating and dishonesty among nursing students than among other disciplines studied. The concern raised by faculty in the McCabe study suggested a correlation between those students who are dishonest (e.g., plagiarism, misrepresentation, and falsification [^{McNabb & Olmstead, 2009} ]) in academic nursing programs, and those who go on to be dishonest in practice as nursing professionals. Nurse educators need to develop expertise in the concepts of moral literacy and in best practices for teaching moral integrity, and they need to develop a skill set to design classroom experiences that bring students to a deeper level...