Ethical Dilemmas: The Experiences of Israeli Nurses

Abstract

In this study I explored ethical dilemmas in nursing to gain a better understanding of nurses' work and their professional status. Qualitative data on ethical dilemmas were collected by interviewing 52 nurses in 18 hospitals and health maintenance organizations. The transcribed interviews were analyzed using a stepwise method. Results indicate a large number of dilemmas that can be divided into five main categories: caring vs. following formal codes; fair process vs. fair outcome; organizational standards vs. family agenda; autonomy vs. deference to higher authority, and guarding secrecy vs. duty to report. The study findings might enhance nurses' ability to cope with ethical dilemmas and bring about change in their professional status. In addition, the results might guide nurses and their supervisors toward developing practitioner programs for nurses that deal with ethical aspects. All these might reduce the expected shortage of nurses and improve the ability of the system to provide quality health care.

Ethical dilemmas in nursing: An integrative review

“…Some focused on nurses’ responses to ethical dilemmas or their thoughts related to ethical dilemmas. Several researchers sought to understand what led nurses to speak up (whistle‐blowing) to protect patients (Ahern & McDonald, ; Jackson et al., ; Shapira‐Lishchinsky, ). Ahern & McDonald () found that whistle‐blowers had a less traditional view of authority than those who remained silent; that is, whistle‐blowers did not automatically defer to persons in positions of authority.…”

“…Without collecting demographics, it is unclear if the participants had a larger presence in either practice setting, which is an important missing element to put the findings in proper context. Further, several qualitative researchers did not explain their recruitment strategies or address saturation (Chaves & Massarollo, ; de Carvalho & Lunardi, ; Eriksson et al., ; Shapira‐Lishchinsky, ), another limitation of the qualitative work.…”

“…Another theme that emerges from the literature and can be broadly applied to the sub themes of family conflict, end of life and physician issues is lack of honesty or truth telling (Barlem et al, 2013;Blasszauer & Palfi, 2005;Blondal & Halldorsdottir, 2009;Chiu et al, 2009;Choe et al, 2015;de Carvalho & Lunardi, 2009;Eriksson et al, 2014;Ersoy & Goz, 2001;Fernandes and Moreira, 2013;Ferrell et al, 2001;Kinoshita, 2007;Konishi et al, 2002;Melia, 2001;Pavlish et al, 2012;Shapira-Lishchinsky, 2009;Shorideh et al, 2012;Sil en et al, 2008;Ulrich et al, 2010;Wadensten et al, 2008). The flavours of truth telling reported in the studies vary from vanilla to dark chocolate: lies of omission or giving incomplete information (McLennon et al, 2013), dishonesty about a prognosis due to physician pressures or the conflict with wanting to give hope (Pavlish et al, 2012), failure to disclose (Rejeh et al, 2009) and is alarming when we consider that, at least in the United States, nursing is still considered the most ethical profession (Brenan, 2017).…”

“…In the qualitative studies, there are clearly limitations. DeWolf Bosek Further, several qualitative researchers did not explain their recruitment strategies or address saturation (Chaves & Massarollo, 2009;de Carvalho & Lunardi, 2009;Eriksson et al, 2014;Shapira-Lishchinsky, 2009), another limitation of the qualitative work.…”

A Case Report of Gunshot Terror Attack in Pregnancy: Implications for Forensic Nursing

“…Furthermore, the nursing profession in Israel is currently in an ominous state: a substantial shortage of nurses is expected in the near future because too few people consider a nursing career and fewer qualified students are choosing nursing (Shapira‐Lishchinsky, 2009). According to health officials, Israel will have an 18% shortage of nurses by 2020, impairing the system's ability to provide quality health care (Rotem‐Picker & Toren, 2004; Shapira‐Lishchinsky, 2009). It is possible that the implementation of a new specialty in nursing could provide a novel venue, offering an integrative conceptual framework and training for the recruitment of potential new nursing students.…”