Unmet Needs for Clinical Ethics Support Services in Nurse: Based on focus group interviews

Abstract

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.