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What actions promote a positive ethical climate? A critical incident study of nurses’ perceptions
Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine.
Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
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2012 (English)In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 19, no 4, 501-512 p.Article in journal (Refereed) Published
Abstract [en]

There is a lack of qualitative studies exploring the phenomenon of positive ethical climate and what is perceived as promoting it. Therefore, the aim of this study was to explore and describe actions that acute care ward nurses perceive as promoting a positive ethical climate. The critical incident technique was used. Interviews were conducted with 20 nurses at wards where the ethical climate was considered positive, according to a previous study. Meeting the needs of patients and next of kin in a considerate way, as well as receiving and giving support and information within the work group, promoted a positive ethical climate. Likewise, working as a team with a standard for behaviour within the work group promoted a positive ethical climate. Future research needs to investigate other conditions that might also promote a positive ethical climate.

Place, publisher, year, edition, pages
2012. Vol. 19, no 4, 501-512 p.
Keyword [en]
ethical climate, nurses, interviews, critical incident technique
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-16265DOI: 10.1177/0969733011436204OAI: oai:DiVA.org:hj-16265DiVA: diva2:446881
Available from: 2011-10-10 Created: 2011-10-10 Last updated: 2017-12-08Bibliographically approved
In thesis
1. Encountering ethical problems and moral distress as a nurse: Experiences, contributing factors and handling
Open this publication in new window or tab >>Encountering ethical problems and moral distress as a nurse: Experiences, contributing factors and handling
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to explore and describe what nurses find ethically problematic and morally distressing in their work, the factors contributing to the arising of ethically problematic situations and the actions reported taken in order to handle them, thus creating an ethical climate.

Descriptive as well as correlational and exploratory designs were employed in the four papers on which this thesis is based. A total of 283 nurses from 21 acute care wards at four Swedish hospitals participated. Interviews were analyzed using qualitative content analysis and the critical incident technique, and questionnaires were analyzed using descriptive and non-parametric statistics.

The nurses described ethical problems and moral distress related to decision making about life-sustaining treatment, but also when they experienced difficulties in preserving a patient’s integrity and when they could not give care that was necessary and safe. Inadequate communication between healthcare staff, the physicians’ ways of handling potentially ethically problematic situations and patients’ poor state of health, which hindered their participation in decisions concerning them, were some of the factors that could contribute to the rise of an ethically problematic situation. Among the actions described as being used to handle ethical problems and moral distress, some were explicitly stated to promote a positive ethical climate, i.e. a perceived positive handling of ethical issues. These were supporting each other in the working group, using policies and routines as help, giving care based on the needs of patients and their next of kin and daring to speak out, thus contributing to setting a standard for behavior. Having the need for explanations and information satisfied and working as a team also promoted a positive ethical climate.

In conclusion, the professional role of being a nurse seems to be of importance not only when it comes to what situations are experienced as ethically problematic and morally distressing, but also concerning what factors may contribute to the rise of them. Perceiving a positive ethical climate may mediate these experiences.

Place, publisher, year, edition, pages
School of Health Sciences, Jönköping University, 2011. 67 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 20
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-16429 (URN)978-91-85835-19-5 (ISBN)
Public defence
2011-11-11, Forum Humanum, Hälsohögskolan, Jönkping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2011-10-21 Created: 2011-10-20 Last updated: 2014-05-20Bibliographically approved

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Kjellström, SofiaChristensson, Lennart
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