Paper
Thursday, July 12, 2007
Ethical Issues in nursing practice: Identifications and comparisons across clinical specialty
Jennifer S. Browning, MS, APRN, BC, Medical-Surgical Nursing, Ohio State University Hospital, Columbus, OH, USA, Pamela J. Salsberry, RN, PhD, College of Nursing, Ohio State University, Columbus, OH, USA, and Carol Reinhardt, BSN, Medical Intensive Care Unit, Ohio State University Hospital, Columbus, OH, USA.
| Learning Objective #1: identify ethical issues nurses may frequently encounter in an acute care setting. |
| Learning Objective #2: discuss differences in ethical issues encountered by clinical specialty. |
Ethical issues present significant challenges in today’s practice environment. As technology changes practice and makes possible what was once impossible, building the nursing expertise to anticipate and manage the ethical questions that result is often overlooked. Moreover, because these technologies may differ across clinical specialty the issues that arise as a consequence may also differ. The primary aim of this research was to examine these questions. Specifically, the research questions were: What are the ethical issues that nurses most frequently encounter? And the second was: Do these issues differ by clinical specialty, i.e., oncology, cardiology, rehabilitation, mental health?
This study used a cross-sectional survey design to address these questions. The Ethical Issues Scale, a tested instrument developed by Fry & Damrosch (1994), was used to collect data on nurse’s perceived frequency of encountering each of 35 issues within the past 12 months. The survey was administered through a computer-assisted format to all nurses within a large U.S. tertiary care academic medical center. Descriptive analyses address each research questions. Complete data from 627 registered nurses were collected, from six institutions covering seven major clinical specialties: oncology, cardiology, critical care, women and infant health, mental health, rehabilitation, and general medical/surgical care.
Preliminary findings indicate that the rankings of the five issues most frequently encountered in each specialty practice share commonalities. Issues surrounding patient autonomy, that is protecting patient rights and respecting informed consents were shared by all specialties and ranked as the most frequently encountered situation. Other issues differed by specialty. These findings suggest that nurses must confront and manage a significant number of ethical issues on a daily basis. Understanding these issues and assisting nurses to have the resources to develop expertise in the management of these issues is critical in the current complex and diverse delivery system.