Ethical climate in nursing environment: A scoping review

Koskenvuori, Janika; Numminen, Olivia; Suhonen, Riitta

doi:10.1177/0969733017712081

Cited by 90 publications

(106 citation statements)

References 67 publications

(179 reference statements)

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“…Respondents who reported higher ethical stress showed lower level of job satisfaction and higher intent to leave their current position.15 Indeed, research suggests that managing ethical concerns can best be achieved through a positive ethical climate and institutional support. 30,31 Our research also highlights the importance of policy and clinical guidelines issued within medical units. Existing guidelines on COVID-19 are associated with greater appreciation of the guidelines, greater overall sense of nurses' competency to treat patients during the pandemic, and less fear of coming to work and caring for patients.…”

Section: Discussionmentioning

confidence: 67%

Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic

2020

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Background: Positioned at the frontlines of the battle against COVID-19 disease, nurses are at increased risk of contraction, yet as they feel obligated to provide care, they also experience ethical pressure. Research question and objectives: The study examined how Israeli nurses respond to ethical dilemmas and tension during the COVID-19 outbreak, and to what extent this is associated with their perceived risk and motivation to provide care? Research design: The study implemented a descriptive correlative study using a 53-section online questionnaire, including 4 open-ended questions. Participants and research context: The questionnaire was complete by 231 registered and intern nurses after being posted on nurses’ Facebook and WhatsApp groups, and through snowball sampling. Ethical considerations: The research was pre-approved by the ethics committee of the Faculty of Social Welfare and Health Sciences at the University of Haifa, Israel. Findings: In all, 68.8% of the respondents had received some form of training about COVID-19. Respondents positioned themselves at perceived high risk levels for contracting the virus. About one-third feared going to work because of potential contraction and due to feeling inadequately protected. While 40.9% were scared to care for COVID-19 patients, 74.7% did not believe they have the right to refuse to treat certain patients. When asked about defining an age limit for providing patients with scarce resources (such as ventilation machines) in cases of insufficient supplies, respondents stated that the maximum age in such scenarios should be 84 (standard deviation (SD = 19) – yet most respondents (81.4%) believed that every patient has the right to receive optimal treatment, regardless of their age and medical background. Discussion: Correlating with their strong commitment to care, nurses did not convey intention to leave the profession despite their stress, perceived risk, and feelings of insufficient support and protection at work. The nurses did not hold a utilitarian approach to resource allocation, thereby acknowledging the value of all people and their entitlement to care, regardless of optimal outcomes. Conclusion: While experiencing significant personal risk and emotional burden, nurses conveyed strong dedication to providing care, and did not regret working in the nursing profession, yet they did seek a supportive climate for their needs and ethical concerns.

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Section: Discussionmentioning

confidence: 67%

Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic

2020

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“…In literature, aspects of ethical climate differ between ethical climate scales. According to a review on ethical climate in nursing environment, most studies either used the instrument developed by Olson or the one by Victor and Cullen (Koskenvuori, Numminen, & Suhonen, ). Victor and Cullen () defined ethical climate as “the shared perception of what is ethically correct behaviour and how ethical issues should be handled” (p.77–78) and operationalized the definition in the Ethical Climate Questionnaire (ECQ) where five dimensions of ethical climate are described: law and code, caring, instrumentalism, independence and rules (Victor & Cullen, ).…”

Section: Discussionmentioning

confidence: 99%

Impact of clinical ethics support on daily practice—First‐line managers’ experiences in the Euro‐MCD project

Silén

Svantesson

2019

J Nurs Manag

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Aim To explore first‐line managers’ experiences of what Moral Case Deliberation has meant for daily practice, to describe perceptions of context influence and responsibility to manage ethically difficult situations. Background In order to find measures to evaluate Moral Case Deliberation, the European Moral Case Deliberation Outcome instrument was developed and is now in the stage of revision. For this, there is a need of several perspectives, one of them being the managerial bird‐eye perspective. Method Eleven first‐line managers at workplaces, participating in the European Moral Case Deliberation Outcome instrument project, were interviewed and thematic analysis was applied. Results Managers’ experiences were interpreted as enhanced ethical climate: a closer‐knit and more emotionally mature team, morally strengthened individuals, as well as ethics leaving its marks on everyday work and morally grounded actions. Despite organizational barriers, they felt inspired to continue ethics work. Conclusion and Implications This study confirmed, but also added ethical climate aspects, such as morally grounded actions. Furthermore, adding ethical climate as a construct in the European Moral Case Deliberation Outcome instrument should be considered. First‐line managers need clear directives from their managers that ethics work needs to be prioritized for the good of both the staff and the patients.

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“…More attention should be paid on sampling procedures to tackle these issues and to recruit samples with generalizable results (Suhonen, Stolt, Katajisto, & Leino‐Kilpi, ). However, these limitations do not concern only research on ethical competence; they seem to be very common in many areas of healthcare research, especially in research on empirical ethics (Koskenvuori, Numminen, & Suhonen, ; Suhonen, Stolt, Virtanen, & Leino‐Kilpi, ).…”

Section: Discussionmentioning

confidence: 99%

Healthcare professionals’ ethical competence: A scoping review

et al. 2018

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AimThe aim of this study was to examine the extent and nature of the available research literature on healthcare professionals’ ethical competence and to summarize the research findings in this field.DesignA scoping review guided by Arksey and O'Malleys methodological framework was conducted.MethodsSix databases including Pubmed/Medline, CINAHL, Web of Science Core Collection, PsycInfo, Philosophers’ Index, and Scopus were searched systematically. Of 1,476 nonduplicate citations, 17 matched the inclusion criteria.ResultsFindings revealed that healthcare professionals’ ethical competence is a limited but topical research area. The focus areas of the studies were conceptualization, measuring, and realization of the ethical competence. The studies provided varying definitions and constructions for ethical competence and a few instruments to measure ethical competence were identified. Research in this area seems to be in a transition phase from theorization to empirical measurement. Methodologically, the research was rather heterogeneous and mainly focused on nurses.

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Ethical climate in nursing environment: A scoping review

Abstract: Novel perspectives and more diverse methodological approaches paying attentions to issues affecting generalizability of the findings could expand our knowledge in this area.

Cited by 90 publications

References 67 publications

Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic

Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic

Impact of clinical ethics support on daily practice—First‐line managers’ experiences in the Euro‐MCD project

Healthcare professionals’ ethical competence: A scoping review

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