Moral distress and professors of nursing: A cluster analysis.

BACKGROUND: Professors of nursing sometimes experience specific situations in their daily practice that conflict with their values and ethical principles and may culminate in moral distress. Moral distress occurs when one is prevented from acting according to his or her knowledge or values, or what one considers to be ethically sound. OBJECTIVES: To identify the profile of professors of nursing through grouping sociodemographic characteristics and intensity of moral distress. METHOD: Cross-sectional and exploratory study addressing 373 nurses teaching in Brazilian federal public higher education institutions. Data were collected from June to December 2018 through email, using the Google Docs tool. A moral distress scale directed to nurse educators was used. Data were analyzed using descriptive statistics, variance analysis, and cluster analysis. ETHICAL CONSIDERATIONS: The Institutional Review Board at the Federal University of Rio Grande approved this study. FINDINGS: Initially, four clusters emerged for each variable predicting the profile of Brazilian professors of nursing: sex; whether the individual worked in a graduate program; age; experience in years in their respective higher education institution; and intensity of moral distress. The profile of Brazilian professors of nursing was represented by the largest cluster, 36.5% (n = 136), composed of women working in graduate programs, aged 37 years old on average, having worked in their respective institutions for approximately 5 years, and presenting a moderate intensity of moral distress. CONCLUSION: Assigning individuals into groups facilitates seeing similarities among the predictors that compose the profile of Brazilian professors of nursing, thus recognizing those workers experiencing moral distress in their daily work routine. In addition, this study's results are expected to encourage reflection on the planning of efficacious interventions directed to the context of education and health.

Writing a Diversity and Inclusivity Statement: Guidelines for Nursing Programs and Faculty.

BACKGROUND: For decades, nursing programs have worked to address the need for a culturally diverse workforce and student body to better reflect the populations they serve. The development of a diversity and inclusivity statement is a first step in ameliorating this issue. PROBLEM: A clearly communicated diversity and inclusivity statement should demonstrate a nursing organization's commitment to the value of people from all backgrounds. It should include language that emphasizes the value of diverse cultures, experiences, thoughts, and contributions. APPROACH: Nursing faculty can benefit from an organized and literature-supported model for writing meaningful diversity and inclusivity statements. CONCLUSIONS: Such an approach will communicate a nursing program's commitment to diversity and inclusion in the organization's mission, policies, practices, relationships, and curricula. This article provides nursing faculty with evidence-supported guidelines for writing meaningful diversity, inclusion, and equity statements for their nursing programs.

Crossing the "line": College students and academic integrity in nursing.

BACKGROUND: Researchers have shown a relationship between academic integrity in the classroom and acts of dishonest behavior in the clinical setting which is concerning for nursing faculty and the health care field. OBJECTIVES: The purpose of this study was to compare the attitudes toward academic integrity and the frequency of behaviors related to academic dishonesty in nursing and non-nursing students at a religiously affiliated institution. DESIGN: A cross-sectional, descriptive design was used to collect data regarding the knowledge, behavior, perceptions, and attitudes related to academic integrity via an online survey. SETTINGS AND PARTICIPANTS: Nursing students and non-nursing students who attended a religiously affiliated (Jesuit) University in the United States were surveyed for this study. RESULTS: Results of the study suggest upper division and second degree nursing students are less tolerant and more condemnatory of cheating than younger students. Frequent dishonest classroom behaviors include asking and telling other students what was on the exam while the most frequent dishonest clinical behaviors included documenting findings that were not assessed or findings that were false. CONCLUSION: Recommendations for nursing faculty include frequent and timely discussion of expected behaviors and values of nurses in order to support students' development of honesty and integrity beyond the classroom and into the clinical setting.

Understanding and addressing missed care in clinical placements - Implications for nursing students and nurse educators.

This paper addresses the issue of substandard care and its effects on healthcare practice. It explores some recent concerns about the problem in nursing, its potential effects on students, how it can be conceptualised and what action needs to be, by both nurses and educators to prevent it. Recent healthcare scandals have tarnished the public image of nursing, and are also likely to influence nursing students' images, expectations and experiences of nursing. While much attention has been paid to the examination of such lapses in care, and potential corrective actions, little attention has been paid to the potential or actual effect on nursing students in practice. While good resources and staffing levels are crucial to ensuring optimal nursing care, developing and encouraging nursing students' awareness of and openness about personal behaviours, reflecting critically on practice reflection and strengthening nurse educators' collaborative links with healthcare practice can all serve to positively influence care deficits.

'Philosophy Lost': Inquiring into the effects of the corporatized university and its implications for graduate nursing education.

Drawing on a comprehensive, pan-national analysis of the corporatization of Canadian universities, as well as the notions of 'parrhesiastic' mentorship and practice, the authors examine the effects of the corporatized university, its implications for graduate nursing education and nursing's relative silence on the subject. With the preponderance of business interests, the increasing dependence of universities on industry funding, cults of efficiency, research intensivity, and the pursuit of profit so prevalent in today's corporatized university, we argue that philosophical presuppositions so crucial to critical teaching, research, and reflection on nursing as a discipline are troublingly losing ground. We lament the erosion and fragmentation of philosophy, politics, and ethics as foundations for graduate education, which are increasingly perceived as less valuable, problematic, and in some cases, even burdensome. The effect of corporatization is the suppression of the critical engagement required of faculty in the everyday workings of institutions. We argue that, when the ideals of intellectual freedom, academic responsibility, duty, and obligation, as supported by philosophical thought, are smothered by the normalizing power of corporatized research agendas, philosophical approaches to inquiry and knowledge development become marginalized as scholars find themselves floundering in the face of a seeming 'philosophy lost'.

Fairness and respect in nurse educators' work- nursing students' perceptions.

This study describes how the ethical principles of fairness and respect come true in the work of nurse educators from the perspective of nursing students. Nurse educators' competence of professional ethics is important in providing an ethical role model to nursing students and to professionals in the field of health care. The descriptive cross-sectional study design was used. The data were collected from graduating nursing students (n = 202) in Finland with an internet-based questionnaire consisting of 22 structured questions with 5-point Likert scale. The data were analyzed by descriptive and inferential statistics. The findings revealed that educators' fairness and respect towards others (colleagues, superiors, mentors, nursing leaders) was good but towards students their fairness did not achieve as good a level. Also, according to the students' assessment, the educators did not respect the students' individual opinions in all cases. Educators' fairness and respect towards their colleagues was satisfactory. The appreciation of educators in the society was reasonably good, but in the opinion of the students the views of educators were not respected very much. As a conclusion, can be said that educators need to put more emphasis on their action.

Professional values of nurse lecturers at three universities in Colombia.

OBJECTIVE: To describe the professional values of the nurse lectures according to 241 nursing students, who participated voluntarily, in three different universities of Bogotá. METHODOLOGY: This is a quantitative, descriptive cross-sectional study that applied the Nurses Professional Values Scale-permission secured-Spanish; three dimensions of values were applied: ethics, commitment, and professional knowledge. Ethical consideration: Project had ethical review and approval from an ethics committee and participants were given information sheets to read before they agreed to participate in the project. FINDINGS: It was concluded that nursing students, in general, do perceive these values in their professors, and they give priority to the dimension of ethics, followed by the knowledge dimension, and finally, commitment. DISCUSSION: It is evident that professional values are transmitted by professors and students place importance to such values. Values related to the other's care are paramount in nursing training in Colombia as well as in other countries. CONCLUSION: It was found that participating students observed professors directly in relation to values focused on direct patient care, respect for privacy, respect for life, while matters related to professional improvement, participation in unions were not actually analyzed may be due to poor promotion activities and unions during undergraduate studies. The results obtained are primary approach to the study of values related to nursing, a topic which needs to be researched, something vital to all the country offering nursing training programs.

Enhancing students' moral competence in practice: Challenges experienced by Malawian nurse teachers.

BACKGROUND: Nurses and student nurses in Malawi often encounter challenges in taking a moral course of action. Several studies have demonstrated a need for increased awareness of ethical issues in the nursing education. OBJECTIVE: To explore the challenges experienced by nurse teachers in Malawi in their efforts to enhance students' moral competence in clinical practice. RESEARCH DESIGN: A qualitative hermeneutic approach was employed to interpret the teachers' experiences. PARTICIPANTS AND RESEARCH CONTEXT: Individual interviews (N = 8) and a focus group interview with teachers (N = 9) from different nursing colleges were conducted. ETHICAL CONSIDERATIONS: Ethical approval was granted and all participants signed their informed consent. FINDINGS: Two overall themes emerged: (1) authoritarian learning climate, with three subthemes: (a) fear of making critical comments about clinical practice, (b) fear of disclosing mistakes and lack of knowledge and (c) lack of a culture of critical discussion and reflection that promotes moral competence; and (2) discrepancy between expectations on learning outcome from nursing college and the learning opportunities in practice comprising three subthemes: (a) gap between the theory taught in class and learning opportunities in clinical practice, (b) lack of good role models and (c) lack of resources. DISCUSSION: Our findings indicated that showing respect was a central objective when the students were assessed in practice. A number of previous studies have enlightened the need for critical reflection in nursing education. Few studies have linked this to challenges experienced by teachers for development of moral competence in practice. This is one of the first such studies done in an African setting. CONCLUSION: There is a clear relationship between the two themes. A less authoritarian learning climate may enhance critical reflection and discussion between students, teachers and nurses. This can narrow the gap between the theory taught in college and what is demonstrated in clinical practice. Moral competence must be enhanced in order to ensure patients' rights and safety.

When Push Comes to Shove: A Comparative Concept Analysis of Motivation and Coercion in Nursing Education.

BACKGROUND: Understanding the fine line between motivation and coercion in nursing education may offer insight into satisfaction and autonomy in young nursing students, leading to increased retention, effectiveness, and professionalism in the workplace. PURPOSE: To compare and analyze the concepts of motivation and coercion with application to nursing academia. METHODS: Using the Walker and Avant method for concept analyses, definitions and defining attributes of motivation and coercion were identified, along with antecedents, consequences, and model cases for each concept. Comparison of the concepts noting comparative terms and notable differences are presented. CONCLUSIONS: The comparison of the concepts of motivation and coercion reveals the stark contrast in the consequences of motivational and coercive power interactions in creating professional, satisfied, and empowered nurses. Nurse educators should seek to identify the best ways to create autonomy, competence, and relatedness in their graduates while minimizing coercive power plays which foster distance and dependence. Miller.

Reflexão sobre o sofrimento moral no trabalho do enfermeiro docente / Reflection about the moral suffering of the teacher nurse at work

Objetivo: refletir sobre o sofrimento moral no trabalho do enfermeiro docente. Método: reflexão teórica, noqual se definiu duas categorias: os problemas éticos no trabalho do enfermeiro; o enfermeiro docente e osofrimento moral. Resultados: entre os fatores que causam problemas éticos no trabalho do enfermeiro temsedesrespeito aos direitos do paciente, insuficiência de recursos humanos e materiais, dificuldades nasrelações interpessoais e condições de trabalho. Como consequência ressalta-se a queda na qualidade dotrabalho e atitudes com implicações éticas para si, para os pacientes e para toda a equipe. No que concerneao enfermeiro docente, destaca-se a desonestidade acadêmica, a hierarquia coercitiva e a deficiência naformação didático-pedagógica como causadores do sofrimento moral. Conclusão: é imprescindível reconhecere ajudar a quem sofre. Para isso, é preciso ter coragem e revelar-se, explicitamente, contra ocomportamento antiético, mesmo quando os outros se calam ou divergem de opinião.

Valores profesionales de los enfermeros profesores según la percepción de los estudiantes de últimos semestres de la carrera de enfermería en tres universidades de Bogotá / Professional values of nursing professors according to the perception of students in the last semesters of the nursing career at three universities in Bogotá

Este trabajo tiene como objetivo describir los valores profesionales de los enfermeros profesores según la percepción de los estudiantes de últimos semestres de la carrera de enfermería en tres universidades de Bogotá, mediante la aplicación de la Escala de Valores de Enfermeros Profesionales (EVEP), diseñada por Weis y Schank, y traducida y verificada por Basurto en 2010. Este es un estudio descriptivo, cuantitativo en el que, de manera voluntaria, participaron un total de 241 estudiantes de tres universidades de Bogotá diligenciando el cuestionario de Basurto. Se encontró que los valores estudiados en general son percibidos por los participantes en sus docentes enfermeros, siendo los valores considerados por los estudiantes como los más importantes para su profesores aquellos que se ubican en la dimensión ética, seguidos por los que integran la dimensión de dominio y por último los de la dimensión de compromiso. Los valores menos importantes para los profesores según la percepción de los estudiantes son fundamentalmente los que tienen que ver con la relación de la enfermera con sus pares (colegaje, evaluación de pares, hacer frente a las prácticas inapropiadas). Se sugiere reforzar la enseñanza y transmisión de los valores que tienen que ver con la relación de la enfermera con sus pares a lo largo de la carrera, así como continuar la investigación en torno a este asunto en diferentes escenarios.

This paper aims to describe the professional values of nurses teachers as perceived by students last semester of nursing career at three universities in Bogota, through implementation of the Values Scale of Professional Nurses (EVEP), designed by Weis and Schank, and translated and verified by Basurto in 2010. This is a descriptive, quantitative where, on a voluntary basis, a total of 241 students from three universities in Bogota filling out the Basurto´s questionnaire. It was found that values considered by students as the most important ones for their professors are placed on the ethical dimension, followed by those that integrate domain and, finally, the compromise dimension. Values less important for professors as perceived by students are primarily related to the relationship of nurses with their peers (team work, peer assessment, addressing inappropriate practices). It is suggested to strengthen the teaching and transmission of values about the relationship of nurses with their peers throughout the undergraduate educaiton, as well as further research on this topic in different scenarios.

Ética e estética no ensinar/cuidar da enfermagem / Ethics and aesthetics in teaching/caring for nursing

O presente é resultado de inquietações referentes ao ensinar/cuidar na enfermagem, e teve como objetivo: compreender as relações vivenciadas pelos docentes do curso de graduação em Enfermagem de uma Instituição privada de Ensino Superior, em uma cidade do Norte do Paraná. Para tanto, foi desenvolvido um estudo norteado pelo pensamento de Merleau-Ponty. Foram realizadas entrevistas para apreensão do significado presente nos discursos dos mesmos, obedecendo aos princípios éticos da pesquisa. Sendo entrevistados oito docentes, dos quais três desistiram após o conhecimento de suas descrições e, portanto, apenas cinco validaram sua falas após a releitura das mesmas. Os discursos foram analisados conforme os passos indicados pela fenomenologia, sendo apreendidas três grandes categorias no processo de análise e de compreensão, que são: o verso e o reverso do ensinar/cuidar, a temporalidade, e o jogo de aparências. A primeira categoria possibilitou a verificação da polarização do saber/poder diante do cotidiano da enfermagem. A temporalidade mostra o transitar na circularidade do tempo dos atores envolvidos como sujeitos históricos, que possuem um ontem, um hoje e um amanhã. Enquanto que o jogo de aparências revela a trama em que os docentes se encontram envolvidos, na qual se protegem das situações de agressividade da vida profissional. O estudo mostra que os docentes, ao vivenciarem o cotidiano no ensinar/cuidar, experienciam uma dialética sem síntese, na qual transitam entre as alteridades dos sistemas complexos, em busca de objetivos comuns, em meio às dualidades da existência humana. O vivenciado no cenário em tela apresentado neste trabalho poderá contribuir com a melhora das relações pessoais, que deverão ser norteadas por princípios éticos e estéticos reiterando a importância de uma Enfermagem mais humana.

The following is a result of the disquietude that refers to teaching/caring in nursing, that aimed to: Comprehend the relations experienced by the professors of the graduation Nursing course, of a private institution in a city in northern Paraná. To do this, a study directed by Merleau-Ponty's thoughts was developed. Interviews were made to capture the meaning present in their speeches, following the research's ethical principles. Eight professors have been interviewed, from which, three have given up after knowing their descriptions, so, only five have validated their speeches after having reread the same. The speeches were analyzed according to the steps indicated by phenomenology, three great classes were apprehended in the process of analysis and comprehension that are: the verse and reverse of teaching/caring, the temporality, and the appearance game. The first class, has made it possible to verify the polarization of knowing/ being able, before nursing's quotidian. Temporality shows the transitation in time's circularity in the actors that were involved as historic subjects, who have a yesterday, a today and a tomorrow. Meanwhile, the appearance game reveals the scheme in which the professors are involved, and in which they protect themselves from the aggressiveness situations of the professional life. The study shows that as the professors experience the quotidian in teaching/caring, they experiment a dialectic without synthesis, in which they transit among the differences of the complex systems, searching for ordinary objectives, being among the dualities of the human existence. What has been experienced in the screen scenery, presented in this piece of work, may contribute to the improvement of the personal relations, that ought to be directed by ethical and esthetical principles reiterating the importance of a more humanized nursing.