[Do We Need More Indigenous Nurses?]

Data collected over the past four decades show the life expectancy of indigenous Taiwanese to be 8 to 10 years lower than the general, predominantly Han Chinese, population. This suggests the persistence of inequities in the public health system in Taiwan. Several facets of this issue, including lack of consideration of the characteristics and lifestyle of ethnic populations in health policy planning and implementation work and the continued location-based focus of medical care resource distribution policies, are being actively discussed. However, investigations of factors related to the relatively poor health status of indigenous Taiwanese have not considered the traumatic and lingering effects of colonisation. This article briefly introduces the health status of indigenous Taiwanese and the indigenous nursing workforce and then presents a review of the literature on factors related to the under-representation of indigenous Taiwanese in nursing programs and the nursing workforce. Indigenous Taiwanese were found to be absent from public-health policymaking. Moreover, indigenous-related traditional knowledge and values are not being effectively transmitted to younger generations. A diverse nursing workforce should reflect and respond to not only indigenous peoples but also the general population in Taiwan.

Translation and psychometric testing of the Polish version of the Neonatal Extent of Work Rationing Instrument (NEWRI).

OBJECTIVE: The aim of the study was to perform translation and cultural adaptation, as well as to assess the validity and reliability of the Polish version of the Neonatal Extent of Work Rationing Instrument (NEWRI) questionnaire for evaluating care rationing in neonatal intensive care units (NICUs) in Poland. MATERIAL AND METHODS: Participants were prospectively recruited at the University Clinical Hospital in Wroclaw, Poland, and the study conducted from January 2018 - June 2018. The adaptation process involved translation of survey items following the guidelines for cross-cultural translation and evaluation of psychometric properties, as well as an assessment of construct validity, reliability, and internal consistency of the NEWRI using Cronbach's alpha. RESULTS: 113 professionally active nurses (n=90) and midwives (n=23) were enrolled in the study. Cronbach's alpha for the entire instrument was 0.982. Results for subscales: life support and technology-oriented nursing care - Cronbach's alpha - 0.95, parental support and teaching and infant comfort care - 0.95, patient surveillance - 0.92, care coordination and discharge planning - 0.79. All items of the questionnaire were found to have a positive discriminatory power. CONCLUSIONS: The present findings indicate a high level of reliability and validity of the translated questionnaire, fully comparable to that of the original. The questionnaire can be used for evaluating care rationing in NICUs.

Nurses' Empathetic Behaviors: The Direct and Indirect Effect of Their Spiritual Orientation.

Spirituality and its role in nurses' performance has gained much attention from the nursing researchers. But there is still some ambiguity about its role in improving the nurses' empathetic behaviors and factors that mediate this relation. To fill these research gaps, a sample of 247 Muslim nurses in a hospital at Shiraz, Iran, were selected and studied. Data were gathered by distributing the standard questionnaires among all of the nurses. Also, structural equation modeling and ANOVA test were used to analyze the data. It was found that nurses' spiritual orientation has a positive effect on their psychological capital and empathetic behaviors. Also, it was found that their work engagement has been affected by their level of psychological capital. Moreover, there was a significant difference between the spirituality of single and married nurses, in a way that married nurses were more spiritual. As a conclusion, it can be said that nurses' empathetic behaviors are a reflection of their spiritual orientation and marriage status.

Dermatology nurses view on factors related to Danish psoriasis patients' adherence to topical drugs: a focus group study.

BACKGROUND: Topical medications are first-line treatment for mild-to-moderate psoriasis, but adherence is low, which negatively affects patients' outcomes and quality of life. Nurses can play a central role in patient care, particularly in improving adherence. OBJECTIVES: To explore the experience of dermatology nurses with psoriasis patients' adherence to topical drugs. METHODS: We conducted a semi-structured focus group study with 6 dermatology nurses and 2 dermatology nursing students. Participants were recruited from a dermatology hospital outpatient clinic. Data were analyzed by a systematic text condensation method with a phenomenological-hermeneutic approach. RESULTS: Nurses experienced that factors such as social inequality, patient-centered nursing, and patients' quality of life can have an influence on adherence. CONCLUSION: Optimal adherence to topical treatments is a complex exercise and is influenced by many different factors. Involving nurses when prescribing topical treatments may be beneficial since they are one of the most trustworthy professions and have a holistic view on psoriasis severity, patient preferences, health care resources available and socioeconomic factors.

Mindfulness Workshops Effects on Nurses' Burnout, Stress, and Mindfulness Skills.

Burnout decreases work performance and quality of care and can result in medical errors, lower patient satisfaction, and higher rates of turnover. A study of 68 000 registered nurses showed that 35% of hospital nurses were experiencing symptoms of burnout. A systematic review identified that mindfulness-based interventions for health care professionals reduced stress and burnout and increased self-compassion and general health. However, the authors determined that more high-quality research is needed. This study examined the impact of a 4-hour workshop on burnout syndrome, perceived stress, and mindfulness skills. The objective of this study was to determine whether a 4-hour mindfulness workshop was effective in reducing burnout and perceived levels of stress and increasing mindfulness. Nurses at a Midwest academic medical center were recruited through e-mail to attend a 4-hour mindfulness workshop. Participants completed the Maslach Burnout Inventory-Human Service Survey, Perceived Stress Scale, and Cognitive and Affective Mindfulness Scale-Revised prior to the start of the workshop and 1 and 6 months after the workshop. The study design allowed for comparisons preintervention and postintervention. Of the 52 nurses who completed the baseline questionnaires, 94% were female with an average age of 38 years. Thirty-one percent completed the questionnaires at 1 month and 20 nurses at 6 months. At 1 month, nurses reported statistically significant decreased perceptions of stress (-2.31, P = .01) and emotional exhaustion (-4.78, P = .03). Mindfulness skills, personal accomplishment, and depersonalization improved but were not statistically significant. At 6 months, statistically significant findings included increased perceptions of mindfulness (2.50, P = .04), personal accomplishment (4.43, P = .04), and decreased emotional exhaustion (-6.21, P = .05). Perceptions of stress and depersonalization improved but were not statistically significant. In this study, nurses reported decreases in burnout and perceived stress and increases in mindfulness after attending a 4-hour mindfulness workshop. Further research is needed to determine the long-term impact of mindfulness-based training on nurses' burnout, stress, and mindfulness skills. The results of this study add to the body of literature that supports the benefits of mindfulness-based interventions.

The relationship between psychological resilience, burnout, stress, and sociodemographic factors with depression in nurses and midwives during the COVID-19 pandemic: A cross-sectional study in Turkey.

PURPOSE: This study aims to determine the relationship between psychological resilience, burnout, stress, and sociodemographic factors with depression in nurses and midwives during the coronavirus disease 2019 pandemic. DESIGN AND METHOD: This cross-sectional study included 377 midwives and nurses. RESULTS: The prevalence of depression in midwives and nurses in our sample was 31.8%. In the logistic regression analysis, the risk of depression in midwives was 1.92 times higher than that of nurses. A high perceived stress score increased the risk of depression by 1.16 times, and a high emotional exhaustion score increased the risk of depression by 1.11 times. A high psychological resilience score was found to be protective against depression (<0.001). PRACTICE IMPLICATIONS: The results showed that one-third of midwives and nurses had symptoms of depression.

Nurses' Attitudes Towards Death and Their Effects on Spirituality and Spiritual Care.

This study aimed to determine the effect of nurses' attitudes towards death on spirituality and spiritual care. This is a descriptive and correlational study. There was a moderate correlation between the total score on the Spirituality and Spiritual Care Rating Scale and the total and subdimension scores on the Attitude Towards Death Scale. It was found that the scores on the subdimensions of objective acceptance, escaping/acceptance and fear of death explained 41.7% of nurses' perceptions of spirituality and spiritual care. For holistic nursing care, it is very important that nurses are aware of their patients' spiritual needs and are capable of providing supportive spiritual service without regard for their own attitudes towards or spiritual thoughts about death.

Identifying optimal labor and delivery nurse staffing: The case of cesarean births and nursing hours.

BACKGROUND: Numerous studies have identified a relationship between nurse staffing and adverse patient outcomes in medical / surgical patient populations. However, little is known about the impact of labor and delivery (L&D) nurse staffing and adverse birth outcomes, such as unintended cesarean delivery, in low-risk term-gestation women. PURPOSE: We examined nurse staffing patterns on the likelihood of cesarean sections (C-sections) among low- risk, full gestation births and provided a testing framework to distinguish optimal from ineffective levels of nurse staffing. METHODS: This retrospective descriptive study used hours of productive nursing time per delivery as the treatment variable to determine direct nursing time per delivery and its impact on the likelihood of a C-section. For comparisons, we also assessed the likelihood of augmentations and of inductions, as well as the number of neonatal intensive care unit (NICU) hours per birth. We limited our sample to those births between 37 and 42 weeks of gestation. Two complimentary models (the quadratic and piecewise regressions) distinguishing optimal staffing patterns from ineffective staffing patterns were developed. The study was implemented in eleven hospitals that are part of a large, integrated healthcare system in the Southwest. DISCUSSION: While a simple linear regression of the likelihood of a C-section on nursing hours per delivery indicated no statistically distinguishable effect, our 'optimal staffing' model indicated that nurse staffing hours employed by using a large sample of hospitals were actually minimizing C-sections (robustness checks are provided using similar model comparisons for the likelihood of augmentation and induction, and NICU hours). Where the optimal staffing models did not appear to be effective for augmentations, inductions, and NICU hours, we found significant differences between facilities (i.e., significant fixed effects for hospitals). In all specifications, we also controlled for weeks of gestation, race, sex of the child, and mother's age.

What is the practice of spiritual care? A critical discourse analysis of registered nurses' understanding of spirituality.

Spirituality has been a part of nursing for many centuries and represents an essential value for people, including nurses and patients. Cumulative evidence points to the positive contribution of spiritually on health and wellbeing. However, there is little clarity about what spirituality means. The literature reveals that nurses have ascribed a diversity of interpretations to spirituality. However, no studies have investigated how registered nurses construct their understanding of spirituality using a critical discourse analysis approach. Therefore, the aim of this study was to uncover how registered nurses construct their understanding of spirituality using a critical discourse analysis approach. Twenty registered nurses from a non-denominational public hospital and a faith-based private hospital were interviewed about their understanding of spirituality and practice of spiritual care. A critical discourse analysis approach was used in the examination of the interview texts to uncover underlying social and power features. Links were made between the linguistic features the registered nurses used in their interviews and the broader social context of the study. Three discourses emerged from the interview texts. These include constructing spirituality through personal religious beliefs discourse, holistic discourse and empathetic care discourse. The findings of this study have implications for nurse education and policy makers.

Self-reported disrespect and abuse by nurses and midwives during childbirth in Tanzania: a cross-sectional study.

BACKGROUND: Facility-based childbirth has increased globally. Unfortunately, there have also been reports of women experiencing disrespect and abuse by healthcare providers during childbirth. This study aimed to measure the prevalence of self-reported disrespect and abuse (D&A) by healthcare providers of women during childbirth in health facilities in Tanzania, and to clarify the factors related to D&A. METHODS: A cross-sectional survey was conducted in public health facilities of three regions in Tanzania from September 2016 to October 2016. Nurses and midwives who had ever conducted deliveries completed a 22-item section about D&A and three sections about working conditions and environment. A model for predicting D&A based on several factors such as their characteristics, working conditions, and working environment was developed by conducting multiple regression analysis. RESULTS: Thirty public health facilities in three regions within Tanzania were selected to reflect different levels of hospitals. Among 456 participants (nurses, midwives, and nursing assistants), 439 were included in the analysis. Average number of self-reported D&A out of 22 items was five, and nearly all participants (96.1%) reported enacting one form of D&A at the least and two forms of D&A at the most. About 25-44% of D&A items were in the forms related to women's experiences with childbirth psychologically. Moreover, at least 10-30% of the participants enacted some form of D&A which could directly affect the well-being of mothers and babies. D&A scores increased with an increase in 'working hours per week' and 'taking a break during evening shifts'. D&A scores decreased with an increase in the scores of the 'two components of the Index of Working Satisfaction (professional status and interaction between nurses)', and 'any type of supervision for new nurse-midwives'. CONCLUSION: Most studies about D&A of healthcare providers previously focused on the reports of women. To our knowledge, this is the first report that focused on D&A reported by healthcare providers. Working conditions and systems including personal relationships with colleagues were both positively and negatively related to D&A of healthcare providers rather than the provider's individual and facility structural characteristics.

Brazilian nurses' concept of religion, religiosity, and spirituality: A qualitative descriptive study.

Evidence points toward the impact of nurses' personal views and knowledge about religion, religiosity, and spirituality on health care. This qualitative research investigates nurses' concepts of religion, religiosity, and spirituality and how they use these concepts in practice. Thirty-four nurses were interviewed at a hospital in the state of São Paulo, Brazil. Content analysis was used to organize and code the results. Three main themes generated from the interviews were (i) religiosity/spirituality as an important dimension in life; (ii) notions of religiosity and spirituality; (iii) formal knowledge of the concept of religion, religiosity, and spirituality. The results indicate that religion, religiosity and spirituality should be incorporated into nurse training to improve the comprehension and competence of nurses in these areas of practice. It is recommended that to ensure holistic and person-centered care, there must be constant reflection on these concepts.

Integrating the "best" evidence into nursing of venous thromboembolism in ICU patients using the i-PARIHS framework.

OBJECTIVES: To explore how to integrate the "best" practice into nursing of venous thromboembolism (VTE) based on the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. METHODS: A mixed-methods design was used. A steering group for clinical evidence implementation (EI) was established to conduct pre-implementation baseline surveys, a thorough analysis of the evidence, and an analysis of the survey results. The hindering and enabling factors associated with the clinical implementation of the evidence were analysed based on the three core elements of i-PARIHS, to formulate the clinical implementation plan for VTE nursing evidence. On-site expert reviews and focus group interviews were used to evaluate the feasibility of the draft plan, make adjustments, and finalize the evidence-based practice plan, which was then put into practice and evaluated. RESULTS: A new nursing process, a health education manual and a nursing quality checklist on VTE has been established and proved to be appropriate through the implementation. Compliance with evidence related to VTE nursing increased significantly in the two units, with better compliance in unit B than unit A. The knowledge, attitude and behaviour scores for VTE nursing increased substantially in both nurses and patients. CONCLUSION: The EI programme of incorporating the "best" evidence on VTE nursing into clinical practice using the i-PARIHS framework demonstrated feasibility, appropriateness and effectiveness and could serve as a reference.

Light-emitting diode photobiomodulation therapy for non-specific low back pain in working nurses: A single-center, double-blind, prospective, randomized controlled trial.

BACKGROUND: Low back pain (LBP) affects approximately 51% to 57% of hospital nurses and nurses' aides in Europe. New high-risk groups include home- and long-term-care nurses and physiotherapists. A number of European countries are experiencing a shortage of healthcare workers. Light therapy has been shown to be an effective treatment for various musculoskeletal disorders, including lateral epicondylitis, temporomandibular joint pain, carpal tunnel syndrome, and delayed-onset muscle soreness. A systematic review and meta-analysis demonstrated that low-level laser therapy is an effective method for relieving non-specific chronic low back pain (NSCLBP). However, the efficacy of light-emitting diode (LED) therapy for NSCLBP is disputed. This study aims to evaluate the effect of LED therapy on NSCLBP. METHODS AND ANALYSIS: We conducted a prospective, double-blind, randomized placebo-controlled trial of 148 patients with NSCLBP. The patients were randomly assigned to 2 groups: intervention group, where patients received LED photobiomodulation therapy 3 times a week for 2 weeks, and the sham group, where patients had sham therapy 3 times a week for 2 weeks. Primary outcome measures included the visual analog scale for pain, lumbar active range of motion assessments, and chair-rising times. Secondary outcome measures included a multidimensional fatigue inventory, fear-avoidance beliefs questionnaire, and the Oswestry disability index. The outcome measures were assessed before therapy and 2weeks, 4 weeks, 8 weeks, 12 weeks, and 6 months after the first interventions were completed. DISCUSSION: This study is a prospective, single-center, double-blind, randomized, controlled study. This study aims to research the efficacy of a 2-week LED program for NSCLBP working nurse. Our results will be useful for patients, working nurses, nurses' aides, and other healthcare workers with chronic low back pain. TRIAL REGISTRATION NUMBER: NCT04424823.

Experiences of registered nurse prescribers; a qualitative study.

Aims: This study aimed to investigate the experiences of registered prescribers and their perceptions of the enablers and barriers to registered prescribing and the value of this fledgling role. Background: The role of prescribing has been extended to registered nurses in New Zealand. By adding the designated prescribing role to a nurse's role, their scope of practice expands and nurses are able to provide patients with holistic care while achieving greater independence and role satisfaction. Yet new nurse prescribers can experience anxiety and fear when confronted with the reality of the responsibility of prescribing. Methods: Sixteen semi-structured interviews were conducted with registered nurse prescribers across New Zealand. Data were analysed using a general inductive approach and thematic analysis utilised to identify themes and sub-themes. Results: Sixteen registered nurse prescribers participated in the study. Three main themes emerged with sub-themes: ability to expand practice, improving access to care, and importance of working in a collaborative team. Participants explained how they enjoyed the challenge and responsibility of the new prescribing role yet were frustrated with the realities of the restrictions of what they could actually prescribe and in some cases lack of role recognition. Registered nurse prescribing also improved access to care as nurses felt they provided more comprehensive care, resulting in reduced wait times, better continuity of care and a reduction in patient costs. The participants highlighted the importance of working in a collaborative team and believed their ability to prescribe maximised clinician time, however cautioned the need for on-going clinical mentorship and a prepared and supportive work environment. Conclusions: The addition of registered nurse prescribing provides a number of advantages to individual nurses in terms of career development and job satisfaction, and to patients and the health care system. The benefits to health care consumers and the health care system align directly to health care priorities of improving equity and access to care. Impact statement: Registered nurse prescribers perceive a number of advantages to the addition of prescribing to their own practice and benefits to patients and the health care system by enabling more accessible and cost-effective care.

Metabolomics Research Conducted by Nurse Scientists: A Systematic Scoping Review.

Metabolomics, one of the newest omics, allows for investigation of holistic responses of living systems to myriad biological, behavioral, and environmental factors. Researcher use metabolomics to examine the underlying mechanisms of clinically observed phenotypes. However, these methods are complex, potentially impeding their uptake by scientists. In this scoping review, we summarize literature illustrating nurse scientists' use of metabolomics. Using electronic search methods, we identified metabolomics investigations conducted by nurse scientists and published in English-language journals between 1990 and November 2019. Of the studies included in the review (N = 30), 9 (30%) listed first and/or senior authors that were nurses. Studies were conducted predominantly in the United States and focused on a wide array of clinical conditions across the life span. The upward trend we note in the use of these methods by nurse scientists over the past 2 decades mirrors a similar trend across scientists of all backgrounds. A broad range of study designs were represented in the literature we reviewed, with the majority involving untargeted metabolomics (n = 16, 53.3%) used to generate hypotheses (n = 13, 76.7%) of potential metabolites and/or metabolic pathways as mechanisms of clinical conditions. Metabolomics methods match well with the unique perspective of nurse researchers, who seek to integrate the experiences of individuals to develop a scientific basis for clinical practice that emphasizes personalized approaches. Although small in number, metabolomics investigations by nurse scientists can serve as the foundation for robust programs of research to answer essential questions for nursing.

Validity and reliability of the Turkish version of the Nurse Spiritual Care Therapeutics Scale.

OBJECTIVE: This study was conducted to evaluate the validity and reliability of the "Nurse Spiritual Care Therapeutics Scale" in Turkish nurses. METHOD: This study was a psychometric design. A convenience sample of 249 nurses working at the Malatya Training Research Hospital completed a structured questionnaire including demographic characteristics and the Nurse Spiritual Care Therapeutics Scale (NSCTS) between August and October 2018. Principal components analysis, internal consistency reliability, and Cronbach's α were used to measure the psychometric properties of the items of the scale. RESULTS: In the evaluation of construct validity, identified one factor with eigenvalues greater than 1 explained 50.83% of the total variance. The Cronbach's α value of the scale is 0.86. SIGNIFICANCE OF RESULTS: The present study provides evidence of NSCTS's validity, reliability, and acceptability. The scale can be used by Turkish nurses. This scale should be further evaluated with a larger sample in different regions in Turkey and various populations. The scale has potential applications for use both in research and as a screening tool in clinical settings.

Performance management in primary healthcare: Nurses' experiences.

BACKGROUND: The use of the performance management (PM) system is highly contested by public servants in South Africa, although its value as essential to the appraisal and management of staff is undeniable. OBJECTIVES: The aim of this study was to explore nurses' perceptions and experiences of the PM system at primary healthcare (PHC) facilities in relation to the current health system's reforms. METHOD: An exploratory, descriptive and qualitative design was utilised. Participants were selected through purposive sampling. A semi-structured interview tool was used to collect data from 18 nurses in four sub-districts of Dr. Kenneth Kaunda district in the North West province. Data were analysed through thematic analysis. RESULTS: The findings of this study confirmed that PM is implemented to some extent. However, various loopholes in its implementation threaten the accuracy and transparency of the system and leave it vulnerable to perceived organisational injustice and unfairness, with the objectivity of the system questioned. The limitations of the current PM system revealed by this study include (1) the lack of alignment with current health system reforms towards comprehensive and integrated care that demands person-centred care; (2) the system's usefulness for career progression, performance improvement and rewarding exceptional performance. CONCLUSION: Performance management is inadequately applied in PHC facilities at district level and needs to be realigned to include the appraisal of key attributes required for the current health system's reforms towards comprehensive and integrated care, including the provision of person-centred care, which is central for responding adequately to South Africa's changing disease profile towards multi-morbidity.

Proposing a conceptual framework of spiritual care competence for Chinese nurses.

Spiritual care competence of nurses is crucial to satisfy the spiritual needs of the clients, but the dearth of conceptual frameworks has hindered the clarification of the construct, especially for nurses in the People's Republic of China. This article developed a 3*3*3 matrix framework to clarify the components of spiritual care competence for Chinese nurses through the synthesis of existing empirical and theoretical work, which includes three aspects (awareness, understanding, and application) on three levels (intrapersonal, interpersonal, and transpersonal) of three contents of spirituality (namely, worldview, connectedness, and transcendence). The proposed framework can be used as a model to promote spiritual care competence of nurses in China. Adoption of the framework to guide studies would allow for the design of interventions for the attainment of this competence.

Moving from practice to praxis: A qualitative descriptive study revealing the value of Project7 Mindfulness Pledge©.

AIM: To examine the experiences of nurses and nursing assistants who participated in a mindfulness project. BACKGROUND: Increased demands and fewer resources have become the norm in most health care settings. As a result, health care professionals face exceptional stress in their work environments and are vulnerable to burnout and compassion fatigue. Even more distressing, many new nurses are leaving their jobs within the first two years. METHODS: Qualitative interviews were conducted with nine participants to discover their experience with the project. RESULTS: The major theme, a process of moving from practice to praxis, is brought forth through in-depth descriptive analysis of nine individual interviews. The process occurred through three themes: fostering self-awareness and compassion; fostering other-awareness and compassion; and compelling transformation in the unit culture. CONCLUSIONS: This study develops an evidence base for incorporating and building mindfulness into health care environments at a time when there is a tremendous need for highly functioning practitioners. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders are encouraged to examine how they can support their staff in moving from practice to praxis as a part of improving professional well-being, retention, quality and safety in health care.

Perception of care quality and ethical sensitivity in surgical nurses.

BACKGROUND: It is stated that high ethical sensitivity positively affects the quality of nursing care. However, the relationship between nursing care quality and ethical sensitivity has not been clearly demonstrated in researches. AIM: This study was carried out to determine the relationship between surgical nurses' care behaviors and their ethical sensitivity. METHOD: The sample of this cross-sectional, descriptive-correlational study consists of 308 nurses who worked at the surgical departments in four Turkish hospitals. The data were collected using the "Nurse Description Form" developed by the researcher, "Caring Behaviours Inventory-24" and "Ethical Sensitivity Questionnaire." Data were evaluated by the Mann Whitney U test, Kruskal Wallis one-way analysis of variance and Spearman correlation analysis. ETHICAL CONSIDERATIONS: The study was approved by the ethics committee. Verbal and written consent was received from the nurses. RESULTS: It was found in the study that nurses' Caring Behaviours Inventory-24 total score median was 5.25 (4.83-5.58), nurses' perception level of caring quality was high, median of Ethical Sensitivity Questionnaire total score was 89.00 (75.00-101.00) and nurses' ethical sensitivity was moderate. A negative significant relation was found between nurses' Caring Behaviours Inventory-24 total score and Ethical Sensitivity Questionnaire total score (r = -0.162; p = 0.009). A negative relation was also detected between nurses' working period at the current clinic and providing benefit (r = -0.147; p = 0.012), holistic approach (r = -0.139; p = 0.018) and orientation (r = -0.175; p = 0.003) scores of Ethical Sensitivity Questionnaire sub-scales. CONCLUSION: Nurses' perception levels of caring quality were high and their ethical sensitivity levels were moderate. It was found out that nurses' ethical sensitivity increased together with their perception of caring quality, and as their working period at the current clinic increased, the ethical sensitivity also increased in terms of the sub-scales of providing benefit, holistic approach, and orientation. The factors that adversely affect the quality of nursing care and ethical sensitivity should be examined and attempts should be made to improve the working environment.