DNR decisions are frequently made in oncology and hematology care and physicians and nurses may face related ethical dilemmas. Ethics is considered a basic competence in health care and can be understood as a capacity to handle a task that involves an ethical dilemma in an adequate, ethically responsible manner. One model of ethical competence for healthcare staff includes three main aspects: being, doing and knowing, suggesting that ethical competence requires abilities of character, action and knowledge. Ethical competence can be (...) developed through experience, communication and education, and a supportive environment is necessary for maintaining a high ethical competence. The aim of the present study was to investigate how nurses and physicians in oncology and hematology care understand the concept of ethical competence in order to make, or be involved in, DNR decisions and how such skills can be learned and developed. A further aim was to investigate the role of guidelines in relation to the development of ethical competence in DNR decisions. Individual interviews were conducted with fifteen nurses and sixteen physicians. The interviews were analyzed using thematic content analysis. Physicians and nurses in the study reflected on their ethical competence in relation to DNR decisions, on what it should comprise and how it could be developed. The ethical competence described by the respondents related to the concepts being, doing and knowing. In order to make ethically sound DNR decisions in oncology and hematology care, physicians and nurses need to develop appropriate virtues, improve their knowledge of ethical theories and relevant clinical guidelines. Ethical competence also includes the ability to act upon ethical judgements. Continued ethical education and discussions for further development of a common ethical language and a good ethical working climate can improve ethical competence and help nurses and physicians cooperate better with regard to patients in relation to DNR decisions, in their efforts to act in the best interest of the patient. (shrink)

Health science students frequently experience ethical dilemmas on clinical placements, yet ethics education rarely prepares students with the ethical leadership skills required. The Leadership in Ethical Practice (LEP) program is an ethics education resource designed to enhance health science students’ knowledge and skills in ethical leadership to prepare them for clinical placements and future professional practice. This qualitative study aimed: to explore the nature of students’ ethical leadership goals; determine whether a specific, measurable, achievable, relevant, and time-bound (SMART) format was (...) an effective tool for students to create ethical leadership goals; and identify any changes in students’ pre- and post-self-ratings of ethical leadership knowledge following the LEP program. Eighty-two diagnostic radiography students from the University of Sydney participated in the study. Inductive and deductive qualitative content analysis (Elo & Kyngas, 2008) were used to explore students’ goals. Descriptive statistics were used to investigate students’ pre- and post-self-ratings. Four themes emerged from students’ goals: initiative, competence, and courage in ethical reasoning; communicating ethical stories through listening, questioning, and connecting; reflecting and growing as an ethical leader; and safe practice and person-centred outcomes. SMART goal format elements were evident in 61% of students’ goals. Students' ethical leadership self-ratings showed positive changes after participating in the LEP program. Findings indicated students planned to further develop ethical leadership skills during clinical placements and future professional practice. This study demonstrated the ethics education approaches used within the LEP could assist health science students to apply ethical leadership in future clinical practice. (shrink)

Background and aim: Surgical intensive care nurses should have ethical sensitivity allowing them to identify ethical issues in order that they can recognize them and make the right decisions. This descriptive study was conducted with the aim of evaluating the ethical sensitivity of surgical intensive care nurses. Materials and methods: The research was carried out with the participation of 160 nurses in six Turkish hospitals, four state, one university, and one private. The data were collected using the “Nurse Description Form” (...) developed by the researcher and the “Ethical Sensitivity Questionnaire.” The percent, mean, standard deviation, median, minimum and maximum values, significance test for the difference between two means, variance analysis, Mann–Whitney U test, and Kruskal–Wallis Variance Analysis test were used to evaluate the data. Ethical considerations: Ethical commission permission and the corporate permission of the hospitals were received before conducting the research. Results: It was determined that the ethical sensitivities of surgical intensive care nurses were moderate based on the Ethical Sensitivity Questionnaire total score and subdimension score averages. A statistical difference was determined between the Ethical Sensitivity Questionnaire total score of surgical intensive care nurses and the institution where they worked, the period of working in the occupation, and the period of working in the intensive care unit (p < 0.05). Conclusion: Based on the results of the research, the organization of training and studies devoted to the elimination of ethical sensitivity differences between institutions and workers is suggested. (shrink)

Background: Since the increasingly complex structure of health care services brings many ethical problems, it is important to use different instructional technologies in the ethical education of future nurses. Aim: The aim of this study was to determine the effect of role play prepared with video support on ethical decision-making and motivation levels of nursing students. Research design: A quasi-experimental study with pretest-posttest design. Participants and research context: The research was conducted in the Nursing Department of a University located in (...) Istanbul, Turkey between October 15 and November 15, 2024. The sample of the research consisted of 3rd year nursing students. Data were collected using the Descriptive Characteristics Form, the Nursing Dilemma Test, and the Instructional Material Motivation Scale for Single-Use. Ethical considerations: Permission was obtained from Bezmialem Vakif University Non-Interventional Ethical Research Committee and the institution where the study was conducted for the implementation of the research. Written and verbal consent was obtained from all participants in accordance with the Helsinki Declaration. Findings: While there was no difference between the students’ Ethical Dilemma Test Principled Thinking pre-test and post-test scores, their Practical Consideration ( p =.005) and motivation levels ( p =.037) post-test scores were found to be higher. There was a weak but significant negative correlation between academic achievement and pre-test teaching material motivation levels (r = −0.375, p =.041). Discussion: The use of different teaching methods and techniques in ethics education in nursing is important for future nurses to find more practical solutions to the ethical problems they will encounter during patient care. Conclusion: The results of the study indicate that the use of video-supported role play can be effective in teaching ethics courses in nursing education. (shrink)

Nurses who try to reduce inequalities in health care by defending individuals they care for should be able to perceive ethical situations sensitively as patient advocates. This study aimed to examine the effects of ethics education provided to nursing students on ethical sensitivity and patient advocacy. The study adopted a pre-test, post-test, one-group quasi-experimental design and was conducted at a public university in Turkey. The sample comprised 44 nursing students taking the Professional Ethics course. Data were collected from October 13, (...) 2021, to January 6, 2022, using a Descriptive Characteristics Form, the Moral Sensitivity Questionnaire, and the Patient Advocacy Scale for Nurses. The study was approved by an ethics committee. While no significant difference was found between the pre-test and post-test mean Moral Sensitivity Questionnaire scores (t = 0.426, p > 0.05), a significant difference was noted between the total mean Patient Advocacy Scale for Nurses scores (Z = − 2.443, p < 0.05). The findings showed that ethics education provided to the nursing students did not affect ethical sensitivity but increased patient advocacy. (shrink)