How to succeed with ethics reflection groups in community healthcare? Professionals’ perceptions

Karlsen, Heidi; Lillemoen, Lillian; Magelssen, Morten; Før­de, Rei­dun; Pedersen, Reidar; Gjerberg, Elisabeth

doi:10.1177/0969733017747957

Cited by 12 publications

(15 citation statements)

References 25 publications

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“… 19 Facilitator-led ethical reflection in groups was the most applied intervention among the participating municipalities. 20 Staff indicated that group reflection on ethics contributed significantly to perceived quality and competence and was considered a meaningful activity promoting better handling of ethical dilemmas. 21 However, organizational instabilities in community healthcare may hinder achievements, 20 and evaluations in 2014 22 showed that only a minority of the municipalities had implemented systematic ethical reflection.…”

Section: Introductionmentioning

confidence: 99%

“… 20 Staff indicated that group reflection on ethics contributed significantly to perceived quality and competence and was considered a meaningful activity promoting better handling of ethical dilemmas. 21 However, organizational instabilities in community healthcare may hinder achievements, 20 and evaluations in 2014 22 showed that only a minority of the municipalities had implemented systematic ethical reflection. Among promoting factors, health personnel find that organizational support – especially from department management – is an important driving force, in that someone organizes and actively expects results from the ethics reflection.…”

Section: Introductionmentioning

confidence: 99%

“…Among promoting factors, health personnel find that organizational support – especially from department management – is an important driving force, in that someone organizes and actively expects results from the ethics reflection. 20 …”

Section: Introductionmentioning

confidence: 99%

“…Among promoting factors, health personnel find that organizational support -especially from department management -is an important driving force, in that someone organizes and actively expects results from the ethics reflection. 20 Several studies focus on the ethical problems nurse managers may encounter 17,23 and their ethical competence related to dealing with such problems. 24 However, less is known about how leaders perceive and attend to their role in supporting their staff and promoting ethical conduct in their organizations.…”

Section: Introductionmentioning

confidence: 99%

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Nurse managers’ perspectives on working with everyday ethics in long-term care

Devik

Munkeby²,

Finnanger

et al. 2020

Nurs Ethics

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Background: Nurse managers are expected to continuously ensure that ethical standards are met and to support healthcare workers’ ethical competence. Several studies have concluded that nurses across various healthcare settings lack the support needed to provide safe, compassionate and competent ethical care. Objective: The aim of this study was to explore and understand how nurse managers perceive their role in supporting their staff in conducting ethically sound care in nursing homes and home nursing care. Design and participants: Qualitative individual interviews were performed with 10 nurse managers with human resources responsibilities for healthcare workers in four nursing home wards and six home nursing care districts. Content analysis was used to analyse the data. Ethical considerations: The Norwegian Centre for Research Data granted permission for this study. Findings: The analysis resulted in seven subcategories that were grouped into three main categories: managers’ perception of the importance of the role, managers’ experiences of exercising the role and managers’ opportunities to fulfil the role. Challenges with conceptualizing ethics were highlighted, as well as lack of applicable tools or time and varying motivation among employees. Discussion: The leaders tended to perceive ethics as a ‘personal matter’ and that the need for and benefit of ethical support (e.g., ethics reflection) depended on individuals’ vulnerability, attitudes, commitment and previous experiences. The managers did not seem to distinguish between their own responsibility to support ethical competence and the responsibility of the individual employee to provide ethical care. Conclusions: Our findings suggest that nurse managers need support themselves, both to understand and to carry out their responsibilities to foster their staffs’ ethical conduct. Supporting staff in conducting ethically sound care requires more than organizing meeting places for ethical reflection; it also requires greater awareness and understanding of what ethical leadership means.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Nurse managers’ perspectives on working with everyday ethics in long-term care

Devik

Munkeby²,

Finnanger

et al. 2020

Nurs Ethics

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“…Collective systematic ethics work may foster greater awareness of ethical aspects, personal and professional development, understanding and respect for colleagues and patients, along with cooperation and new ways to approach di cult situations (13,(32)(33)(34). This can be done by ethics re ection groups, as in the Norwegian project in municipal healthcare services which resulted in improvements in these areas; handling ethical challenges, employee cooperation, service quality and relations to patients and relatives (35,36).…”

Section: Ethical Challenges In Clinical Practicementioning

confidence: 99%

Norwegian Nurses’ Reflections Upon Experiences of Ethical Challenges in Older People Care - A Qualitative Thematic Analysis

Rykkje

Holm

Hem

2020

Preprint

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Background: Many countries face an increasingly older population in need of health care services. There are reports of lack of qualified staff and resources, resulting in poor quality and undignified care. Care quality is depended upon factors like organization and staffing, but it is also recommended to focus on what staff members experience in clinical practice. In addition, ethical competence is a precondition for high quality care. The aim of this study is to provide knowledge about ethically challenging situations in caring for older people in institutions such as nursing homes and hospitals, and to gain insight into nurses’ written reflections about their experiences and management of ethical challenges in clinical practice.Methods: The data material consist of reflection notes by continuous education students in advanced gerontology in Norway. Data was collected in 2017–2018. We included 42 of 83 notes and utilized qualitative thematic analysis.Findings: “Doing what is in the patients’ best interest” is the guiding principle for the participants, portrayed through three themes as follows: a) Meeting vulnerability, discomfort and emotional pain, b) Collaboration with relatives, and c) Struggling to perform professional care. Within each theme, we provide a variety of ethically challenging situations in older people care. The findings represent the participants’ written experiences and reflections upon how they manage the situation and their effort to provide the best possible care.Conclusions: Health care professionals’ ethical competences may develop when reflecting upon their care performance. Therefore, building ethical competence should be a priority in education of healthcare professionals and in clinical practice. We acknowledge that ethical reflection does not automatically improve care quality, although we find that it fosters increased awareness of one’s action, and as such, it can act as a potential for change.Implications for practice: How nurses reflect upon and manage challenging situations indicates that quality in care is possible despite scarce resources, and this may contribute to reduce ageism and encourage health care personnel to be willing to work in older people care.

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Can a structured model of ethical reflection be used to teach ethics to nursing students? An approach to teaching nursing students a tool for systematic ethical reflection

Jakobsen

Mæhre

2022

Nursing Open

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Background Nurses encounter many ethical dilemmas in their practice. The ability to make good ethical decisions is a necessary competence in healthcare professions. International studies call for development and research on various methods to teach healthcare professionals ethics. This article describes an approach for learning how to be aware of and discover ethical dilemmas. By applying experienced narratives from healthcare practice and using question guidelines from a structured ethical model, nursing students learn to discover and find possible solutions for ethical problem in their practice. Aim The aim of this study was to describe second‐ and third‐year nursing students’ experiences by using structured ethical reflection as an approach to increase ethical awareness and deal with ethical decisions. Design This study has a descriptive exploratory design. A three‐day ethics seminar was carried out to help students learn how to recognize and explore ethical dilemmas in their practice. Materials and Methods The data are collected from questionnaires used to evaluate the ethics seminar where 52 nursing students participated. The questionnaire contained open‐ended and closed questions and was analysed using Braun and Clarke’s reflexive thematic analysis. The empirical data were collected by 52 nursing students answering an evaluation questionnaire after the ethics seminar. Findings Four themes were developed: Becoming aware of ethical dilemmas, Learning ethics by discussing knowledge and experiences with other students, Increased curiosity about ethics as a subject and Understanding the importance of critical ethical reflection work in clinical practice. Discussion The process of learning how to understand the ethical principles in real‐life nursing context continues progressing through the bachelor’s program. Using group discussions and discussing examples of ethical dilemmas from practice help the students to a more comprehensive reflection process. Conclusion The nursing students experienced video lessons, group discussions and the use of a structured reflection model as a valuable approach in learning to recognize ethical dilemmas and how to deal with real‐life ethical dilemmas.

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How to succeed with ethics reflection groups in community healthcare? Professionals’ perceptions

Cited by 12 publications

References 25 publications

Nurse managers’ perspectives on working with everyday ethics in long-term care

Nurse managers’ perspectives on working with everyday ethics in long-term care

Norwegian Nurses’ Reflections Upon Experiences of Ethical Challenges in Older People Care - A Qualitative Thematic Analysis

Can a structured model of ethical reflection be used to teach ethics to nursing students? An approach to teaching nursing students a tool for systematic ethical reflection

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