Expert nurses' coping strategies in ethically challenging situations: a qualitative study

The experiences of intensive care nurses coping with ethical conflict: a qualitative descriptive study

BACKGROUND

The critical conditions and life risk scenarios make intensive care nurses susceptible to ethical conflict. Negative consequences were recognized at both the individual level and the professional level which highly compromised the patient care and nurses' well-being. Therefore, ethical conflict has become a major concern in nursing practice. However, the experience of coping with ethical conflict among intensive care nurses remains unclear.

AIMS

This study aims to explore the experience of intensive care nurses coping with ethical conflict in China.

METHODS

From December 2021 to February 2022, in- depth interviews with 15 intensive care nurses from five intensive care units in a tertiary general hospital in China was performed using purposive sampling. An inductive thematic analysis approach was used to analyze the data. We applied the consolidated criteria for reporting qualitative research for this study.

RESULTS

Two distinctive themes were found: detachment and engagement, which contained four subthemes: ignoring ethical problems in the workplace, seeking ways to express emotions, perspective-taking, and identifying positive assets. Theses coping strategies demonstrated an ongoing process with different essential features.

CONCLUSION

This study provides a new insight into the experience of intensive care nurses coping with ethical conflict in clinical nursing. Intensive care nurses demonstrated differential experience of coping with ethical conflict including problem-focused, emotion-focused and meaning-making strategies. These findings have implications for policymakers and nursing administrators to develop ethical education and training and supportive environment for intensive care nurses to tackle this issue.

Impact of ethical climate, moral distress, and moral sensitivity on turnover intention among haemodialysis nurses: a cross-sectional study

BACKGROUND

While several studies have been performed on turnover intention among nurses, limited studies have considered the ethical perspectives on turnover intention among haemodialysis nurses. The purpose of this study was to clarify the impact of ethical factors, namely ethical climate, moral distress, and moral sensitivity on turnover intention among haemodialysis nurses.

METHODS

This cross-sectional research was conducted between July and August 2017. A total of 148 haemodialysis nurses were invited to participate in the study by convenience sampling from 11 general and university hospitals in South Korea. Data were analysed using SPSS for t-test, one-way analysis of variance, Pearson's correlation coefficients, and multiple regression analysis.

RESULTS

In the final regression model, the adjusted R-squared significantly explained 34.6% of the variance in turnover intention (F = 22.534, p < .001) when moral distress related to physician practice (β = 0.310, p = .001) and ethical climate related to the hospital climate (β = - 0.253, p = .003) and manager (β = - 0.191, p = .024) were included. Following the stepwise multiple regression process, all subdomains related to moral sensitivity were excluded due to no statistical significance in the final regression model.

CONCLUSION

To reduce turnover intention among haemodialysis nurses, hospitals and managers should pay attention to haemodialysis nurses' moral distress originating from physicians' practice and improve their ethical climate. Additionally, it is required that the impact of moral sensitivity on turnover among nurses working in diverse care settings be examined further.

Coping strategies that motivated frontline nurses while caring for the COVID-19 patients during the pandemic: A scoping review

BACKGROUND

The world faced a great health crisis during the COVID-19 pandemic. Consequently, the health care providers struggled and faced tremendous difficulties in treating high-load critical patients. This was particularly true in low- and middle-income countries where the work and patient loads are always higher and nurses at the forefront must deal with emergencies while being at high risk of exposure. However, little is known about the survival strategies of frontline nurses as dealt with the pandemic.

OBJECTIVES

This study catalogued the coping strategies of frontline nurses to deal with caring for the COVID-19 patients during the pandemic.

METHODS

The Arksey O'Malley framework was followed to conduct a scoping review. A systematic literature search was conducted using three databases: Google Scholar, Scopus and PubMed; and out of the 192 studies, 12 met the inclusion criteria set for this review study.

RESULTS

A total of 44 strategies were identified that motivated nurses to deal with the COVID-19 situation, and these strategies could be categorized into five main themes: nurses' self-strategies, nurses' strategies at the ethical level, employers' strategies, nursing leaders' strategies and supplementary strategies.

CONCLUSIONS

The findings of this study will provide guidance for health care workers, employers, policymakers, regulators and other stakeholders to adopt and promote different strategies in managing difficult emergency situations in future.

IMPLICATIONS FOR NURSING MANAGEMENT

This study emphasizes the importance of learning how to deal with adversity by health care workers and organizations in an emergency.