Ethical Decision-Making Confidence and Professional Values Among Nurse Leaders

OBJECTIVES

The aims of this study were to describe differences in nurse leaders' ethical decision-making confidence and their professional values based on identified characteristics and to explore the relationship between ethical decision making and professional values.

BACKGROUND

Nurse leaders have multiple duties and obligations toward their patients, other staff, and the organizations where they work. However, ethical decisions can be complex, requiring the guidance of professional values and critical appraisal of the situation.

METHODS

This study was conducted using a correlational design. Convenience sampling was used, resulting in a sample of 56 nurse leaders in various positions.

RESULT

Ethical decision making and professional values were found to be strongly correlated.

CONCLUSION

Ethical decision making and professional values are highly correlated in this sample. Understanding the importance of the effects of certain factors on ethical decision making can assist in forming an environment supportive of ethical practices for nurses.

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

Introduction

Internationally, aging populations have increased needs for health care services, and often specialized care is required. However, services for older people tend to be underfunded, resulting in lack of qualified staff and poor quality care. Resource shortages lead to ethical challenges and insufficient nursing care. Therefore, quality in daily care for older people also depends upon the nurses’ ability to make complex, ethical decisions in their practice.

Objectives

To explore ethical challenges experienced by nurses caring for older people in clinical practice, and to provide examples of management for the challenges.

Methods

The data collected were written reflection notes by Norwegian continuous education students in advanced gerontology. Forty two of 83 notes were included and a thematic analysis in six steps was utilized.

Findings

There are three main themes: (1) meeting vulnerability, discomfort, and suffering, (2) collaboration with relatives, and (3) struggling to perform professional care.

Conclusion

Nurses strive to “do what is in the patients’ best interest”, and this is fostered through collaboration, professionalism, care, and presence. Nurses’ ethical competencies may develop when reflecting upon their own care performance. Building ethical competencies should be a priority in both nursing education and clinical practice. However, to improve care quality, nurses also need professional knowledge about older people care and ethical awareness should be supported by the workplace.

Ethical Coffee Room: An international collaboration in learning ethics digitally

BACKGROUND

Ethics is a fundamental part of health care professionals' competence and one of the major quality factors in good nursing care. Research shows challenges in learning and applying ethics. Ethical Coffee Room is an electronic platform, where the students, nurses and teachers discuss anonymously ethical issues during students' clinical practice. ECR offers 1 credit (27 working hours) for the students. This work included reading theoretical material, contributions for discussion of ethical dilemmas and reflection of one's own learning. Every user - student, nurse supervisor or teacher - could choose her or his own pseudonym.

AIM

The aim of this study was to describe how nursing students experience learning ethics with digital learning activity during clinical practice, how usable the Ethical Coffee Room platform is and how this learning activity should be developed further.

RESEARCH DESIGN, PARTICIPANTS AND CONTEXT

The study employed a qualitative descriptive design and was an EU project between Finland, Sweden and Latvia. In total, 34 second-year nursing students participated in the study. The data collection methods were semi-structured interviews and written comments in the discussion forum Ethical Coffee Room. The data were analysed using content analysis.

ETHICAL CONSIDERATIONS

Ethical approval and research permission were obtained from each partner organization, according to their national standards.

FINDINGS

The results are presented under three themes: positive learning experiences of Ethical Coffee Room, challenges in learning during Ethical Coffee Room and practical suggestions for future development of Ethical Coffee Room. The results showed that the Ethical Coffee Room was experienced as a novel type of learning activity and an interesting way to learn ethics.

DISCUSSION AND CONCLUSION

Ethical Coffee Room seems to be a promising learning activity enhancing students' ethical competence in clinical practice. However, active participation of the mentor nurses and teachers is essential. Therefore, mentor nurses and teachers need in-depth knowledge of ethical theories and concepts and how to apply them in clinical context.

Dental hygiene graduates' educational preparedness: Self-confidence ratings of the CDHA baccalaureate competencies

PURPOSE

In 2015, the Canadian Dental Hygienists Association (CDHA) published the first Canadian Competencies for Baccalaureate Dental Hygiene Programs (CCBDHP). To date, there is little evidence to support that baccalaureate graduates have gained these abilities. The purpose of the study was to investigate the confidence levels of baccalaureate graduates in their ability to demonstrate the CCBDHP.

METHODS

An online, anonymous study was conducted with the 2013-2016 graduates of the University of British Columbia to rate their confidence level in the 13 competency domains and associated 110 sub-competencies of the CCBDHP based on a 5-point scale ranging from not confident to confident.

RESULTS

Thirty of the 84 graduates responded to the survey for a 36% response rate. The mostly confident and confident scores were added to determine the number of sub-competencies within each domain in which 75% to 100% of respondents identified such confidence. The competency domains in which graduates expressed the highest confidence included Collaboration (100%), Communication (100%), Clinical Therapy (100%), Disease Prevention (100%), Oral Health Education (90%), Professionalism (90%), Research Use (90%) and Leadership (90%). They expressed the least confidence in the competency domains of Health Promotion (50%), Advocacy (22%) and Policy Use (0%).

CONCLUSION

These data provided the UBC faculty with important insights into the educational preparedness of baccalaureate graduates. The findings are also relevant for other Canadian programmes and contribute to a larger national dialogue about the CCBDHP and the transition of graduates into practice.