"Spinning Their Wheels "-Influences That Shape How Nurse Educators Teach Social Justice.

Despite institutional claims that social justice is a core professional nursing value, efforts to fulfill this claim remain uneven. The purpose of this study was to examine the circumstances that shape nursing educators' approaches to social justice. In-depth semi-structured interviews with 28 educators teaching theory courses in baccalaureate nursing programs shed light upon the influences that shape how educators integrate social justice. These include formative experiences, institutional factors, and curricular opportunities. Formative experiences include upbringing, educational background, and preparation to teach. Institutional factors consist of the type of institution, geographic location, and the specter of retention, promotion, and tenure. Finally, curricular opportunities and fit include the positioning of Community Health Nursing, fragmentation and tension between "content and context," and the "driving force" of the National Council Licensure Examination for Registered Nurses (NCLEX). Findings indicate that the capacity to uphold the value of social justice is shaped by experiences across the lifespan, institutional policies, and practices related to faculty hiring, development, career advancement, as well as curricular vision. This study calls for a concerted effort to enact social justice nursing education.

Moral distress in undergraduate nursing students: A systematic review.

BACKGROUND: Nurses and nursing students appear vulnerable to moral distress when faced with ethical dilemmas or decision-making in clinical practice. As a result, they may experience professional dissatisfaction and their relationships with patients, families, and colleagues may be compromised. The impact of moral distress may manifest as anger, feelings of guilt and frustration, a desire to give up the profession, loss of self-esteem, depression, and anxiety. OBJECTIVES: The purpose of this review was to describe how dilemmas and environmental, relational, and organizational factors contribute to moral distress in undergraduate student nurses during their clinical experience and professional education. RESEARCH DESIGN: The research design was a systematic literature review. METHOD: The search produced a total of 157 articles published between 2004 and 2014. These were screened with the assessment sheet designed by Hawker and colleagues. Four articles matched the search criteria (one quantitative study and three qualitative), and these were separately read and analyzed by the researchers. The process of review and analysis of the data was supervised by a colleague experienced in moral distress who provided an independent quality check. ETHICAL CONSIDERATION: Since this was a systematic review, no ethical approval was required. FINDINGS: From the analysis, it emerged that inequalities and healthcare disparities, the relationship with the mentor, and students' individual characteristics can all impact negatively on the decisions taken and the nursing care provided, generating moral distress. All these factors condition both the clinical experience and learning process, in addition to the professional development and the possible care choices of future nurses. CONCLUSION: Few studies dealt with moral distress in the setting of nurse education, and there is a knowledge gap related to this phenomenon. The results of this review underline the need for further research regarding interventions that can minimize moral distress in undergraduate nursing students.

Privacidade e confidencialidade em saúde na vigilância epidemiológica: relato de experiência sob o olhar bioético / Privacy and confidentiality in health in epidemiological surveillance: experience report on bioethical look

Durante experiência de trabalho em vigilância epidemiológica, na Bahia, entre as atividades desenvolvidas, destaca-se a notificação compulsória de agravos e doenças. O estudo da disciplina Bioética em Ciência da Saúde, do Programa de Pós Graduação em Enfermagem e Saúde, nível de Mestrado, mobilizou-nos à retomada de vivências cotidianas nos serviços de saúde que envolve questões bioéticas e que merece reflexão crítica. O presente estudo teve como objetivo desenvolver uma reflexão, segundo a perspectiva bioética, sobre a experiência vivenciada, envolvendo privacidade e confidencialidade em saúde, no contexto da vigilânciaepidemiológica. Trata-se de estudo descritivo da vivência em atividade de notificação compulsória no serviço de vigilância epidemiológica da Secretaria Municipal de Saúde de município da Bahia, no período de novembro de 2011 a março de 2013. Permitiu-nos perceber que a negligência na aplicação de princípios bioéticos no âmbito da notificação compulsória pode interferir na saúde do usuário, pois não garante a integridade de seus direitos e reflete a inadequação da ambiência para os atendimentos e o despreparo dos profissionais, no que se refere ao conhecimento teórico-prático de bioética

During work experience in epidemiological surveillance, Bahia, between the activities, there is mandatory reporting of injuries and Illnesses. The study of the discipline of Health Scienc and in Bioethics, the Graduate Program in Nursing and Health, Master level, mobilized us to the resumption of daily experiences in health services Involving bioethical issues que deserve critical reflection. The present study Aimed to develop the reflection, According to bioethical perspective on the lived experience Involving privacy and confidentiality in health, in the context of epidemiological surveillance. This is a descriptive study of the experience of Mandator y reporting on activity in the epidemiological surveillance service of the Municipal Health Secretariat of the state of Bahia, in the period november 2011 to march 2013.Allowed us to perform que negligence in the application of bioethical principles under compulsory notification may interfere with the health of the user, it does not guarantee the integrity of Their Rights and Reflects the inadequacy of ambience for consultations and the unpreparedness of professionals, with regard to the theoretical and practical knowledge of bioethics.

Nursing students' perceptions toward the nursing profession from clinical practicum in a baccalaureate nursing program-a qualitative study.

The purpose of this study was to explore senior nursing students' perceptions toward the nursing profession and their experiences in clinical practicum in Taiwan. This study used semistructured interview guides and unstructured face-to-face dialogue with the participants based on a qualitative method. A purposive sample with a snowball method from a baccalaureate nursing program in Southern Taiwan was used to recruit participants. A total of 30 senior nursing students participated in this study. Data were collected from February to May 2011. The interviews were transcribed verbatim, and data were analyzed based on the phenomenological approach of qualitative methodology. Data were categorized into three major themes: in-depth recognition of nursing, recognition of the meaning and value of life, and decision conflicts for being a nurse. The findings of the study not only help nursing educators further understand the educational effects of clinical practicum, but also provide information for managers of medical organizations to recruit and train newly graduated nurses.

Bioethics education of nursing curriculum in Korea: a national study.

The aim of this study is to examine the current profile of bioethics education in the nursing curriculum as perceived by nursing students and faculty in Korea. A convenience sampling method was used for recruiting 1223 undergraduate nursing students and 140 nursing faculty in Korea. Experience of Bioethics Education, Quality of Bioethics Education, and Demand for Bioethics Education Scales were developed. The Experience of Bioethics Education Scale showed that the nursing curriculum in Korea does not provide adequate bioethics education. The Quality of Bioethics Education Scale revealed that the topics of human nature and human rights were relatively well taught compared to other topics. The Demand for Bioethics Education Scale determined that the majority of the participants believed that bioethics education should be a major requirement in the nursing curriculum. The findings of this study suggest that bioethics should be systemically incorporated into nursing courses, clinical practice during the program, and during continuing education.

Nursing values in China: the expectations of registered nurses.

Abstract The purpose of this study was to identify the essential professional values of Chinese nurses and their manifestations in the current health-care environment. Data were collected from 29 nurse experts by semi-structured individual interviews or focus groups in Beijing and Shanghai, China. Thematic analysis was used to analyze the data. Seven themes were identified: altruism, caring, trustworthiness, dignity, responsibility for the development of the profession, autonomy, and justice. On the whole, these values were in accordance with the codes of the International Council of Nurses and the Chinese Nursing Association. Additionally, culture and socioeconomic trends were found to have an influence on nurses' understanding and explanation of professional values. The findings of this study provided insight into Chinese nurses' professional values and might contribute to the future development of a culturally sensitive scale to measure nursing values in China.

The ethics of nursing student international clinical experiences.

This article explores the motivations for offering international nursing student experiences and the reasons students choose to participate. Students should prepare by learning cultural humility rather than cultural competency, and they should be oriented to the ethical responsibility implicit in caring for those in developing countries. Programs that provide these experiences need to be developed with an eye to sustainability so the lives of those receiving care will be enriched after the students go home.

Interactional justice in student-staff nurse encounters.

The focus of this article is on nursing students' perceptions of interactional justice during student-staff nurse encounters. A descriptive survey using a combined questionnaire on interactional justice was used to collect the data. Reliability analysis for the theoretical dimensions of interactional justice revealed a Cronbach's alpha value greater than 0.70. The student nurses perceived staff nurses to be interactionally unjust during their contact with them. Significant differences were observed between interactional justice and some demographic characteristics of students. Fourth year students perceived staff to provide better justifications for decisions that affect them than third and second year students. Although black students, in contrast to white students, perceived clinical staff as significantly more truthful, these results are inconclusive. Students who engage for longer periods of time in the clinical learning context perceived their relationships and how they are treated by clinical staff as more just. Recommendations for further research are made.

The ethical basis of teaching spirituality and spiritual care: a survey of student nurses perceptions.

BACKGROUND: There is a professional requirement for student nurses to achieve competence in the delivery of spiritual care. However, there is no research exploring students nurses perceptions of being educated in these matters. AIM: This paper explores the ethical basis of teaching student nurses about the concepts of spirituality and spiritual care by reporting the findings from the first year of a 3 year investigation. DESIGN: An exploratory longitudinal design was used to obtain student nurses perceptions of spirituality and spiritual care as they progressed through a 3 year programme. METHOD: A questionnaire incorporating the Spirituality and Spiritual Care Rating Scale was distributed to 176 pre-registration nursing students undertaking either the Advanced Diploma or Bachelor of Science degree programmes. RESULTS: A response rate of 76.7% was obtained. Findings reveal that the majority of student nurses perceived spirituality to be a universal phenomenon of a type that can be associated with existentialism. Some students were very uncertain and apprehensive about being instructed in spiritual matters. CONCLUSION: A cohort of student nurses held similar understandings of spirituality to those presented in the nursing literature. However the results also suggest an overwhelming majority felt it was wrong for spirituality to imply that some people are better than others and most were uncertain whether spirituality was related to good and evil. RELEVANCE TO NURSE EDUCATION: The investigation reveals that there are a number of ethical concerns surrounding the teaching of spirituality to student nurses that need to be resolved.

Teaching spiritual care in a public institution: legal implications, standards of practice, and ethical obligations.

This article reviews the status of teaching spiritual care in a public institution of higher education. The resurgence of interest in spiritual care across the United States has spurred interest and expanded theories of spirituality within the nursing profession. Nursing education rose to the challenge of teaching spiritual care theories and interventions to students, despite the absence of policy to guide educators. However, differences between public and private educational institutions have led to variations in the teaching of spiritual care. In addition to the legal implications stemming from the need for separation of church and state, nurses must also be aware of their ethical obligations in order to teach spiritual care concepts appropriately. The accrediting agencies for nursing education programs and hospitals, as well as state licensure boards, foster high expectations for nurses to provide spiritual care. A call for research and policy development to guide nurse educators is also addressed in this article.

On being of good character: nurse education and the assessment of good character.

The Nursing and Midwifery Council sets good character as a condition not only of entry to the UK register of nurses but also for entry to and continuation on pre-registration nursing programmes in the UK. This requires education providers to assess the character of potential and actual nursing students yet the guidance offered by the NMC for making such assessments is insufficiently developed and serves to provide criteria by which determination can be made of good character only in a narrow sense. Assessment of character requires making value judgements about others and lends support to the idea that nurse education has an explicit moral component. This paper outlines some of the difficulties in assessing character, explores the idea that good character can be assessed in both a thin and a thick sense, and considers some of the consequent implications for nurse educationalists.

High tech cheating.

The use of technology has enhanced the convenience, flexibility, and efficiency of both preparatory and continuing education. Unfortunately, academic dishonesty, including plagiarism, has shown a positive correlation with the increased use of technology in education. A review of the literature related to unintended outcomes of the use of technology in nursing education and continuing education was conducted to determine the ethical implications for the nursing profession. Although nursing research dealing with academic and professional misconduct is sparse, evidence suggests that academic dishonesty is a predictor of workplace dishonesty. Given this correlation between unethical classroom behavior and unethical clinical behavior, efforts to staunch academic dishonesty may help allay professional misconduct. A combination of high tech and low tech methods may be used to minimize unethical behaviors among students and practicing professional nurses in order to maintain the integrity of the profession.

Moral content and assignment marking: an exploratory study.

This small scale exploratory survey investigates the relation between the moral content of student assignments and potential marking behaviour by lecturers. A questionnaire containing a number of deliberately discriminatory statements was sent to a sample of nurse academics, and participants were asked to indicate whether the inclusion of these statements might affect the mark awarded. The sample was too small to undertake tests of statistical significance. However, the results tentatively suggest that a majority of participants would penalise assignments that contain morally questionable statements, and many would cite the code of professional conduct in justification. There appeared to be little difference in the response to statements that offered opinions (normative) or described actions (descriptive). However, differences between responses to statements discriminating against different groups were apparent, with racist statements being penalised more often and with greater severity than other categories. Qualitative data support the quantitative data. Several areas for discussion are identified, including the academic status of nursing, the use of the code of professional conduct, the moral claims made for nurses, a potential 'hierarchy of wrongness', student self censorship, and inconsistency in marking. Further research is justified.

A Q-methodological study on nursing students' attitudes toward nursing ethics.

PURPOSE: Professional nursing ethics is a living, dynamic set of standards for nurses'professional moral behavior. Furthermore, in daily clinical nursing training, nursing students are constantly confronted with decision-making that is moral in nature. The aim of this study was to identify the perceived ethical attitudes in the clinical training process of senior nursing students using Q-methodology to offer basic strategies for nursing ethics education and thereby improve patients'care. METHODS: Q-methodology provides a scientific method for identifying perception structures that exist within certain individuals or groups. Thirty-seven participants in a university rated 38 selected Q-statements on a scale of 1-9. The collected data were analyzed using pc-QUNAL software. RESULTS: Principal component analysis identified 3 types of ethical attitudes in nursing students in Korea. The categories were labeled Sacred-life, Science-realistic and Humane-life. Sacred-life individuals think that a life belongs to an absolute power (God), not a man, and a human life is a high and noble thing. Science-realistic individuals disagreed that allowing an induced abortion or embryo (human) duplication is unethical behavior that provokes a trend, which takes the value of a life lightly; most of them took a utilitarian position with respect to ethical decisions. Humane-life individuals exhibit a tendency toward human-centered thought with respect to ethical attitudes. CONCLUSION: This study will be of interest to educators of students of nursing and hospital nursing administrators. Also, the findings may provide the basis for the development of more appropriate strategies to improve nursing ethics education programs.