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Hammonds, Linda Sue, Nelda Godfrey, Terry Bryant, Margaret Mata, Corinne Fessenden, Shirley Farrah, Amy Vogelsmeier, et al. "Advocating for Early-Career Nurse Innovators: Modeling the Institute of Medicine Report." Creative Nursing 25, no. 1 (February 1, 2019): 10–16. http://dx.doi.org/10.1891/1078-4535.25.1.10.
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The Future of Nursing: Leading Change, Advancing Health was published by the of Medicine (IOM) of the National Academies in 2011. The Missouri Nurses Foundation and Missouri nurses modeled a sustainable project, the Early Career Nurse Innovator Project, exemplifying the intent of that report. The Missouri Nurses Foundation Executive Board comprises experienced nurses, nurse educators, nurses in other leadership roles, retired nurses, public members of the board, and administrative support staff. This article describes a project that was developed, implemented, and evaluated to recognize and encourage early-career nurses who have designed and led innovations to improve and promote the health of Missourians. Five of these early-career nurses were the recipients of monetary awards to encourage future innovations; the second recognition cycle is in the planning phase. Through the work of the Missouri Nurses Foundation, the scholarship of bedside nurses was recognized.
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Dawes, David, and Karen Dobson. "Nurses on Board." Primary Health Care 11, no. 8 (October 2001): 18–21. http://dx.doi.org/10.7748/phc2001.10.11.8.18.c332.
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Smalls, Harriett Twiggs. "What Happens When the Board of Nursing Comes Calling: Investigation and Disciplinary Actions." Neonatal Network 33, no. 2 (2014): 106–8. http://dx.doi.org/10.1891/0730-0832.33.2.106.
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Each state has a Board of Nursing that governs the nurses that practice in that state. Each Board of Nursing has a process by which it investigates and hears cases against nurses accused of wrongdoing. This article gives a general overview of what steps are usually taken when the Board of Nursing suspects that a nurse’s actions may be in violation of the laws that govern nursing practice.
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Hudson, Marilyn L., and Oliver J. Droppers. "Licensed Nurses Disciplined in Oregon Between September 1996 and June 2008." Western Journal of Nursing Research 33, no. 8 (October 14, 2010): 1030–46. http://dx.doi.org/10.1177/0193945910384491.
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This study is undertaken to better identify the types of errors being made by nurses in Oregon, to have a more thorough understanding of who is making the errors, and to examine how the Board is sanctioning nurses through Board (Board of Nursing) discipline. Results show that older nurses, and a disproportionately high number of male nurses, are being disciplined. RNs tend to be disciplined more for substance abuse and LPNs for substandard or inadequate care or for unprofessional conduct. RNs tend to be reprimanded more often than other licensure types, and LPNs receive more licensure suspensions. It may be helpful for administrators and nurse managers to use the information for staff education and development decisions. It may also inform Oregon nursing regulators, charged with protecting the public, when developing strategies aimed at ensuring equity and consistency in Board actions.
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Galemore, Cynthia, Hedaya Y. Alattar, Kate Fatica, Amy Huey, and Kathy Schulz. "Millennial School Nurses: A Roundtable Discussion." NASN School Nurse 34, no. 6 (June 24, 2019): 329–34. http://dx.doi.org/10.1177/1942602x19858392.
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School nurses are proportionally older in age as compared to the overall U.S. nursing workforce. In anticipation of a school nurse workforce shortage in the next few years, we must focus our attention on developing and implementing orientation and transition programs for new school nurses, many of whom represent the millennial generation. Formative experiences are thought to create specific characteristics and difference between generations; yet, stereotypes are sometimes present in defining generations. The NASN School Nurse Editorial Advisory Board interviewed four millennial school nurses to highlight the need to embrace this new generation as they enter the specialty practice of school nursing.
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Burgel, Barbara J., Emily M. Wallace, Sharon Donnelly Kemerer, and Margery Garbin. "Certified Occupational Health Nursing." AAOHN Journal 45, no. 11 (November 1997): 581–91. http://dx.doi.org/10.1177/216507999704501101.
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Specialty nursing certification programs, such as that administered by the American Board for Occupational Health Nurses, Inc. (ABOHN), must be firmly based on current practice to maintain validity. To determine this, ABOHN performed its most recent job analysis and role delineation study between 1992 and 1994. A comprehensive survey tool was developed by ABOHN Board members, and administered to all 3,805 certified occupational health nurses in practice at the time of the study. With a final return rate of 42.7%, the results were believed to be representative of the knowledge, skills, and abilities needed to practice occupational health nursing in the United States at the proficient level of practice. The results of the study formed the basis for the ABOHN test blueprints and the creation of two credentials for occupational health nurses: the Certified Occupational Health Nurse (COHN) and the Certified Occupational Health Nurse Specialist (COHN-S).
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Lazarus, Jean B., and Belinda (Wendy) Downing. "Monitoring and Investigating Certified Registered Nurse Practitioners in Pain Management." Journal of Law, Medicine & Ethics 31, no. 1 (2003): 101–18. http://dx.doi.org/10.1111/j.1748-720x.2003.tb00061.x.
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The Mayday Scholars Program for 2001-2002 provided an opportunity to boards of nursing to present their experiences in monitoring the prescribing practices of advanced practice nurses and to research ways for improving their own investigation processes as professional disciplinary agencies for prescribing practices related to pain management. The Alabama Board of Nursing was interested in participating in the program based on its commitment to accountability for public protection. A gradual increase in disciplinary cases involving violations of prescribing practices by certified registered nurse practitioners (CRNPs) prompted our inquiry as to whether a proactive monitoring system was needed to determine compliance with regulations for advanced practice nurses in collaborative practice.In this article, we discuss selected elements related to pain management and regulatory factors, including nursing, that affect the treatment of pain. We present a brief overview of the evolution of advanced practice nursing, with an emphasis on the nurse practitioners movement, and prescription practices and pain management by nurse practitioners.
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Belfield, Louise. "A pioneer in dental nursing." Dental Nursing 16, no. 9 (September 2, 2020): 444–45. http://dx.doi.org/10.12968/denn.2020.16.9.444.
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Bobo, Nichole, Virginia W. Adams, and Leslie Cooper. "Excellence in School Nursing Practice: Developing a National Perspective on School Nurse Competencies." Journal of School Nursing 18, no. 5 (October 2002): 277–85. http://dx.doi.org/10.1177/10598405020180050701.
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Developing a national position on competencies for school nurses can directly in-fluence professional practice, which ultimately affects the well-being and academic success of students. Collaboration between national experts, such as school nurse educators and school nurse consultants, interested in moving this development forward is key. Closely aligning the work done by the Southern Regional Education Board Council on Collegiate Education for Nursing on entry-level competencies with the Standards of Professional School Nursing Practice provides a framework to carry the school nurse competency initiative forward. Continued competency development will provide guidance for the academic programs that design curricula to prepare school nurses and for the practice settings that hire school nurses.
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Larkin, Mary E., Brian Beardslee, Enrico Cagliero, Catherine A. Griffith, Kerry Milaszewski, Marielle T. Mugford, Joanna M. Myerson, et al. "Ethical challenges experienced by clinical research nurses:: A qualitative study." Nursing Ethics 26, no. 1 (March 1, 2017): 172–84. http://dx.doi.org/10.1177/0969733017693441.
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Background: Clinical investigation is a growing field employing increasing numbers of nurses. This has created a new specialty practice defined by aspects unique to nursing in a clinical research context: the objectives (to implement research protocols and advance science), setting (research facilities), and nature of the nurse–participant relationship. The clinical research nurse role may give rise to feelings of ethical conflict between aspects of protocol implementation and the duty of patient advocacy, a primary nursing responsibility. Little is known about whether research nurses experience unique ethical challenges distinct from those experienced by nurses in traditional patient-care settings. Research objectives: The purpose of the study was to describe the nature of ethical challenges experienced by clinical research nurses within the context of their practice. Research design: The study utilized a qualitative descriptive design with individual interviews. Participants and research context: Participating nurses (N = 12) self-identified as having experienced ethical challenges during screening. The majority were Caucasian (90%), female (83%), and worked in outpatient settings (67%). Approximately 50% had > 10 years of research experience. Ethical considerations: The human subjects review board approved the study. Written informed consent was obtained. Findings: Predominant themes were revealed: (1) the inability to provide a probable good, or/do no harm, and (2) dual obligations (identity as a nurse vs a research nurse). The following patterns and subthemes emerged: conflicted allegiances between protocol implementation, needs of the participant, desire to advance science, and tension between the nurse–patient therapeutic relationship versus the research relationship. Discussion: Participants described ethical challenges specific to the research role. The issues are central to the nurse–participant relationship, patient advocacy, the nurse’s role in implementing protocols, and/or advancing science. Conclusion: Ethical challenges related to the specialized role of clinical research nurses were identified. More research is warranted to fully understand their nature and frequency and to identify support systems for resolution.
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&NA;. "ONCB ORTHOPAEDIC NURSES CERTIFICATION BOARD." Orthopaedic Nursing 17, no. 1 (January 1998): 107. http://dx.doi.org/10.1097/00006416-199801000-00018.
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&NA;, &NA;. "ORTHOPAEDIC NURSES CERTIFICATION BOARD FORMS." Nursing Administration Quarterly 11, no. 2 (1987): 81. http://dx.doi.org/10.1097/00006216-198701120-00012.
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&NA;. "ORTHOPAEDIC NURSES CERTIFICATION BOARD FORMS." Journal of Ambulatory Care Management 10, no. 2 (May 1987): 85. http://dx.doi.org/10.1097/00004479-198705000-00014.
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&NA;. "Orthopaedic Nurses Board Certified List." Orthopaedic Nursing 33, no. 6 (2014): 361–62. http://dx.doi.org/10.1097/nor.0000000000000093.
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&NA;. "ORTHOPAEDIC NURSES CERTIFICATION BOARD FORMS." Advances in Nursing Science 9, no. 2 (January 1987): 81. http://dx.doi.org/10.1097/00012272-198701000-00011.
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Bergren, Martha Dewey, and Lina Monsalve. "The 2011 NASN Membership Survey." NASN School Nurse 27, no. 1 (January 2012): 36–41. http://dx.doi.org/10.1177/1942602x11429829.
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In 2011, NASN conducted a needs assessment to identify and analyze member demographic trends and identify priorities for current members. Ninety-five percent of survey respondents were currently registered nurses, 1% were licensed practical nurses, 3% were advance practice registered nurses, and 1% had other types of licensure. School nurses’ ages ranged between 21 and 66+ years of age with the highest concentration of school nurses (63%) older than 51 years of age. Thirty-one percent of respondents were nationally certified through the National Board for the Certification of School Nurses. Eighty-three percent had a bachelor’s degree or higher. Fifteen percent had a master’s in nursing, and another 15% held a master’s in another field. Nine percent of respondents had an associate’s degree in nursing and 4% had a registered nurse diploma as their highest level of education. The typical NASN member is a female, registered nurse with a bachelor’s degree who is over the age of 50.
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Filipova, Anna A. "Direct-to-consumer advertising effects on nurse–patient relationship, authority, and prescribing appropriateness." Nursing Ethics 25, no. 7 (December 16, 2016): 823–40. http://dx.doi.org/10.1177/0969733016679469.
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Background: Discussing direct-to-consumer advertising of prescription drugs during a visit could affect prescribing practices and provider–patient relationship. Research objectives: The study examines advanced practice nurse prescribers’ perceptions of direct-to-consumer advertising and its effects on nurse–patient relationship, prescriptive authority, and appropriateness of patient clinical requests. Research design: A cross-sectional survey design was implemented. Participants and research context: The random sample consisted of 316 nurses (27.17% response rate) in one of the Midwestern states in the United States. Pearson’s chi-square analysis and multiple/multinomial logistic regression analyses were used. Ethical considerations: Permission to conduct the study was obtained from the university’s Institutional Review Board. Participation was voluntary, and measures were taken to protect the anonymity and confidentiality of consenting participants. Findings: Most nurses (69%) believed that patients were “poor or very poor” at assessing the relevance of drug advertisements, 61% reported that the increase in drugs advertisements directed at patient was “a bad or a very bad thing,” and only 16% thought the advertisements were accurate to “a very or to a great extent.” Improved nurse–patient relationship was associated with factors such as the patient not bringing printed material, seeking nurse’s opinion only, taking responsibility for their health, and not challenging nurse’s prescriptive authority. Discussion: Advertising discussion during a visit could improve as well as pose a challenge to a nurse–patient relationship and nurse’s prescriptive authority. Conclusion: The positives of discussing advertising information can be maximized and the negatives minimized through enhanced interpersonal nurse–patient communication.
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Chen, Shu-Yueh, and Hui-Chen Hsu. "Nurses’ reflections on good nurse traits." Nursing Ethics 22, no. 7 (September 22, 2014): 790–802. http://dx.doi.org/10.1177/0969733014547973.
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Background: Good nurses show concern for patients by caring for them effectively and attentively to foster their well-being. However, nurses cannot be taught didactically to be “good” or any trait that characterizes a good nurse. Nurses’ self-awareness of their role traits warrants further study. Objectives: This study aimed (a) to develop a strategy to elicit nurses’ self-exploration of the importance of good nurse traits and (b) to explore any discrepancies between such role traits perceived by nurses as ideally and actually important. Research design: For this mixed-method study, we used good nurse trait card play to trigger nurses’ reflections based on clinical practice. Nurse participants appraised the ideal and actual importance of each trait using a Q-sort grid. The gap between the perceived ideal and actual importance of each trait was examined quantitatively, while trait-related clinical experiences were analyzed qualitatively. Participants and research context: Participants were 35 in-service nurses (mean age = 31.6 years (range = 23–49 years); 10.1 years of nursing experience (range = 1.5–20 years)) recruited from a teaching hospital in Taiwan. Ethical considerations: The study was approved by the Institutional Review Board of the study site. Findings: Good nurse trait card play with a Q-sort grid served as an icebreaker to help nurse participants talk about their experiences as embodied in good quality nursing care. Nurses’ perceived role–trait discrepancies were divided into three categories: over-performed, least discrepant, and under-performed. The top over-performed trait was “obedience.” Discussion: Patients’ most valued traits (“patient,” “responsible,” “cautious,” and “considerate”) were perceived by participants as ideally important but were under-performed, perhaps due to experienced nurses’ loss of idealism. Conclusion: Good nurse trait card play with Q-sort grid elicited nurses’ self-dialogue and revealed evidence of the incongruity between nurses’ perceived ideal and actual importance of traits. The top over-performed trait, “obedience,” deserves more study.
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Pohlman, Katherine, and Nadine Schwab. "Nursing Discipline: Demystifying The Process." Journal of School Nursing 19, no. 1 (February 2003): 52–57. http://dx.doi.org/10.1177/10598405030190010801.
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This article provides a general overview of the disciplinary process for nurses. It also outlines at least one example of an alternative, often called a diversion program, to the standard disciplinary process. It urges school nurses to obtain legal counsel when responding to an inquiry from the board of nursing and discusses several factors to consider when seeking an attorney. The article also briefly discusses how the Nurse Licensure Compact affects the disciplinary process.
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Roll, Lona, Kristin Stegenga, Verna Hendricks-Ferguson, Yvonne J. Barnes, Brooke Cherven, Sharron L. Docherty, Sheri L. Robb, and Joan E. Haase. "Engaging Nurses in Research for a Randomized Clinical Trial of a Behavioral Health Intervention." Nursing Research and Practice 2013 (2013): 1–6. http://dx.doi.org/10.1155/2013/183984.
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Nurse involvement in research is essential to the expansion of nursing science and improved care for patients. The research participation challenges encountered by nurses providing direct care (direct care nurses) include balancing patient care demands with research, adjusting to fluctuating staff and patient volumes, working with interdisciplinary personnel, and feeling comfortable with their knowledge of the research process. The purpose of this paper is to describe efforts to engage nurses in research for the Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study. SMART was an NIH-funded, multisite, randomized, behavioral clinical trial of a music therapy intervention for adolescents/young adults (AYA) undergoing stem cell transplant for an oncology condition. The study was conducted at 8 sites by a large multidisciplinary team that included direct care nurses, advanced practice nurses, and nurse researchers, as well as board-certified music therapists, clinical research coordinators, and physicians. Efforts to include direct care nurses in the conduct of this study fostered mutual respect across disciplines in both academic and clinical settings.
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Lemmenes, Donna, Pamela Valentine, Patricia Gwizdalski, Catherine Vincent, and Chuanhong Liao. "Nurses’ perception of ethical climate at a large academic medical center." Nursing Ethics 25, no. 6 (September 7, 2016): 724–33. http://dx.doi.org/10.1177/0969733016664980.
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Background: Nurses are confronted daily with ethical issues while providing patient care. Hospital ethical climates can affect nurses’ job satisfaction, organizational commitment, retention, and physician collaboration. Purpose: At a metropolitan academic medical center, we examined nurses’ perceptions of the ethical climate and relationships among ethical climate factors and nurse characteristics. Design/participants: We used a descriptive correlational design and nurses ( N = 475) completed Olson’s Hospital Ethical Climate Survey. Data were analyzed using STATA. Ethical considerations: Approvals by the Nursing Research Council and Institutional Review Board were obtained; participants’ rights were protected. Results: Nurses reported an ethical climate total mean score of 3.22 ± 0.65 that varied across factors; significant differences were found for ethical climate scores by nurses’ age, race, and specialty area. Conclusion: These findings contribute to what is known about ethical climate and nurses’ characteristics and provides the foundation to develop strategies to improve the ethical climate in work settings.
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Upley, Nick. "Nurses battle for NHS board seats." Nursing Standard 16, no. 22 (February 13, 2002): 7. http://dx.doi.org/10.7748/ns.16.22.7.s14.
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Yarbrough, Susan, Pam Martin, Danita Alfred, and Charleen McNeill. "Professional values, job satisfaction, career development, and intent to stay." Nursing Ethics 24, no. 6 (January 24, 2016): 675–85. http://dx.doi.org/10.1177/0969733015623098.
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Background: Hospitals are experiencing an estimated 16.5% turnover rate of registered nurses costing from $44,380 - $63,400 per nurse—an estimated $4.21 to $6.02 million financial loss annually for hospitals in the United States of America. Attrition of all nurses is costly. Most past research has focused on the new graduate nurse with little focus on the mid-career nurse. Attrition of mid-career nurses is a loss for the profession now and into the future. Research objective: The purpose of the study was to explore relationships of professional values orientation, career development, job satisfaction, and intent to stay in recently hired mid-career and early-career nurses in a large hospital system. Research design: A descriptive correlational study of personal and professional factors on job satisfaction and retention was conducted. Participants and research context: A convenience sample of nurses from a mid-sized hospital in a metropolitan area in the Southwestern United States was recruited via in-house email. Sixty-seven nurses met the eligibility criteria and completed survey documents. Ethical considerations: Institutional Review Board approval was obtained from both the university and hospital system. Findings: Findings indicated a strong correlation between professional values and career development and that both job satisfaction and career development correlated positively with retention. Discussion: Newly hired mid-career nurses scored higher on job satisfaction and planned to remain in their jobs. This is important because their expertise and leadership are necessary to sustain the profession into the future. Conclusion: Nurse managers should be aware that when nurses perceive value conflicts, retention might be adversely affected. The practice environment stimulates nurses to consider whether to remain on the job or look for other opportunities.
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Brandt, Charlotte M. "Enhancing School Nurse Visibility." Journal of School Nursing 18, no. 1 (February 2002): 5–10. http://dx.doi.org/10.1177/10598405020180010301.
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The school nurse is in a powerful position in the school district, but only by expanding visibility efforts can it be a viable one. School nurses are viewed as “health experts” in their school districts. They need to continually fine-tune and expand their visibility, as well as to widen their circle of influence in the school district and its community-based partnerships. Feeling comfortable in giving school board presentations and participating in other highly visible activities will highlight and enhance the valuable services school nurses provide. School nurses must be visible to be perceived as a powerful influence for health in the school district.
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Sampson, Deborah A. "Alliances of Cooperation: Negotiating New Hampshire Nurse Practitioners’ Prescribing Practice." Nursing History Review 17, no. 1 (January 2009): 153–78. http://dx.doi.org/10.1891/1062-8061.17.153.
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Nurse practitioner legislation varies among states, particularly in relation to practice without physician oversight, altering the legal environment within which nurse practitioners can use knowledge and skills to meet patient needs. Using New Hampshire as a case study, this historical analysis of nurse practitioners’ negotiations over time for independent practice, defined in state practice acts, illuminates the complex social and economic factors affecting nurses’ struggle to gain legal rights over their own professional practice without supervision and intervention from another profession. In New Hampshire, not only did organized medicine oppose nurses’ rights to practice, but pharmacists demanded the right to control all aspects of medication management, including who could prescribe and under what circumstances prescribing could occur. Shifting social and political terrain as well as changes in legislative and state professional board leadership affected the environment and negotiations of a small group of nurses who were ultimately successful in obtaining the right to define their own professional practice.
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McAndrew, Natalie S., and Joshua B. Hardin. "Giving nurses a voice during ethical conflict in the Intensive Care Unit." Nursing Ethics 27, no. 8 (July 14, 2020): 1631–44. http://dx.doi.org/10.1177/0969733020934148.
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Background: Ethical conflict and subsequent nurse moral distress and burnout are common in the intensive care unit (ICU). There is a gap in our understanding of nurses’ perceptions of how organizational resources support them in addressing ethical conflict in the intensive care unit. Research question/objectives/methods: The aim of this qualitative, descriptive study was to explore how nurses experience ethical conflict and use organizational resources to support them as they address ethical conflict in their practice. Participants and research context: Responses to two open-ended questions were collected from critical care nurses working in five intensive care units at a large, academic medical center in the Midwestern region of the United States. Ethical considerations: This study was approved by the Institutional Review Board at the organization where the study took place. Findings: Three main interwoven themes emerged: nurses perceive (1) intensive care unit culture, practices, and organizational priorities contribute to patient suffering; (2) nurses are marginalized during ethical conflict in the intensive care unit; and (3) organizational resources have the potential to reduce nurse moral distress. Nurses identified ethics education, interprofessional dialogue, and greater involvement of nurses as important strategies to improve the management of ethical conflict. Discussion: Ethical conflict related to healthcare system challenges is intrinsic in the daily practice of critical care nurses. Nurses want to be engaged in discussions about their perspectives on ethical conflict and play an active role in addressing ethical conflict in their practice. Organizational resources that support nurses are vital to the resolution of ethical conflict. Conclusion: These findings can inform the development of interventions that aim to proactively and comprehensively address ethical conflict in the intensive care unit to reduce nurse moral distress and improve the delivery of patient and family care.
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Hamilton, Linda, Julie Morath, and Marty Lewis-Hunstiger. "Leader Interview: Supporting Patient Safety at the Bedside: An Interview with Linda Hamilton and Julie Morath." Creative Nursing 12, no. 3 (January 2006): 8–12. http://dx.doi.org/10.1891/1078-4535.12.3.8.
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Linda Hamilton, RN, BSN, is a staff nurse and ECMO Specialist in NICU at Children’s Hospitals and Clinics of Minnesota, and a Minnesota Nurses Association bargaining unit leader at Children’s. Julie Morath, RN, MS, is Chief Operating Officer at Children’s, and Board Member and Distinguished Advisor to the National Patient Safety Foundation. Marty Lewis-Hunstiger, RN, BSN, MA, is a staff nurse and preceptor in NICU at Children’s and an editor of Creative Nursing.
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Santry, Helen, and Dame June Clark. "Primary care groups: nurses on the board." Nursing Standard 14, no. 5 (October 20, 1999): 34–39. http://dx.doi.org/10.7748/ns1999.10.14.5.34.c2699.
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Jang, Yujin, and Younjae Oh. "Impact of ethical factors on job satisfaction among Korean nurses." Nursing Ethics 26, no. 4 (December 21, 2017): 1186–98. http://dx.doi.org/10.1177/0969733017742959.
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Background: Although numerous studies on job satisfaction among nurses have been conducted, there is a lack of research considering the ethical perspectives of leadership and organizational climate in job satisfaction. Objective: The purpose of this study was to clarify the impact of the ethical climate and ethical leadership as perceived by nurses on job satisfaction in South Korea. Research design: A descriptive and correlational study was conducted with a convenience sample of 263 nurses from four general hospitals in South Korea. Ethical considerations: This study was approved by the Institute Review Board of Hallym University before data collection. Results: Job satisfaction was positively correlated with ethical climate and ethical leadership. The ethical climate in relationship with hospitals and people orientation leadership were influential factors in the level of job satisfaction among nurses. Discussion: Organizations in the nursing environment should pay attention to improving the ethical climate with acceptable ethical norms in the workplace and nurse leaders should respect, support and genuinely care about their nurses in ethical concerns.
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Ko, Hsun-Kuei, Chi-Chun Chin, Min-Tao Hsu, and Shu-Li Lee. "Phenomenon of moral distress through the aspect of interpretive interactionism." Nursing Ethics 26, no. 5 (April 15, 2018): 1484–93. http://dx.doi.org/10.1177/0969733018766579.
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Background: Most previous studies on moral distress focused on the factors that cause moral distress, paying inadequate attention to the moral conflict of nurses’ values, the physician–nurse power hierarchy, and the influence of the culture. Research objective: To analyze the main causes for moral distress with interpretive interactionism. Research design: A qualitative study was adopted. Participants: Through purposeful sampling, 32 nurses from 12 different departments were chosen as the samples. Ethical considerations: Approval from the Institutional Review Board of the Kaohsiung Medical University Hospital. Findings: Moral distress is likely to occur in the following clinical situations: patients have no idea about their diseases; the medical decisions fail to meet the optimum benefit of patients; and patients with terminal cancers are not given a proper death. The reason why nurses become trapped in moral distress is that they fail to achieve moral goodness. Inadequate confidence, the physician–nurse power hierarchy, and the Oriental culture affect nurses’ goodness-based intention for patients, which deteriorates moral distress. Discussion: The main cause for moral distress is the moral goodness of nurses. If nurses’ goodness-based intention for patients is inconsistent with the moral objective of achieving optimum benefit for patients, it leads to moral distress. Culture is an essential background factor of care for patients. In the Oriental culture, family members influence patients’ right to know about their diseases, the choice of treatment, and patients’ autonomy of not receiving cardio-pulmonary resuscitation. This results in moral distress in medical care. Conclusion: The occurrence of moral distress demonstrates that nurses have moral characteristics such as goodness and caring. It is suggested that appropriate educational strategies can be adopted to weaken the power hierarchy between physicians and nurses and enhance nurses’ confidence and cultural sensitivity, so as to reduce the moral distress of nurses.
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Greco, Karen E., Susan Tinley, and Diane Seibert. "Development of the Essential Genetic and Genomic Competencies for Nurses With Graduate Degrees." Annual Review of Nursing Research 29, no. 1 (December 2011): 173–90. http://dx.doi.org/10.1891/0739-6686.29.173.
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Scientific advances in genetics and genomics are rapidly redefining our understanding of health and illness and creating a significant shift in practice for all health care disciplines. Nurses educated at the graduate level are well-prepared to assume clinical and leadership roles in health care systems and must also be prepared to assume similar roles related to genetic/genomic health care. This chapter describes the processes used to create a consensus document identifying the genetic/genomic competencies essential for nurses prepared at the graduate level. Three groups were involved in the competency development; a steering committee provided leadership and used qualitative methods to review and analyze pertinent source documents and create an initial competency draft; an advisory board evaluated and revised the draft, and a consensus panel refined and validated the final set of competencies. The concensus process resulted in 38 competencies organized under the following categories: Risk Assessment and Interpretation; Genetic Education, Counseling, Testing and Results Interpretation; Clinical Management; Ethical, Legal, and Social Implications; Professional Role; Leadership, and Research. These competencies apply to all individuals functioning at the graduate level in nursing, including but not limited to advanced practice registered nurses, clinical nurse leaders, nurse educators, nurse administrators, and nurse scientists and are intended to inform and guide their practice.
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Ford, Natalie J., and Wendy Austin. "Conflicts of conscience in the neonatal intensive care unit: Perspectives of Alberta." Nursing Ethics 25, no. 8 (January 4, 2017): 992–1003. http://dx.doi.org/10.1177/0969733016684547.
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Background: Limited knowledge of the experiences of conflicts of conscience found in nursing literature. Objectives: To explore the individual experiences of a conflict of conscience for neonatal nurses in Alberta. Research design: Interpretive description was selected to help situate the findings in a meaningful clinical context. Participants and research context: Five interviews with neonatal nurses working in Neonatal Intensive Care Units throughout Alberta. Ethical consideration: Ethics approval from the Health Research Ethics Board at the University of Alberta. Findings: Three common themes emerged from the interviews: the unforgettable conflict with pain and suffering, finding the nurse’s voice, and the unique proximity of nurses. Discussion and conclusion: The nurses described a conflict of conscience when the neonate in their care experienced undermanaged pain and unnecessary suffering. During these experiences, they felt guilty, sad, hopeless, and powerless when they were unable to follow their conscience. Informal ways to follow their conscience were employed before declaration of conscientious objection was considered. This study highlights the vital importance of respecting a conflict of conscience to maintain the moral integrity of neonatal nurses and exposes the complexities of conscientious objection.
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Scocca, A., A. Gioia, and P. Poli. "Initial Experience of a Nurse-Implemented Peripherally Inserted Central Catheter Program in Italy." Journal of the Association for Vascular Access 13, no. 1 (March 1, 2008): 27–30. http://dx.doi.org/10.2309/java.13-1-6.
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Abstract In Italy prior to 2006 central venous catheters were inserted only by anaesthesiologists. Nurses were excluded based on professional profile. In 2005 the nursing staff of the Pain Therapy and Palliative Care Unit (PTPCU) at Santa Chiara Hospital in Pisa, proposed that nurses be permitted to insert Peripherally Inserted Central Catheters (PICCs). The recommendation was submitted to the Italian National Board of Nurses with a request to implement a training program. The Board approved the proposal in January 2006. Initially the PTPCU nursing staff had PICC training programs through the St. Chiara Hospital Vocational Training Office. The program was initially implemented by a nurse volunteer who had critical care training, intravenous therapy experience and who demonstrated competence with PICC placement based on training by PTPCU interventional anaesthesiologists. To date, nearly 250 successful PICC placements have been performed using the Modified Seldinger Technique (MST) in conjunction with ultrasound guidance. Physicians and nurses identified potential candidates and the patients were assessed by the PICC nurse. The combination of PICC/MST was found to facilitate placement in patients with impalpable vessels and above the antecubital fossa as well as improve freedom of movement and reduce the likelihood of patients accidentally dislodging the device. The primary reasons for PICC placement included antibiotic or antiviral therapy (26%), total parenteral nutrition administration (35%) and chemotherapy (39%). There were 211 catheters used exclusively for inpatients and 39 catheters exclusively for outpatients. The PICC program resulted in an excellent safety profile, a high success rate, and few post-procedural complications. It was a less costly option compared to centrally inserted, tunnelled, or implanted central vascular access devices; it improved the quality of nursing care and decreased patients' waiting time for vascular access placement.
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Armstrong, S. H., C. V. Ruckley, R. J. Prescott, J. J. Dale, and E. A. Nelson. "Deficiencies in Leg Ulcer Care: A National Survey in Scotland." Phlebology: The Journal of Venous Disease 13, no. 2 (June 1998): 40–44. http://dx.doi.org/10.1177/026835559801300202.
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Objective: To identify what specialist expertise and services are currently available, in Scotland, to support general practitioners (GPs) and community nurses in the management of leg ulcer patients and the perceived need for the improvement of the service. Design: Postal questionnaires to randomly selected samples of GPs and community nurses. Setting: All 15 Scottish Health Board areas. Subjects: Six hundred and seventy-three GPs and 441 community nurses were questioned. Results: Five hundred and twelve (76%) GPs replied. Barely half, 285 (56%), expressed satisfaction with the service and only 155 (30%) had access to a recognized leg ulcer specialist. GPs who had access to a specialist expressed a greater level of satisfaction with the leg ulcer service than those without a local specialist. Community nurse questionnaire: Three hundred and sixty (82%) nurses replied. Two hundred and forty six (68%) indicated that the diagnosis of the cause of ulceration was usually made by both the GP and the nurse but the choice of treatment was most often made by the nurse alone. The great majority (69%) did not have access to a local leg ulcer clinic and only 34 (9%) indicated that they had access to management protocols, almost 90% of nurses expressing a need for protocols. Both questionnaires revealed a lack of specialist support, dedicated leg ulcer clinics, better education and training, and leg ulcer management protocols. Conclusion: Serious deficiencies in the support available for community care of leg ulcer patients have been identified. The situation requires to be remedied if more cost-effective outcomes for leg ulcer patients are to be achieved.
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Oakley, Melanie. "Education in post anaesthetic care nursing." British Journal of Anaesthetic and Recovery Nursing 3, no. 1 (February 2002): 4–6. http://dx.doi.org/10.1017/s1742645600000747.
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ABSTRACTPost anaesthetic care nursing was viewed for many years as the ‘poor relation’ of theatre and anaesthetic nursing. This was for a number of reasons, but primarily because recovery of the anaesthetised patient was, until relatively recently ward based. However with the advent of anaesthesia becoming more ‘high tech’ the skill required to look after a patient post anaesthesia has increased and with that increase the need for a high level of education for nurses within this speciality. There is now a long English National Board course for the Post anaesthetic care nurse, and opportunities are arising for nurses working in this area to add to the body of knowledge in post anaesthetic care nursing.
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Quinn, Brenna L. "Precepted Experiences for Doctoral Student Nurses." Creative Nursing 23, no. 2 (2017): 124–28. http://dx.doi.org/10.1891/1078-4535.23.2.124.
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Across many levels of nursing education, mentored experiences are an essential part of learning. To enhance understanding, learning, and comfort for those new to professional roles, experienced and skilled professionals provide motivation while teaching professional skills, demonstrating technical competence, and displaying behavior expected of a professional. Educator preparation topics such as curriculum development, evaluation, and lesson planning are not typically included in PhD programs, leaving PhD students feeling unprepared to teach (Hudacek & Carpenter, 1998; Ivey, 2007). The lack of educator pedagogy forces nurse faculty members to learn on the job (Gardner, 2014; Oermann, 2017). Preceptorships are among the faculty role development opportunities not commonplace for aspiring nurse educators; these opportunities for PhD students to observe and model nurse educators have been noted as limited (Gardner, 2014). Experts have called for more educator-focused learning experiences and preceptorship opportunities in PhD programs (National League for Nursing Board of Governors, 2002; Oermann, 2017). The purpose of this article is to describe a creative approach to introducing nurses enrolled in doctoral programs to the faculty role within the academic setting.
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Jones-Berry, Stephanie. "Why aren’t there more nurses at board level?" Nursing Standard 33, no. 2 (May 2, 2018): 19–21. http://dx.doi.org/10.7748/ns.33.2.19.s11.
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Hughes, Phil. "National Examining Board for Dental Nurses' survey results." Dental Nursing 6, no. 4 (April 2010): 228–29. http://dx.doi.org/10.12968/denn.2010.6.4.47305.
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Landis, Nancy Tarleton. "State board disciplines nurses for Dana-Farber overdoses." American Journal of Health-System Pharmacy 56, no. 8 (April 15, 1999): 707–8. http://dx.doi.org/10.1093/ajhp/56.8.707.
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Cook, Neal. "European Association of Neuroscience Nurses annual board meeting." British Journal of Neuroscience Nursing 8, no. 3 (June 2012): 143–44. http://dx.doi.org/10.12968/bjnn.2012.8.3.143.
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Dhillon, Hardip Kaur, Gurmeet Kaur, Jasminder Kaur, and Anuar Zaini Md Zain. "Vital Bridge Transforming Postgraduate Nurse Education And Employability To Employment." International Journal for Innovation Education and Research 3, no. 2 (February 28, 2015): 17–24. http://dx.doi.org/10.31686/ijier.vol3.iss2.309.
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Today’s universities are constantly looking for a competitive edge in delivering a postgraduate nurse curriculum with a positive outcome of future employability and employment. In this respect, Monash University Malaysia is no different since market differentiation is important for the survival of Private Institutions of Higher Learning in Malaysia. Currently, some Malaysian public and private universities do offer specific postgraduate courses in advanced clinical skills nurse practice which have been accredited by Malaysia Qualifications Agency and recognized by both Ministry of Higher Education as well as Ministry of Health. In addition to that, the Nurses Board Malaysia, also consider the postgraduate courses that are currently offered to be too generic with very little application of theory to practice in the clinical healthcare settings. In view of the gap that exists in the present postgraduate courses, this paper would critically examine the preliminary market information gathered on the requirements of higher educational needs of nurses in Malaysia. The future development of an appropriate higher education course, “the vital bridge”, is in the planning stage. It is expected to be both vigor and relevant to today’s Malaysian nurses’ employability and employment.
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Kim, Sanghee, Minjeong Seo, and Doo Ree Kim. "Unmet Needs for Clinical Ethics Support Services in Nurse: Based on focus group interviews." Nursing Ethics 25, no. 4 (July 8, 2016): 505–19. http://dx.doi.org/10.1177/0969733016654312.
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Background: As nurses’ ethical competence in their own fields is essential, clinical ethics support services help nurses improve ethical competence. Objectives: The purpose of this study was to identify the unmet needs of ethical support for nurses in clinical settings and explore the differences by nursing units. Research design: Focus group interview design was applied. Participants and research context: Data were collected via four rounds of focus group interviews with 37 nurses at intensive care units, medical-surgical units, emergency departments and oncology units. Major questions were as follows: ‘What is nurses’ experience of ethical difficulties while working as a clinical nurse?’ and ‘What kinds of clinical ethics support services do nurses require in different clinical settings?’ Inductive content analysis was performed to analyse the data. Ethical considerations: Ethical approval was obtained from the institutional review of board at the College of Nursing. Findings: Five categories (with 14 subcategories) were identified: difficulty providing evidence-based care, lack of support in maintaining patients’ and family members’ dignity, insufficient education regarding clinical ethics, loss of professional self-esteem and expectations concerning organizational support. Nurses’ desire for ethical support varied according to department. Conclusion: Nurses face both practical and existential ethical issues that require rapid solution each day. There is a need for ethical counselling to prevent compassion fatigue and identify means via which nurses reflect on their daily lives in their own fields. In-house training should be provided for each unit, to improve ethical competence and facilitate the development of pragmatic, sensible solutions.
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Axson, Sydney A., Nicholas A. Giordano, Robin M. Hermann, and Connie M. Ulrich. "Evaluating nurse understanding and participation in the informed consent process." Nursing Ethics 26, no. 4 (November 20, 2017): 1050–61. http://dx.doi.org/10.1177/0969733017740175.
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Background: Informed consent is fundamental to the autonomous decision-making of patients, yet much is still unknown about the process in the clinical setting. In an evolving healthcare landscape, nurses must be prepared to address patient understanding and participate in the informed consent process to better fulfill their well-established role as patient advocates. Research objective: This study examines hospital-based nurses’ experiences and understandings of the informed consent process. Research design: This qualitative descriptive study utilized a semi-structured interview approach identifying thematic concerns, experiences, and knowledge of informed consent across a selected population of clinically practicing nurses. Participants and research context: In all, 20 baccalaureate prepared registered nurses practicing in various clinical settings (i.e. critical care, oncology, medical/surgical) at a large northeastern academic medical center in the United States completed semi-structured interviews and a demographic survey. The mean age of participants was 36.6 years old, with a mean of 12.2 years of clinical experience. Ethical considerations: Participation in this study involved minimal risk and no invasive measures. This study received Institutional Review Board approval from the University of Pennsylvania. All participants voluntarily consented. Findings: The majority of participants (N = 19) believe patient safety is directly linked to patient comprehension of the informed consent process. However, when asked if nurses have a defined role in the informed consent process, nearly half did not agree (N = 9). Through this qualitative approach, three major nursing roles emerged: the nurse as a communicator, the nurse as an advocate, and the clerical role of the nurse. Discussion and conclusion: This investigation contributes to the foundation of ethical research that will better prepare nurses for patient engagement, advance current understanding of informed consent, and allow for future development of solutions. Nurses are at the forefront of patient–provider interactions and they are often presented opportunities to learn about and engage in the informed consent process.
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Wachs, Joy E. "The American Association of Occupational Health Nurses: Seventy-Five Years of Education, Practice, and Research." Workplace Health & Safety 65, no. 4 (April 2017): 148–53. http://dx.doi.org/10.1177/2165079917701139.
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For the past 75 years, the American Association of Industrial Nurses, and later the American Association of Occupational Health Nurses, has advocated for occupational and environmental health nurses by supporting quality undergraduate and graduate education in the specialty and certification through the American Board of Occupational Health Nurses, Inc., and providing funding for and dissemination of occupational health nursing research as well as by developing occupational health nursing practice standards, competencies, and code of ethics.
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Sturm, Bonnie A., and Jane C. Dellert. "Exploring nurses' personal dignity, global self-esteem and work satisfaction." Nursing Ethics 23, no. 4 (February 9, 2015): 384–400. http://dx.doi.org/10.1177/0969733014567024.
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Background: This study examines nurses’ perceptions of dignity in themselves and their work. Nurses commonly assert concern for human dignity as a component of the patients’ experience rather than as necessary in the nurses’ own lives or in the lives of others in the workplace. This study is exploratory and generates potential relationships for further study and theory generation in nursing. Research questions: What is the relationship between the construct nurses’ sense of dignity and global self-esteem, work satisfaction, and identified personal traits? Participants and research context: This cross-sectional correlation study used a stratified random sample of nurses which was obtained from a US University alumni list from 1965 to 2009 ( N = 133). Ethical considerations: University Institutional Review Board approval was achieved prior to mailing research questionnaire packets to participants. Participation was optional and numerical codes preserved confidentiality. Findings: Statistical results indicated a moderately strong association between the nurse’s sense of personal dignity and self-esteem ( rx = .62, p = .000) with areas of difference clarified and discussed. A positive but moderate association between nurses’ personal dignity and nurses’ work satisfaction ( rx = .37, p = .000) and a similar association between self-esteem and nurses’ work satisfaction ( rs = .29, p = .001) were found. A statistically significant difference was found ( F = 3.49 ( df = 4), p = .01) for dignity and categories of spiritual commitment and for nurses’ personal dignity when ratings of health status were compared ( F = 21.24 ( df = 4), p = .000). Discussion: Personal sense of dignity is discussed in relation to conceptual understandings of dignity (such as professional dignity) and suggests continued research in multiple cultural contexts. Conclusion: The relationships measured show that nurses’ sense of dignity has commonalities with self-esteem, workplace satisfaction, spiritual commitment, and health status; the meaning of the findings has ramifications for the welfare of nurses internationally.
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Hold, Judith L. "A good death." Nursing Ethics 24, no. 1 (August 3, 2016): 9–19. http://dx.doi.org/10.1177/0969733015602051.
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Background: On a day to day basis, nurses are facing more ethical dilemmas during end-of-life care resulting in not being able to actualize a good death for patients. Research objective: The purpose of this study was to explore how experienced hospice nurses resolve day to day ethical dilemmas during end-of-life care. Research design: The study used a qualitative narrative approach. Participants: Through purposeful sampling, a total of six experienced hospice nurse participated. Ethical considerations: Approval from the researcher’s university Institutional Review Board for ethical review was obtained. Findings: Using core story creation, several different ethical dilemmas were identified divulging struggles with key stakeholders including family members and providers. Thematic analysis generated three main themes: Ethics within Practice, Ethical Knowledge, and Ethical Solutions. Discussion: The participants told their stories depicting a keen awareness of ethical conflicts situated by contextual factors including social, political, and personal issues. The nurses’ deliberations were informed through formal, experiential, and intuitive knowledge. Ethical predicaments were resolved by either following rules or choosing acts of resistance. Conclusion: A better understanding was obtained on how experienced hospice nurses successfully resolve ethical dilemmas culminating in better deaths for patients.
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Ko, Hsun-Kuei, Hui-Chen Tseng, Chi-Chun Chin, and Min-Tao Hsu. "Phronesis of nurses: A response to moral distress." Nursing Ethics 27, no. 1 (April 11, 2019): 67–76. http://dx.doi.org/10.1177/0969733019833126.
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Background: As moral action could help nurses reduce moral distress, it is necessary to carry out qualitative research to present the experiences in which nurses apply moral action. Aim: To describe and analyze the phronesis applied by nurses in the face of moral distress. Research design: The research participants were invited to participate in in-depth interviews. The research materials were based on the stories described by the research participants and recorded by means of first-person narrative. Narrative analysis was applied to interpret the nurses’ phronesis. Participants: Twenty-seven nurses from Taiwan. Ethical considerations: The Institutional Review Board of the Kaohsiung Medical University Hospital in Taiwan confirmed that this study passed the research ethical review. Findings: According to the narrative analysis results, the phenomenon of moral distress contains difficulty, action, and idea transformation. The difficulty is the source of moral distress, action is the practice of moral courage, and idea transformation is the nurse’s emotional movement. Action and idea transformation are collectively called phronesis in this study. Discussion: Moral distress refers to a state of suffering caused by situations in which nurses cannot carry out their ethical intentions. Phronesis is the process through which nurses take actions and relocate the subjects and is an ethical way to find relief from moral distress. Starting with empathy and respectful attitudes arising from self-reflection, nurses may be helped to get relief from the suffering of moral distress. Conclusion: Phronesis can help nurses positively face the emotional strain of moral distress. This article puts forward a narrative method to complete the four steps of phronesis: write about the care experience, identify the difficulties in the stories, seek the possibility of action, and form a new care attitude, which could help nurses learn to reduce their moral distress.
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Boyal, Amunpreet, and Alistair Hewison. "Exploring senior nurses’ experiences of leading organizational change." Leadership in Health Services 29, no. 1 (February 1, 2016): 37–51. http://dx.doi.org/10.1108/lhs-03-2015-0005.
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Purpose – The aim of this paper is to explore Senior nurses’ experiences of leading organizational change. There is a substantial literature reporting middle-level nurse managers’ experiences of change; however, there is less evidence concerning senior nurses’ perspectives. In view of this, interview data collected from senior nurses, as part of a study of major organizational change, were analysed to redress this imbalance. Design/methodology/approach – In-depth semi-structured interviews (n = 14) were conducted with senior nurses (between 2009 and 2012). Findings – Senior nurses’ activity centred on leadership and workforce issues, internal influences and external pressures. In periods of change, appropriate leadership was vital, and “weak” leaders were considered to have an adverse effect on teams. Concerns were expressed about financial strictures and their impact on patient care and service provision. The senior nurses were striving to provide the best quality of service delivery with the limited resources available. Concentration on operational matters was necessary to maintain stability in periods of change. However, this prevented senior nurses from influencing strategic decision-making in their organizations. Practical implications – If senior nurses are to realise their potential to operate at a strategic level, they need to be given time and support to lead, rather than just react to change. This research emphasises the importance of a “nursing voice” to inform board-level decisions and maintain a focus on patient care. Originality/value – This research sheds light on the work of a key group of staff in health-care organizations. Understanding senior nurses’ experience of and contribution to change is a useful contribution to health services research.
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Danaci, Esra, and Zeliha Koç. "The association of job satisfaction and burnout with individualized care perceptions in nurses." Nursing Ethics 27, no. 1 (April 9, 2019): 301–15. http://dx.doi.org/10.1177/0969733019836151.
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Background: Individualized care is closely related to the fulfillment of nurses’ ethical responsibilities regarding the provision of healthcare as well as having a strong foundation in the philosophy of nursing. Objective: This study aimed to determine the association of job satisfaction and burnout with individualized care perceptions in nurses working at a university hospital located in the Central Black Sea region of northern Turkey. Research design: A cross-sectional correlational survey design. Participants and research context: The study was conducted between 15 February 2017 and 15 August 2017 with 419 nurses working at a public university hospital located in Samsun. Data were collected using an information form, the Individualized Care Scale-Nurse Version, the Minnesota Job Satisfaction Scale, and the Maslach Burnout Inventory. The Mann–Whitney U test, Kruskal–Wallis test and Spearman Correlation were used. Ethical considerations: Ethical approval for the study was obtained from the Ondokuz Mayıs University Clinical Studies Board of Ethics. Oral informed consent was taken from the participants. Findings: There was a significant positive relationship between the total Individualized Care Scale-A Nurse Version score and the General Satisfaction subscale score of the Minnesota Job Satisfaction Scale (r = 0.121, p < 0.05). The total Individualized Care Scale-A Nurse Version score increased as the General Satisfaction subscale score of the Minnesota Job Satisfaction Scale increased. There was a significant negative relationship between the total Individualized Care Scale-B Nurse Version score and the Desensitization (r = –0.143, p < 0.01) and Personal Achievement subscale scores of the Maslach Burnout Inventory (r = –0.182, p < 0.01). The Desensitization and Personal Achievement subscale scores of the Maslach Burnout Inventory increased as the total Individualized Care Scale-B Nurse Version score decreased. Discussion: Factors associated with the individualized care perceptions of nurses, such as job satisfaction and burnout levels and factors related to personal life and worklife should be taken into consideration. Also in order to increase job satisfaction and motivation in nurses, personal preferences regarding the service they want to work at should be taken into account. Conclusion: Nurses with lower burnout and higher job satisfaction were found to have higher individualized care perceptions and to support the individuality of patients in care applications. It is important to consider work-related factors associated with individualized care perceptions, job satisfaction, and burnout in nurses.
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Lamb, Christina, Yolanda Babenko-Mould, Marilyn Evans, Carol A. Wong, and Ken W. Kirkwood. "Conscientious objection and nurses: Results of an interpretive phenomenological study." Nursing Ethics 26, no. 5 (April 3, 2018): 1337–49. http://dx.doi.org/10.1177/0969733018763996.
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Background: While conscientious objection is a well-known phenomenon in normative and bioethical literature, there is a lack of evidence to support an understanding of what it is like for nurses to make a conscientious objection in clinical practice including the meaning this holds for them and the nursing profession. Research question: The question guiding this research was: what is the lived experience of conscientious objection for Registered Nurses in Ontario? Research design: Interpretive phenomenological methodology was used to gain an in-depth understanding of what it means to be a nurse making a conscientious objection. Purposive sampling with in-depth interview methods was used to collect and then analyze data through an iterative process. Participants and research context: Eight nurse participants were interviewed from across practice settings in Ontario, Canada. Each participant was interviewed twice over 9 months. Ethical considerations: This study was conducted in accordance with Health Science Research Ethics Board approval and all participants gave consent. Findings: Six themes emerged from data analysis: encountering the problem, knowing oneself, taking a stand, alone and uncertain, caring for others, and perceptions of support. Discussion: This study offers an initial understanding of what it is like to be a nurse making a conscientious objection in clinical practice. Implications for nursing practice, education, policy, and further research are discussed. Conclusion: Addressing ethical issues in nursing practice is complex. The need for education across nursing, healthcare disciplines and socio-political sectors is essential to respond to nurses’ ethical concerns giving rise to objections. Conscience emerged as an informant to nurses’ conscientious objections. The need for morally inclusive environments and addressing challenging ethical questions as well as the concept of conscience are relevant to advancing nursing ethics and ethical nursing practice.