STAFF NURSES' PARTICIPATION IN ETHICAL DECISION MAKING: A DESCRIPTIVE STUDY OF SELECTED SITUATIONAL VARIABLES (MORAL).
Contributors: Columbia University. Teachers College.
Published: 1986
Number of pages: 182
Subjects: Health Sciences, Nursing.
Description: The study examined the relationship between nurses' participation in ethical decision making and several selected situational variables. Phenomena were examined as they existed in hospital environments. The design was correlational in nature and employed both quantitative and qualitative methods. The study involved one hundred and seventy-one female, staff nurses who volunteered to participate.

Data were obtained using a four-part survey. Part I was a biographical sheet. Part II consisted of open-ended questions that revealed nurses' knowledge of and role in ethical dilemmas, and those nurses consider most difficult to deal with in daily practice. Part III was a scale measuring perceived social support. Part IV was a scale measuring participation in ethical decision making.

Results indicated that the majority of nurses were unable to define and/or exemplify an ethical dilemma related to their practice in terms of rights and justice. The most troublesome dilemma nurses confronted were those concerned with the institution and/or removal of life support. Nurses perceived themselves to have a bureaucratic role orientation in ethical decision making.

The majority of nurses (71%) reported that when ethical decisions are needed, they are made by physicians or with reference to established hospital policy. The factors found related to participation included personal beliefs, wishes of the patient and levels of social support.

These results are consistent with the position argued by Carol Gilligan (1982) that women's conceptions of morality are related to the needs of others, and offer an alternative interpretative of previous research that has placed nurses at the conventional level of moral development using Kohlberg's framework. Nurses are principled thinkers who hold a non-violent morality in private, but are forced to function at conventional levels in the bureaucratic organization of the hospital if they are to survive.

It was concluded that nurses who attempt to operate from a base of caring and responsibility are relegated to a conventional role. Nurses perceived a lack of social support in ethical dilemmas beyond that available on individual patient care units. Nurses fail to define ethical dilemmas in terms of rights and justice. This failure may be related to either an overexposure to ethical dilemmas with resultant lack of sensitivity or a difference in a working definition of such dilemmas. Either may serve to frustrate nurses in attempts to deliver quality nursing care.
Notes: Source: Dissertation Abstracts International, Volume: 47-06, Section: B, page: 2372.

Thesis (ED.D.)--COLUMBIA UNIVERSITY TEACHERS COLLEGE, 1986.

School code: 0055.