This study examined the relationship between nurses’ ethical decision-making levels and their professional behaviours. Data were collected from 225 nurses who were recruited from university hospitals in Ankara using proportionate sampling. Data were analysed using descriptive statistics and Pearson correlations. Most of the nurses were familiar with ethical dilemmas in nursing practice. The Nursing Principled Thinking level was above average, while the Practical Consideration level was average. Nurses’ professionalism level was low. There was a positive but weak correlation between professional (...) behaviours of the nurses and their ethical decision-making levels. Increasing nurses’ professionalism level can provide a positive contribution to the ethical decision-making level. (shrink)

Nurses are encountering an increasing number of ethical dilemmas in clinical practice. Ethics courses for baccalaureate nursing students provide the opportunity for the development of critical thinking skills in order to deal with these effectively. The purpose of this descriptive qualitative study was to describe ethical reasoning in 70 baccalaureate nursing students enrolled in a nursing ethics course. Reflective clinical journals were analyzed as appropriate for qualitative inquiry. The overriding theme emerging from the data was `in the process of becoming', (...) which includes: practicing as a professional, lacking the confidence as a student nurse to take an ethical stand, advocating for patients, being just in the provision of care, identifying the spiritual dimensions of nursing practice, confronting the `real world' of health care, making a commitment to practice with integrity, and caring enough to care. The development of critical thinking and ethical reasoning within the framework of knowing and connecting is essential in nursing education. (shrink)

Background: The Taiwan Nursing Accreditation Council has proposed eight core professional nursing qualities including ethical literacy. Consequently, nursing ethics education is a required course for student nurses. These courses are intended to improve the ethical literacy. Moral sensitivity is the cornerstone of ethical literacy, and learning moral sensitivity is the initial step towards developing ethical literacy. Objectives: To explore the effect of nursing ethics educational interventions based on multiple teaching strategies on student nurses moral sensitivity. Based on the visual, auditory (...) and kinaesthetic model, three strategies were developed for determining the programme components and corresponding learning styles. Research design: This was a quasi-experimental study. Participants: A total of 234 junior-college student nurses participated in this study. All participants were aged 18–19 years. Ethical considerations: The study protocol was approved by the institutional review boards of Kaohsiung Veterans General Hospital. Only the participants who signed an informed consent form took part in the study. The participants were permitted to withdraw from the study at any point if they wished to do so without affecting their academic score. Results: The scores of Modified Moral Sensitivity Questionnaire for Student Nurses were significantly improved after the intervention of integrating multiple teaching strategies ( p =.042). Significant relationships were observed between the satisfaction scores of two teaching strategies and moral sensitivity. The results indicated that using multiple teaching strategies is effective for promoting nursing ethics learning. Conclusion: This strategy was consistent with the student nurses’ preferred learning style and was used to correct their erroneous ethical conceptions, assisting in developing their ethical knowledge. (shrink)

There is a need to explore educational strategies that translate ethics knowledge into ethical behavior. Commonly used pedagogical approaches steeped in traditional normative ethical theory are less powerful than sensemaking in preparing clinicians to respond to ethical problems in practice. This integrative review of 15 articles explores the use of sensemaking as an instructional method for clinical ethics. Whittemore and Knafl’s :546–553, 2005) integrative review method guided a systematic appraisal of data from both qualitative and quantitative research traditions, synthesizing disparate (...) studies in analyzing literature about the use of sensemaking as a pedagogical approach in teaching ethics. Findings supported the use of Weick’s sensemaking theory to develop instructional methods that encourage ethical decision making in students as well as promote ethical response by health care providers. The review reveals important theoretical and training implications for introducing sensemaking as a means to promote ethical action in clinical practice. (shrink)

Aims: To review the literature on perceptions of nursing students and/or educators on the contribution of ethics education to ethical competence in nursing students. Background: Nurses do not always demonstrate the competencies necessary to engage in ethical practice. Educators continue to debate about the best ways to teach ethics to nurses so that they can develop ethical competencies. Data sources: MEDLINE, Embase, CINAHL, PsycINFO, and Web of Science. Review methods: A total of 15 articles with a quantitative, qualitative, or mixed-methods (...) design published between January 1992 and March 2012 were analyzed. Results: According to students and educators, ethics education increases ethical perception of nursing students and the development of reflective and analytical skills. However, its contribution to the development of ethical behavior was barely mentioned. The accounts of students and educators revealed essential features of effective ethics education: active involvement of students in case study discussions and use of ethical frameworks. The use of activating educational strategies requires a safe learning environment where students can openly reflect on values at stake in their care practice. Conclusion: A better understanding of how students learn to develop ethical skills and of influencing factors can guide educators to develop ethics courses for nursing curriculum. Future research needs to focus on the methodological accuracy of sampling and measuring instruments. (shrink)

Background: The complexity and variety of ethical issues in nursing is always increasing, and those issues lead to special concerns for nurses because they have critical impacts on nursing practice. Research objectives: The purpose of this study was to gather comprehensive information about ethical issues in nursing practice, comparing the issues in different types of nursing units including general units, oncology units, intensive care units, operating rooms, and outpatient departments. Research design: The study used a descriptive research design. Ethics/human rights (...) issues encountered by nurses in their daily nursing practice were identified by using the Ethical Issues Scale. Participants: The study sample included 993 staff nurses working in a university hospital in South Korea. Ethical considerations: This study was approved by the University Institutional Review Board. Completed questionnaires were returned sealed with signed informed consent. Findings: The most frequently and disturbingly encountered issues across nursing units were “conflicts in the nurse–physician relationship,” “providing care with a possible risk to your health,” and “staffing patterns that limit patient access to nursing care.” The findings of this study showed that nurses from different nursing units experienced differences in the types or frequency of ethical issues. In particular, intensive care units had the greatest means of all the units in all three component scales including end-of-life treatment issues, patient care issues, and human rights issues. Discussion: Nurses experienced various ethical challenges in their daily practice. Of the ethical issues, some were distinctively and frequently experienced by nurses in a specific unit. Conclusion: This study suggested that identifying and understanding specific ethical issues faced by nurses in their own areas may be an effective educational approach to motivate nurses and to facilitate nurses’ reflection on their experiences. (shrink)

Graduate nursing students should have a strong ethical theoretical foundation to identify and explore scientific and technological ethical issues impacting nursing care, to assume leadership positions in practice and education, and to conduct research contributing to nursing’s knowledge base. This paper reports the implementation and evaluation of a new ethics course at Turkish doctoral nursing programs. The first section describes course design and implementation. The second section evaluates the course and discusses results. Students’ evaluations indicated that the concept of caring (...) in key ethical theories, particularly care ethics, was vital to course content. The most preferred teaching method was case analysis. Students suggested increase in course length and credits, content inclusion of feminist ethics, and real-world knowledge application by other teaching strategies such as clinical practice visits and hospital ethics committee member participation. (shrink)

Background Working as an ambulance nurse involves facing ethically problematic situations with multi-dimensional suffering, requiring the ability to create a trustful relationship. This entails a need to be clinically trained in order to identify ethical conflicts. Aim To describe ethical conflicts in patient relationships as experienced by ambulance nursing students during clinical studies. Research design An exploratory and interpretative design was used to inductively analyse textual data from examinations in clinical placement courses. Participants The 69 participants attended a 1-year educational (...) programme for ambulance nurses at a Swedish university. Ethical considerations The research was conducted in accordance with the Declaration of Helsinki. Participants gave voluntary informed consent for this study. Findings The students encountered ethical conflicts in patient relationships when they had inadequate access to the patient’s narrative. Doubts regarding patient autonomy were due to uncertainty regarding the patient’s decision-making ability, which forced students to handle patient autonomy. Conflicting assessments of the patient’s best interest added to the conflicts and also meant a disruption in patient focus. The absence of trustful relationships reinforced the ethical conflicts, together with an inadequacy in meeting different needs, which limited the possibility of providing proper care. Discussion Contextual circumstances add complexity to ethical conflicts regarding patient autonomy, dependency and the patient’s best interest. Students felt they were fluctuating between paternalism and letting the patient choose, and were challenged by considerations regarding the patient’s communication and decision-making ability, the views of third parties, and the need for prioritisation. Conclusion The essence of the patient relationship is a struggle to preserve autonomy while focusing on the patient’s best interest. Hence, there is a need for education and training that promotes ethical knowledge and ethical reflection focusing on the core nursing and caring values of trust and autonomy, particularly in situations that affect the patient’s decision-making ability. (shrink)

Professional identity and competent ethical behaviors of nursing students are commonly developed through curricular inclusion of professional nursing values education. Despite the enactment of this approach, nursing students continue to express difficulty in managing ethical conflicts encountered in their practice. This descriptive correlational study explores the relationships between professional nursing values, self-esteem, and ethical decision making among senior baccalaureate nursing students. A convenience sample of 47 senior nursing students from the United States were surveyed for their level of internalized professional (...) nursing values (Revised Professional Nursing Values Scale), level of self-esteem (Rosenberg’s Self-Esteem Scale), and perceived level of confidence in ethical decision making. A significant positive relationship (p < 0.05) was found between nursing students’ professional nursing values and levels of self-esteem. The results of this study can be useful to nursing educators whose efforts are focused on promoting professional identity development and competent ethical behaviors of future nurses. (shrink)

This descriptive study was conducted to determine nursing students’ observation of ethical problems encountered in their clinical practice. Data were collected through a questionnaire from 153 volunteer nursing students at a university-based nursing school in Ankara, Turkey. The students reported that some patients are either physically or psychologically mistreated by doctors and nurses; they were not given appropriate information; they were subjected to discrimination according to their socio-economic situation; and their privacy was ignored. The findings reveal that nurses’ own unethical (...) behaviors contribute to a rise in ethical problems. It is argued that nurses should internalize their professional and ethical roles in order to provide safe and ethical care and be good role models for students. (shrink)

Providing ethically competent care requires nurses to reflect not only on nursing ethics, but also on their own ethical traditions. New challenges for nurse educators over the last decade have been the increasing globalization of the nursing workforce and the internationalization of nursing education. In New Zealand, there has been a large increase in numbers of Chinese students, both international and immigrant, already acculturated with ethical and cultural values derived from Chinese Confucian moral traditions. Recently, several incidents involving Chinese nursing (...) students in morally conflicting situations have led to one nursing faculty reflecting upon how moral philosophy is taught to non-European students and the support given to Chinese students in integrating the taught curriculum into real-life clinical practice settings. This article uses a case study involving a Chinese student to reflect on the challenges for both faculty members and students when encountering situations that present ethical dilemmas. (shrink)