Situations in Which Clinical Nurses Encounter Ethical Problems

Nishimura A

Published on: 2022-04-25

Abstract

Background: In Japan, comprehensive provision of nursing ethics education has been achieved since the beginning of the 21st century. It was considered necessary to conduct a survey on nursing personnel who had received ethics education as a part of their basic nursing education since 2000, covering how they had experienced ethical problems in clinical practice and how these experiences had changed.

Objectives: We aimed to clarify situations in which clinical nurses encounter ethical problems during nursing practice in Prefecture A.

Methodology: Responses were freely entered in a questionnaire titled “Situations in which ethical problems are encountered.” The analysis comprised 361 entry units from 181 participants, using the Berelson content analysis method. After the study was approved by the research ethics review committees, prospective participants were given written explanations of the study objectives, methods, and ethical considerations, and their informed consent was obtained by their returning completed questionnaires.

Results: Of the 361 entry units, 69 that could not be understood and/or were highly abstract were excluded, leaving 292 entry units for the analysis. Two, seven, one, six, and three categories were established for the five principles of nursing ethics, respectively: beneficence and non-maleficence, autonomy, justice, totality and integrity, and fidelity. In addition, four, five, two, and one categories were established for nurses’ duties, cooperation and collaboration, nurses’ human rights and harassment by patients, and workplace atmosphere and environment, respectively. Among these, the most common experiences of the participants were “relationships with physicians,” “prioritization of family members’ wishes,” and “satisfactory care impossible due to understaffing.”

Discussion: The categories identified by the largest proportion of nurses were similar to those observed in previous studies, suggesting that these situations are ethical problems that occur universally.