Background: Ethical issues are increasingly being reported by care-providers; however, little is known about the nature of these issues within the nursing home. Ethical issues are unavoidable in healthcare and can result in opportunities for improving work and care conditions; however, they are also associated with detrimental outcomes including staff burnout and moral distress. Objectives: The purpose of this review was to identify prior research which focuses on ethical issues in the nursing home and to explore staffs’ experiences of ethical (...) issues. Methods: Using a systematic approach based on Aveyard (2014), a literature review was conducted which focused on ethical and moral issues, nurses and nursing assistants, and the nursing home. Findings: The most salient themes identified in the review included clashing ethical principles, issues related to communication, lack of resources and quality of care provision. The review also identified solutions for overcoming the ethical issues that were identified and revealed the definitional challenges that permeate this area of work. Conclusions: The review highlighted a need for improved ethics education for care-providers. (shrink)

Background: Although human dignity is an unconditional value of every human being, it can be shattered by extrinsic factors. It is necessary to discover the authentic meaning of patients’ dignity preservation from different religious perspectives to provide professional cross-cultural care in a diverse setting. Research objective: This article identifies common experiences of Iranian Muslim and Armenian Christian patients regarding dignified care at the bedside. Research design: This is a qualitative study of participants’ experiences of dignified care elicited by individual in-depth (...) semi-structured interviews. Participants and research context: A purposeful sample of 10 participants (five Iranian Muslims and five Iranian Armenians) from various private and governmental hospital settings was chosen. Ethical considerations: This study was approved by the ethics committee of Tehran University of Medical Sciences. All the participants were provided with information about the purpose and the nature of the study, the voluntary condition of their participation in this study, and the anonymous reporting of recorded interviews. Findings: The common experiences of Christian and Muslim patients regarding dignity preservation emerged as “exigency of respecting human nobility” and “providing person-centered care.” Discussion and conclusion: It is essential to recognize the humanness and individuality of each patient to preserve and promote human dignity in diverse cross-cultural settings. The findings support and expand current understanding about the objective and subjective nature of dignity preservation in cross-cultural nursing. (shrink)

The aim of the study was to report the results of a systematically conducted literature review of empirical studies about healthcare organizations’ ethics and management or leadership issues. Electronic databases MEDLINE and CINAHL yielded 909 citations. After a two stage application of the inclusion and exclusion criteria 56 full-text articles were included in the review. No large research programs were identified. Most of the studies were in acute hospital settings from the 1990s onwards. The studies focused on ethical challenges, dilemmas (...) in practice, employee moral distress and ethical climates or environments. Study samples typically consisted of healthcare practitioners, operational, executive and strategic managers. Data collection was mainly by questionnaires or interviews and most of the studies were descriptive, correlational and cross-sectional. There is need to develop conceptual clarity and a theoretical framework around the subject of organizational ethics and the breadth of the contexts and scope of the research needs to be increased. (shrink)

Nurses’ religious beliefs influence their motivations and perspectives, including their practice of ethics in nursing care. When the impact of these beliefs is not recognized, great potential for unethical nursing care exists. Thus, this article examines how the theology of one religious tradition, Seventh-day Adventism (SDA), could affect nurses. An overview of SDA history and beliefs is presented, which explains why ‘medical missionary’ work is central to SDAs. Theological foundations that would permeate an SDA nurse’s view of the nursing metaparadigm (...) concepts of person, health, environment (i.e. community), and nursing (i.e. service) are presented. The ethical principles guiding SDA nurses (i.e. principled, case-based, and care ethics) and the implications of these theological foundations for nurses are noted in a case study. (shrink)

North American society has undergone a period of sacralization where ideas of spirituality have increasingly been infused into the public domain. This sacralization is particularly evident in the nursing discourse where it is common to find claims about the nature of persons as inherently spiritual, about what a spiritually healthy person looks like and about the environment as spiritually energetic and interconnected. Nursing theoretical thinking has also used claims about the nature of persons, health, and the environment to attempt to (...) establish a unified ontology for the discipline. However, despite this common ground, there has been little discussion about the intersections between nursing philosophic thinking and the spirituality in nursing discourse, or about the challenges of adopting a common view of these claims within a spiritually pluralist society. The purpose of this paper is to discuss the call for ontological unity within nursing philosophic thinking in the context of the sacralization of a diverse society. I will begin with a discussion of secularization and sacralization, illustrating the diversity of beliefs and experiences that characterize the current trend towards sacralization. I will then discuss the challenges of a unified ontological perspective, or closed world view, for this diversity, using examples from both a naturalistic and a unitary perspective. I will conclude by arguing for a unified approach within nursing ethics rather than nursing ontology. (shrink)

Background: Healthcare organizations are now challenged to retain nurses’ generation and understand why they are leaving their nursing career prematurely. Acquiring knowledge about the effect of ethical work climate and level of perceived organizational support can help organizational leaders to deal effectively with dysfunctional behaviors and make a difference in enhancing nurses’ dedication, commitment, satisfaction, and loyalty to their organization. Purpose: This study aims to determine the relationship between ethical work climate, and perceived organizational support and nurses’ organizational commitment, job (...) satisfaction, and turnover intention. Methods: A descriptive correlational research design was conducted in all inpatient care units at three major hospitals affiliated to different health sectors at Alexandria governorate. All nurses working in these previous hospitals were included in the study (N = 500). Ethical Climate Questionnaire, Survey of Perceived Organizational Support, Organizational Commitment Questionnaire, Index of Job Satisfaction, and Intention to Turnover scale were used to measure study variables. Ethical considerations: Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects’ informed consent to participate in the research before data collection. Findings: The result revealed positive significant correlations between nurses’ perception of overall ethical work climate and each of perceived organizational support, commitment, as well as their job satisfaction. However, negative significant correlations were found between nurses’ turnover intention and each of these variables. Also, approximately 33% of the explained variance of turnover intention is accounted by ethical work climate, organizational support, organizational commitment, and job satisfaction, and these variables independently contributed significantly in the prediction of turnover intention. Recommendation: Strategies to foster and enhance ethical and supportive work climates as well as job-related benefits are considered significant factors in increasing nurses’ commitment and satisfaction and decreasing their turnover intention. (shrink)

This article calls nursing to engage in the study of religions and identifies six considerations that arise in religious studies and the ways in which religious faith is expressed. It argues that whole-person care cannot be realized, neither can there be a complete understanding of bioethics theory and decision making, without a rigorous understanding of religious-ethical systems. Because religious traditions differ in their cosmology, ontology, epistemology, aesthetic, and ethical methods, and because religious subtraditions interact with specific cultures, each religion and (...) subtradition has something distinctive to offer to ethical discourse. A brief example is drawn from Native American religions, specifically their view of `speech' and `words'. Although the example is particular to an American context, it is intended to demonstrate a more general principle that an understanding of religion per se can yield new insights for bioethics. (shrink)

Religion, belief and culture should be recognized as potential sources of moral purpose and personal strength in healthcare, enhancing the welfare of both clinicians and patients amidst the experience of ill-health, healing, suffering and dying. Communication between doctors and patients and between healthcare staff should attend sensitively to the welfare benefits of religion, belief and culture. Doctors should respect personal religious and cultural commitments, taking account of their significance for treatment and care preferences. Good doctors understand their own beliefs and (...) those of others. They hold that patient welfare is best served by understanding the importance of religion, belief and culture to patients and colleagues. The sensitive navigation of differences between people's religions, beliefs and cultures is part of doctors' civic obligations and in the UK should follow the guidance of the General Medical Council and Department of Health. In particular, apparent conflict between clinical judgement or normal practices and a patient's culture, religion and belief should be considered carefully. Doctors' own religion or culture may play an important role in promoting adherence to this good practice. In all matters, doctors' conduct should be governed by the law and arrangements for conscientious objection that are in effect. (shrink)

In recent years, knowledge management has been utilized as an essential strategy to foster the creation of organizational intellectual capital. Organizational intellectual capital can be derived both individually and collectively in the process to create, store, share, acquire, and apply personal and organizational knowledge. However, some organizations only focus on the development of public good, despite the concerns arising from individuals' self-interest or possible risks. The different concern of individual and collective perspectives toward knowledge management inevitably leads to ethical conflicts (...) and ethical culture in the organization (Jarvenpaa et al., J Manage Inf Syst 14(4): 29-64, 1998; Ruppel and Harrington, IEEE Trans Prof Commun 44(l): 37-52, 2000). The purpose of this study is to examine the ethical climate within the organization and its possible influence on members' evaluation, satisfaction, engagement, and job performance with respect to knowledge management practice. The research results reveal that several types of organizational ethical climate coexist in the organization and have different degrees of influence on employees' attitude as well as participation in knowledge management activities. In this article, we argue the importance of organizational ethical climate and highlight the implications of such a climate for facilitating knowledge management. (shrink)

Over the past two decades, Victor and Cullen's (Adm Sci Q 33:101-125, 1988) typology of ethical climates has been employed by many academics in research on issues of ethical climates. However, little is known about how managerial practices such as communication and empowerment influence ethical climates, especially from a functional perspective. The current study used a survey of employees from Taiwan's top 100 patent-owning companies to examine how communication and empowerment affect organizational ethical climates. The results confirm the relationship between (...) these two managerial practices and organizational ethical climates. We discuss our results and their implications for both future academic research and practice. (shrink)

This empirical study investigates the effects of nine ethical climate types (self-interest, company profit, efficiency, friendship, team interest, social responsibility, personal morality, company rules and procedures, and lastly laws and professional codes) on employee work satisfaction. The ethical climate typology developed by Victor and Cullen (in W. C. Frederick (ed.) Research in Corporate Social Performance and Policy, 1987; Administrative Science Quarterly 33, 101–125, 1988) is tested on a sample of staff and managers from 62 different telecommunication firms in Turkey. The (...) results obtained from the 1174 usable questionnaires confirm the existence of nine different ethical climate types observed in western cultures in the present sample context, which is a developing Muslim country. Regarding the effects of ethical climatic factors on employee work satisfaction, self-interest climate type appears to negatively influence work satisfaction, whereas team interest, social responsibility and law and professional codes climate types are found to have positive impacts. Managerial and further research implications of the findings are discussed. (shrink)

This article is part of a wider study entitled Value of Nursing, and contains the literature search from electronic databases. Key words for the search included `values of nursing', `values in nursing', `organisational values' and `professional identity'. Thirty-two primary reports published in English between 2000 and 2006 were identified. The findings highlight the importance of understanding values and their relevance in nursing and how values are constructed. The value of nursing is seen to be influenced by cultural change, globalization, and (...) advancement in technology and medicine. These factors are crucial in providing a more structured and measured view of what nursing is, which will result in greater job satisfaction among nurses, better nurse retention and enhanced patient care within a supportive and harmonious organization. The findings of this review have implications for policy makers in recruitment and retention in determining the global value of nursing. (shrink)

Background: The performance of nurses has become vital in hospitals. Some studies have suggested that nurses’ perceptions of the ethical climate in their hospitals are related to higher job satisfaction and organizational commitment and in turn lessen the issue of nursing shortage. Hypothesis: (1) The ethical climate types “caring,” “independent,” “law and code,” and “rules” have a significant positive impact on overall job satisfaction. (2) The ethical climate types and overall job satisfaction have significant positive influences on normative and affective (...) and significant negative influences on continuance commitment. Research design: The study uses path analysis to understand which types of ethical climate impact overall job satisfaction. It also tries to find the effect of different types of ethical climate and overall job satisfaction on the components of organizational commitment. The relationships between variables were evaluated using factor analysis, reliability, descriptive statistics, correlations, and regression in this study. Participants and research context: A total of 171 useful questionnaires were collected from nurses working in public and private hospitals in Bosnia and Herzegovina. Ethical considerations: Formal research approval was obtained from the administration of each study hospital. Questionnaires with a cover letter were mailed to the hospitals that agreed to participate in the study. In the cover letter, the researchers explained the study purpose, encouraged nurses’ voluntary participation, and guaranteed the anonymity of participants. Findings: In the first path analyses, “rules” and “caring” climates significantly and positively affected overall job satisfaction. In the second one, while overall job satisfaction and “rules” climate significantly influenced normative commitment, “caring” climate and overall job satisfaction significantly affected affective commitment. Discussion: The findings of the study have been convenient with the literature. Conclusion: Public and private hospitals can enhance overall job satisfaction and organizational commitment by altering the ethical climate of organizations. Hospital administrations should nurture caring and rule types of ethical climate which influence overall satisfaction. By this way, they could reduce nursing shortage. (shrink)

This study examined the relationship between unethical employee behavior and the dimensions of the Ethical Climate Questionnaire (ECQ). In order to explore the relationship between the dimensions of the ECQ and unethical behavior, the factor structure of five previously identified empirical models and the hypothesized nine-dimension model for the ECQ was tested with a confirmatory factor analysis. The analysis revealed that the hypothesized nine-dimension model provided as good or even better fit to the data than the five empirically derived models. (...) Therefore, the nine-dimensional model was used to examine the criterion-related validity of the ECQ. The results demonstrated that the nine ethical climate dimensions were correlated with some of the unethical behaviors examined in this study, but not others. However, the results clearly demonstrated that most of the ethical climate dimensions were significantly related to an aggregate measure of unethical behavior. It was suggested that these results might account for the differences in previous studies on the criterion-related validity of the ECQ. The results also replicated a previous report that the association between unethical behavior and ethical climate is stronger in organizations that do not have a code of ethics. Finally, a difference was observed in the ethical climates for organizations with a code of ethics and organizations without a code of ethics. (shrink)

At least five sets of ethical standards influence business people's decisions: general cultural, company, personal, situational, and industry standards. Each has an official or espoused form encoded in written documents such as policy statements and codes of ethics and an unofficial form that develops as people use the espoused standards. (We call these unofficial standards values in action.) To determine whether the high-technology industry deserves its reputation for moral laxness, a pilot questionnaire was designed. It asked employees to rate the (...) acceptability in the workplace of ethical behaviors relating to safety, third parties, and cheating the company. The findings show that employees in high-and low-technology industries uphold espoused values of safety. Relations with third parties are influenced by the existence of company codes of ethics, especially in small companies. Actions involving cheating the company need to be investigated further. (shrink)

Background: Nurses are confronted daily with ethical issues while providing patient care. Hospital ethical climates can affect nurses’ job satisfaction, organizational commitment, retention, and physician collaboration. Purpose: At a metropolitan academic medical center, we examined nurses’ perceptions of the ethical climate and relationships among ethical climate factors and nurse characteristics. Design/participants: We used a descriptive correlational design and nurses ( N = 475) completed Olson’s Hospital Ethical Climate Survey. Data were analyzed using STATA. Ethical considerations: Approvals by the Nursing Research (...) Council and Institutional Review Board were obtained; participants’ rights were protected. Results: Nurses reported an ethical climate total mean score of 3.22 ± 0.65 that varied across factors; significant differences were found for ethical climate scores by nurses’ age, race, and specialty area. Conclusion: These findings contribute to what is known about ethical climate and nurses’ characteristics and provides the foundation to develop strategies to improve the ethical climate in work settings. (shrink)

A relatively small but intellectually robust strand in the Christian religion is the Reformed tradition. Especially, its Calvinist sensibilities inform this Protestant stance towards human culture in general and vocations in particular. Correspondingly, there are some small but robust contributions to academic discourse in nursing ethics. So far there has been no attempt to bring those together as a distinct approach. This article suggests such a Reformed Christian, especially Calvinist, account of nursing ethics. Central to the Reformed perspective is the (...) notion that God is sovereign over all of creation and culture and hence that there can be no religiously or morally neutral area in human life. Consequently, nursing is not seen as professional to the extent it is based on research evidence or theoretical models, but to the extent it serves the ultimate purpose of the practice of care. In the Reformed view, this purpose is fostering the well-being of human beings in need as intrinsically valuable. Nurses are professionals who accept this responsibility, that is, the whole of expectations holding for personal qualities, conduct and outcomes, required to serve the purpose of care. As this is a moral purpose, succeeding or failing to live up to these expectations is the source of moral issues in nursing. (shrink)

Although we theorize that nurses ‘make a difference’ to patient outcomes and speculate that this happens because nurses ‘care’, there is so far little evidence to support this nebulous claim. Efforts to promote care as the defining characteristic of nursing, and an ‘ethic of care’ as the ethical basis of nursing, have sparked debate within the discipline. This debate has resulted in a polarization that has effectively stalled productive discourse on the issues. Moreover, the focus on care has been at (...) the expense of understanding the true nature of the relationship between caring and the broader base of ethical knowledge that underpins nursing and that must underpin nursing if it is a viable practice profession. This paper used the framework of philosophical argument to explore the moral and ethical foundations of nursing from the perspective of personal and public morals, and responsive nurse–patient relationships as the reflection of ethical nursing knowledge. The foundation of ethical nursing knowledge is the personal moral sense that resides within the individual and that nurses hold in common with others. Personal moral knowledge is transformed into disciplinary ethical knowledge specific to nursing through disciplinary consensus. Responsive relationships are conceptualized in the nursing literature as founded on three essential elements: respect, trust, and mutuality. These three elements are grounded in ethical nursing knowledge; therefore responsive nurse–patient relationships reflect both personal moral knowledge and disciplinary ethical knowledge. By facilitating the articulation of ethical nursing knowledge in practice, responsive relationships connect theory, ethical knowledge, and clinical outcomes. (shrink)

The author examines, in the context of Litwin and Stringer''s (1968) operationalization, the influence of social inclusion (organizational warmth and organizational identity) as a marketing ethics correlate. The results indicate that both organizational warmth and organizational identity underlie marketing professionals'' ethical behavior. Furthermore, the influence pattern for each variable is consistent witha priori hypothesis.

This article explores how ethics and religion interface in everyday life by drawing on a study examining the negotiation of religious and spiritual plurality in health care. Employing methods of critical ethnography, namely, interviews and participant observation, data were collected from patients, health care providers, administrators and spiritual care providers. The findings revealed the degree to which `lived religion' was intertwined with `lived ethics' for many participants; particularly for people from the Sikh faith. For these participants, religion was woven into (...) everyday life, making distinctions between public and private, secular and sacred spaces improbable. Individual interactions, institutional resource allocation, and social discourses are all embedded in social relationships of power that prevent religion from being a solely personal or private matter. Strategies for the reintegration of religion into nursing ethics are: adjusting professional codes and theories of ethics to reflect the influence of religion; and the contribution of critical perspectives, such as postcolonial feminism, to the understanding of lived ethics. (shrink)