Nurses' Views On Ethical Practices In Nursing Care: A Qualitative Study

Şükriye Şahin; Şule Alpar Ecevit

doi:10.7197/cmj.1238689

Research Article

Nurses' Views On Ethical Practices In Nursing Care: A Qualitative Study

Year 2023, , 11 - 20, 30.09.2023

Şükriye Şahin , Şule Alpar Ecevit

https://doi.org/10.7197/cmj.1238689

Abstract

ABSTRACT
Objectives: Nurses are required to make ethical decisions with the ethical principles of the nursing profession while making decisions in clinical practice. Therefore, it is very important to recognize and solve ethical problems. The purpose of this research is to learn in-depth the views of nurses about ethical practices and nurses' behavior towards individuals when giving care.
Methods: A hermeneutic-phenomenological qualitative study was performed. Qualitative data were gathered through semi-structured in-depth interviews from March to November 2020, four hospital in Kocaeli. This qualitative study was carried out with the data collected in face-to-face in-depth interviews with the semi-structured questionnaire. Interviews were conducted with 40 nurses and each interview took 30–60 min. The obtained data were evaluated with the inductive content analysis method.
Results: Content analysis of the interview based on nurses' descriptions revealed four major themes. Themes: The meaning given to care ethics, difficulties encountered in nursing care, ethical values in nursing care and ethical approachs of hospital management. The nurses indicated level of care ethics knowledge was insufficient and they needed to receive comprehensive ethical care training from a qualified specialist. In addition, nurses' personal characteristics, religious and cultural values, and professional experiences were found to be factors affecting nursing care. It was also find that the support and motivation of nurses by their managers positively affected their care.
Conclusion: In the interviews, nurses consider it necessary to provide care by paying attention to ethical behaviors in nursing care and practices for the development and professionalism of the profession, but they state that they do not have an idea about how this will be provided. It was determined that nurses thought that more attention should be paid to the importance and value of ethics in nursing interventions, and ethical practices in nursing care should be included in in-service training programs.

Keywords

nursing ethics, nursing care, ethical practices

Supporting Institution

This article is derived from Şükriye Şahin's doctoral thesis.

References

1. Baykara ZG. The concept of nursing care. TJOB 2014;1(2):92-99.
2. Dinç L. The concept of caring and its’ moral component. Hacettepe Univ Faculty of Health Sciences J 2010; 74-82.
3. Elçigil A, Bahar Z, Beşer A, Mızrak B, Bahçelioğlu B, Demirtaş D, Özdemir D, Özgür E, Yavuz H. Ethical dilemmas which are faced by nurses. J Nursology 2011; 14(2):52-60.
4. Riggio ER, Taylor JS. Personality and communication skills as predictors of hospice nurse performance. JBP 2000; 15(2):351-359.
5. Cortis JD, Kendrick K. Nursing ethics, caring and culture. Nurs Ethics 2003; 10:77-88.
6. Ağaçdiken S, Aydoğan A. Empathic skills and ethical sensitivity relationship in nurses. Gumushane Univ J Health Sciences 2017; 6(2):122–129.
7. Held V. The ethics of care: personal, political, and Global. In: Care and Moral Theory, Oxford University Press 2006, p. 9-29.
8. Dinç L. The importance of ethics of care for nursing practice. Turkish Clinics J Med Ethics Law Hist-Special Topics 2017; 3(1):1-9.
9. Vanlaere L, Gastmans C. A personalist approach to care ethics. Nurs Ethics. 2011;18(2):161-73.
10. Ngulube P. Qualitative data analysis and interpretation: systematic search for meaning. In. Mathipa ER, Gumbo MT (Eds) Addressing research challenges: making headway for developing researchers. Noordywk: Mosala-MASEDI, 2015; pp 131-156.
11. Yıldırım A, Şimşek H. Qualitative research methods. In: Yıldırım A, Şimşek H (Eds) Qualitative research methods in social sciences. 5nd ed. Ankara: Seçkin Publications, 2016; pp 232-266.
12. Haahr A, Norlyk A, Martinsen B, Dryer P. Nurses experiences of ethical dilemmas: A review, Nurs Ethics 2020; 27(1):258-272.
13. Kim M, Oh Y, Kong B. Ethical conflicts experienced by nurses in geriatric hospitals in South Korea: “If You Can’t Stand the Heat, Get Out of the Kitchen”. IJERPH 2020; 17(4442):2-13.
14. Yıldırım B, Gerçek E, Karabudak SS. The problems of nurses working in the newborn intensive care unit: A Qualitative Research. J Adnan Menderes Univ Health Sciences Faculty 2020; 4(2):144-153.
15. Başak T, Uzun Ş, Arslan F. Investigation of the moral sensibility of intensive care nurses. Gulhane Med J 2010; 52:76-81.
16. Aksu T, Akyol A. Investigation of the moral sensibility of nurses in İzmir. Turkiye Klinikleri J Med Ethics 2011; 19(11):16-24.
17. Özyer K, Azizoğlu Ö. The impacts of demographic variables on people’s ethical attitude. IJESR 2010; 6(2):59-84.
18. Tosun H. Determining the Sensitivity of Physicians and Nurses to Ethical Dilemmas Experienced in Health Care Practices. Istanbul: Istanbul Univ; 2005.
19. Dalcalı KB, Şendir M. Determining the relationship between nurses personal values and their ethical sensitivity. Florence Nightingale J Nurs 2016; 24(1);1-9.
20. Aslan Ö, Vural H, Avcı PY. Determination of operating room nurses' approaches to ethical problems. Gulhane Med J 2003; 45(2):147-152.
21. Dikmen Y. An observation on the moral sensibility of intensive care nurses. Cumhuriyet Nurs J 2013; 2(1):1-7.
22. Kahriman İ, Çalık KY. Ethical sensitivity of clinical nurses. Gumushane Univ J Health Sciences 2017; 6(3):111–121.
23. Burkhardt AM, Nathaniel AK. Ethical Priciples. In: Alpar ŞE, Bahçecik N and Karabacak Ü (Eds). Ethics Issues in Contemporary Nursing. 3nd ed. İstanbul, Istanbul Tip Kitapevi, 2013; pp 52-78.
24. Grace PJ. Nursing ethics and professional responsibility in advanced practice.In.Gaylord NM (Eds). Ethical Liedership by Advanced Practises Nurses. 3nd ed. Burlington, Massachusetts: Jones and Bartlett Learning; 2018; chap 5.
25. Aytaç N, Naharcı H, Öztunç G. Knowledge about nozocomial infections of nurses working in intensive care in training and research hospitals in Adana. Journal of Adnan Menderes Univ Med Faculty 2008; 1(3):9-15.
26. Çelen Ö, Karaalp T, Kaya S, Demir C, Teke A, Akdeniz A. The considerations about and expectations from in-service training programs of the nurses working at the intensive care units of the education hospital of gulhane military medical faculty. Gulhane Med J 2007; 49(1):25-31.
27. Arslan G. The İmpact Of Nurse's Ethical Sensitivity Levels On Their Approaches To Ethical İssues Spesific To İntensive Care. Istanbul: Acıbadem Mehmet Ali Aydınlar Univ; 2017.
28. Kulju K, Suhonen R, Leino KH. Ethical problems and moral sensitivity in physiotherapy: A Descriptive Study. Nurs Ethics 2013; 20(5):568-577.
29. Huang FF, Yang Q, Zhang J, Khoshnood K, Zhang JP. Chinese nurses ‘perceived barriers and facilatators of ethical sensitivity. Nurs Ethics 2016; 23(5):507-522.
30. Demirsoy N, Yılmaz AT, Şaylıgil Ö. Nurses' approaches to ethical dilemmas: An example of a public hospital. JHS 2018; 15(3):1568-1583.
31. Eşer İ, Orkun N, Çetin P. The image of nursing and a series of advertisements published in the 1950s. DEUHFED 2017; 10(4):275-278.
32. Çelik As, Pasinlioğlu T, Kocabeyoğlu T, Çetin S. Determination of the image of nursing profession in community. Florence Nightingale J Nurs 2013; 21(39):147-153.
33. Derin N, Ilkım NŞ and Yayan H. Expression of professional adherence by professional prestige in nurses. Hacettepe Univ Faculty of Health Sciences J 2017; 4(3):24-37.
34. Crawford P, Brown B, Majomi P. Professional identity in community mental healty nursing: a tehematic analysis. IJNS 2008; 45:1055-1063.
35. Meiring A, Van Wyk NC. The image of nurses and nursing as perceived by the south african public. AJHNM 2013; 15(2): 3–15.
36. Marcinowicz L, Foley M, Zarzycka D, Chlabicz S, Windak A, Buczkowski K. Polish medical students’ perceptions of the nursing profession: A cross-sectional study. Scand Journal Caring 2009; 23:438–445.
37. Öğüt A, Kaya D. Teamwork in healthcare organizations. Selcuk University J Social and Technical Researches 2011; 1(1):88-95.
38. Keçeci A, Durmuş SÇ, Oruç D, Kapisiz ÖÖ. The society's view of nursing in Turkey. Hospital Topics 2014; 92(2):36– 43.
39. Ertem G, Dönmez YC, Oksel E. Investıgatıon of nursıng news in daily Turkish newspapers. Maltepe University J Nurs Science and Art 2009; 2(2):70-75
40. Kavak ŞN. Investigation Of Ethical Sensitivity And Burnout Levels Of Nurses. Istanbul:Usküdar Üniv; 2020.
41. Dezhkam L, Kargar Z, Kalani N, Tafvizi MD, Jahromi HK. The study of moral sensitivity of fasting nurses working in therapeutic educational hospitals of jahrom. International J Med Research & Health Sciences 2016; 5(7):158-165.
42. Öztürk EA, Şener A, Koç Z, Duran L. Factors ınfluencing the ethical sensitivity of nurses working in a university hospital. Eastern J Med 2019; 24(3):257-264

Year 2023, , 11 - 20, 30.09.2023

Şükriye Şahin , Şule Alpar Ecevit

https://doi.org/10.7197/cmj.1238689

Abstract

References

1. Baykara ZG. The concept of nursing care. TJOB 2014;1(2):92-99.
2. Dinç L. The concept of caring and its’ moral component. Hacettepe Univ Faculty of Health Sciences J 2010; 74-82.
3. Elçigil A, Bahar Z, Beşer A, Mızrak B, Bahçelioğlu B, Demirtaş D, Özdemir D, Özgür E, Yavuz H. Ethical dilemmas which are faced by nurses. J Nursology 2011; 14(2):52-60.
4. Riggio ER, Taylor JS. Personality and communication skills as predictors of hospice nurse performance. JBP 2000; 15(2):351-359.
5. Cortis JD, Kendrick K. Nursing ethics, caring and culture. Nurs Ethics 2003; 10:77-88.
6. Ağaçdiken S, Aydoğan A. Empathic skills and ethical sensitivity relationship in nurses. Gumushane Univ J Health Sciences 2017; 6(2):122–129.
7. Held V. The ethics of care: personal, political, and Global. In: Care and Moral Theory, Oxford University Press 2006, p. 9-29.
8. Dinç L. The importance of ethics of care for nursing practice. Turkish Clinics J Med Ethics Law Hist-Special Topics 2017; 3(1):1-9.
9. Vanlaere L, Gastmans C. A personalist approach to care ethics. Nurs Ethics. 2011;18(2):161-73.
10. Ngulube P. Qualitative data analysis and interpretation: systematic search for meaning. In. Mathipa ER, Gumbo MT (Eds) Addressing research challenges: making headway for developing researchers. Noordywk: Mosala-MASEDI, 2015; pp 131-156.
11. Yıldırım A, Şimşek H. Qualitative research methods. In: Yıldırım A, Şimşek H (Eds) Qualitative research methods in social sciences. 5nd ed. Ankara: Seçkin Publications, 2016; pp 232-266.
12. Haahr A, Norlyk A, Martinsen B, Dryer P. Nurses experiences of ethical dilemmas: A review, Nurs Ethics 2020; 27(1):258-272.
13. Kim M, Oh Y, Kong B. Ethical conflicts experienced by nurses in geriatric hospitals in South Korea: “If You Can’t Stand the Heat, Get Out of the Kitchen”. IJERPH 2020; 17(4442):2-13.
14. Yıldırım B, Gerçek E, Karabudak SS. The problems of nurses working in the newborn intensive care unit: A Qualitative Research. J Adnan Menderes Univ Health Sciences Faculty 2020; 4(2):144-153.
15. Başak T, Uzun Ş, Arslan F. Investigation of the moral sensibility of intensive care nurses. Gulhane Med J 2010; 52:76-81.
16. Aksu T, Akyol A. Investigation of the moral sensibility of nurses in İzmir. Turkiye Klinikleri J Med Ethics 2011; 19(11):16-24.
17. Özyer K, Azizoğlu Ö. The impacts of demographic variables on people’s ethical attitude. IJESR 2010; 6(2):59-84.
18. Tosun H. Determining the Sensitivity of Physicians and Nurses to Ethical Dilemmas Experienced in Health Care Practices. Istanbul: Istanbul Univ; 2005.
19. Dalcalı KB, Şendir M. Determining the relationship between nurses personal values and their ethical sensitivity. Florence Nightingale J Nurs 2016; 24(1);1-9.
20. Aslan Ö, Vural H, Avcı PY. Determination of operating room nurses' approaches to ethical problems. Gulhane Med J 2003; 45(2):147-152.
21. Dikmen Y. An observation on the moral sensibility of intensive care nurses. Cumhuriyet Nurs J 2013; 2(1):1-7.
22. Kahriman İ, Çalık KY. Ethical sensitivity of clinical nurses. Gumushane Univ J Health Sciences 2017; 6(3):111–121.
23. Burkhardt AM, Nathaniel AK. Ethical Priciples. In: Alpar ŞE, Bahçecik N and Karabacak Ü (Eds). Ethics Issues in Contemporary Nursing. 3nd ed. İstanbul, Istanbul Tip Kitapevi, 2013; pp 52-78.
24. Grace PJ. Nursing ethics and professional responsibility in advanced practice.In.Gaylord NM (Eds). Ethical Liedership by Advanced Practises Nurses. 3nd ed. Burlington, Massachusetts: Jones and Bartlett Learning; 2018; chap 5.
25. Aytaç N, Naharcı H, Öztunç G. Knowledge about nozocomial infections of nurses working in intensive care in training and research hospitals in Adana. Journal of Adnan Menderes Univ Med Faculty 2008; 1(3):9-15.
26. Çelen Ö, Karaalp T, Kaya S, Demir C, Teke A, Akdeniz A. The considerations about and expectations from in-service training programs of the nurses working at the intensive care units of the education hospital of gulhane military medical faculty. Gulhane Med J 2007; 49(1):25-31.
27. Arslan G. The İmpact Of Nurse's Ethical Sensitivity Levels On Their Approaches To Ethical İssues Spesific To İntensive Care. Istanbul: Acıbadem Mehmet Ali Aydınlar Univ; 2017.
28. Kulju K, Suhonen R, Leino KH. Ethical problems and moral sensitivity in physiotherapy: A Descriptive Study. Nurs Ethics 2013; 20(5):568-577.
29. Huang FF, Yang Q, Zhang J, Khoshnood K, Zhang JP. Chinese nurses ‘perceived barriers and facilatators of ethical sensitivity. Nurs Ethics 2016; 23(5):507-522.
30. Demirsoy N, Yılmaz AT, Şaylıgil Ö. Nurses' approaches to ethical dilemmas: An example of a public hospital. JHS 2018; 15(3):1568-1583.
31. Eşer İ, Orkun N, Çetin P. The image of nursing and a series of advertisements published in the 1950s. DEUHFED 2017; 10(4):275-278.
32. Çelik As, Pasinlioğlu T, Kocabeyoğlu T, Çetin S. Determination of the image of nursing profession in community. Florence Nightingale J Nurs 2013; 21(39):147-153.
33. Derin N, Ilkım NŞ and Yayan H. Expression of professional adherence by professional prestige in nurses. Hacettepe Univ Faculty of Health Sciences J 2017; 4(3):24-37.
34. Crawford P, Brown B, Majomi P. Professional identity in community mental healty nursing: a tehematic analysis. IJNS 2008; 45:1055-1063.
35. Meiring A, Van Wyk NC. The image of nurses and nursing as perceived by the south african public. AJHNM 2013; 15(2): 3–15.
36. Marcinowicz L, Foley M, Zarzycka D, Chlabicz S, Windak A, Buczkowski K. Polish medical students’ perceptions of the nursing profession: A cross-sectional study. Scand Journal Caring 2009; 23:438–445.
37. Öğüt A, Kaya D. Teamwork in healthcare organizations. Selcuk University J Social and Technical Researches 2011; 1(1):88-95.
38. Keçeci A, Durmuş SÇ, Oruç D, Kapisiz ÖÖ. The society's view of nursing in Turkey. Hospital Topics 2014; 92(2):36– 43.
39. Ertem G, Dönmez YC, Oksel E. Investıgatıon of nursıng news in daily Turkish newspapers. Maltepe University J Nurs Science and Art 2009; 2(2):70-75
40. Kavak ŞN. Investigation Of Ethical Sensitivity And Burnout Levels Of Nurses. Istanbul:Usküdar Üniv; 2020.
41. Dezhkam L, Kargar Z, Kalani N, Tafvizi MD, Jahromi HK. The study of moral sensitivity of fasting nurses working in therapeutic educational hospitals of jahrom. International J Med Research & Health Sciences 2016; 5(7):158-165.
42. Öztürk EA, Şener A, Koç Z, Duran L. Factors ınfluencing the ethical sensitivity of nurses working in a university hospital. Eastern J Med 2019; 24(3):257-264

There are 42 citations in total.

Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Basic Science Research Articles
Authors	Şükriye Şahin 0000-0001-8321-8475 Şule Alpar Ecevit 0000-0003-0951-0106
Publication Date	September 30, 2023
Acceptance Date	September 25, 2023
Published in Issue	Year 2023

Cite

AMA	Şahin Ş, Alpar Ecevit Ş. Nurses’ Views On Ethical Practices In Nursing Care: A Qualitative Study. CMJ. September 2023;45(3):11-20. doi:10.7197/cmj.1238689

Article Files

Full Text