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Published on: February 16, 2011
Ethical Care Begins With Wellbeing: Reframing Nursing Practice Within Inequitable Systems.
Johanna Gaskins, Roberta Waite1, Kechi Iheduru-Anderson2
1Dean and Chief Nursing Officer, Berkley School of Nursing, Georgetown University, Washington, District of Columbia, USA.
Nursing Inquiry
|June 15, 2026
Summary
Ethical nursing care requires prioritizing caregiver wellbeing as a foundational capacity, not just an outcome. This approach addresses systemic inequities and promotes accountability in healthcare.
Area of Science:
- Nursing Ethics
- Healthcare Inequity
- Organizational Psychology
Background:
- Nursing scholarship highlights healthcare inequities like racism and bias impacting patients and nurses.
- A critical ethical question remains: what does ethical care demand from nurses within unjust systems?
Purpose of the Study:
- To reframe wellbeing as a necessary capacity for ethical, relational, and accountable nursing practice.
- To introduce implicit conditioning as a framework for understanding responses to systemic strain.
- To explore the role of institutions in fostering or hindering ethical practice.
Main Methods:
- Conceptual analysis of ethical care within inequitable systems.
- Introduction of implicit conditioning to analyze systemic imprinting.
- Examination of wellbeing as ethical infrastructure.
Main Results:
- Wellbeing is essential for regulation, reflection, and accountability in nursing practice.
- Inequitable care arises from conditioned responses in depleted environments.
- Institutions significantly influence the cultivation of capacities for ethical practice.
Conclusions:
- Wellbeing must be viewed as foundational ethical infrastructure for nurses.
- Understanding implicit conditioning shifts focus from individual blame to systemic issues.
- Reframing wellbeing clarifies responsibilities and expands possibilities for equitable care.
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