Nurses are involved in complex decision-making processes when delivering care which often have a moral and ethical dimension.  

Recent global events, such as the COVID-19 pandemic have challenged nursing practice by placing greater demands on their time compromising the delivery of high quality care.  

The public health crisis is exacerbating some pre-existing issues in the nursing workforce (high turnover, unsafe nurse-patient ratios) which can all increase nurses’ moral distress and negatively affect mental health which can also compromise the delivery of high quality and safe nursing care.  

These issues not only increase the potential for burnout among nurses, but might also affect their ability to make ethically sound judgements in complex situations.  The constantly changing health care arena requires nurses to have advanced education to support ethical decision making.   

Applied ethics educational activities are often underrepresented within formal ethics courses in current undergraduate and continuing education programs and practicing nurses need to be empowered in their decision-making processes when dealing with situations requiring ethical sensitivity.  

Furthermore, across the EU, educators may benefit following a common morally competent profile of nurses, supporting them to select appropriate contents, methodologies, and evaluation systems. Therefore, we need to focus our efforts on improving knowledge, skills and attitudes as well as education opportunities on moral and ethical competencies. 

We will involve nursing professionals, nursing students, nursing educators, and all stakeholders interested in promoting nursing moral and ethical competencies.  

• To promote the development of moral and ethical competencies in the target group through an applied nursing ethics educational program. 
• To enhance the ethical decision-making and professional judgment of nurses that consequently will facilitate the delivery of better care. 
• To raise awareness of the ethical and moral challenges emerging at the international level and how they can have long-term effects in terms of moral distress and burnout. 
• Identifying gaps in current nurses’ ethics education programs. 

The project will be conducted through four main work packages:  

1. The training methodology 

In this first step of the project, we aim at collecting nurses’ and nursing students’ needs regarding moral and ethical competencies through a transnational qualitative study. In addition, we will conduct systematic literature reviews to identify tools to assess nursing moral and ethical competencies and interventions to promote it. With the results from this first phase, we will develop the structure and contents of the curriculum for a Massive Open Online Course (MOOC).  

2. The MOOC e-learning course 

In this second step, we will develop the course content and curriculum from the findings from phase one for. This will be informed by the principles of e-learning and will involve the development of a free online platform that will host the final version of the Massive Open Online Course aimed at improving nurses moral and ethical competencies. The pedagogical approaches will also be responsive to the findings from phase one but it is anticipated that they will be contemporary innovative and allow for flexible learning.    

3. Implementation and evaluation of the MOOC 

In this phase we will conduct three important activities to validate and disseminate the MOOC:  

• To pilot and evaluate the MOOC among nursing students and practicing nurses and educators among participating countries. 

• To develop a “Train the Trainers” toolkit, including a training manual, teaching resources, and detailed lesson plans along with teaching and evaluation strategies. 

• To perform a “Train the trainers” summer school by bringing together nurse educators following  completion of the MOOC to further develop their ethical and moral knowledge and to critically discuss how the MOOC can be integrated and standardized across EU nursing curricula.  

4. The Good Practices Guide 

The objective of this last phase of the project is to develop a Good Practice Guide to help nurses to implement more ethically sensitive care providing practical solutions to help combat the challenges of everyday practice. The Guide will support educators, professionals, students, and professional bodies to improve patient care by empowering and developing their moral and ethical competencies. The Guide will be evaluated on its quality by potential users and experts in the field.