Altruism, honesty and religiosity in nursing students.

AIMS AND OBJECTIVES: To identify, at different stages of nursing education, the extent to which nursing students appreciate altruism, honesty, religiosity and other, sometimes contrasting, values in practice. BACKGROUND: Nursing is informed by values that guide care ethos and activities. Embodiment of these core values has become a matter of concern. Reports outlining deficiencies in health care followed by polemics in nursing journals have called into question whether nursing students are sufficiently motivated by values and educated in their application. This study explores these values among undergraduate nursing students in the Republic of Ireland. Considering the strong religious tradition in health care in Ireland, religiosity was also included. DESIGN: A link to an online survey was distributed via email to all nursing students in the thirteen Schools of Nursing in the Republic of Ireland. METHOD: Quantitative data were collected using an adaptation of the Salford-Scott (Journal of Advanced Nursing, 57(8), 2007, 366) Nursing Values Questionnaire. RESULTS: Participants (n = 158) reported positively to statements related to honesty and altruism. Both altruism and religiosity received support, but the latter was to a lesser extent. Students considered their professionalism more important than altruism, and honesty varied according to the situation. CONCLUSIONS: This study adds new information by confirming that students exhibit support for two of the most essential values in nursing: altruism and honesty. The adapted Salford-Scott instrument has shown reliability and promise in further empirical study in nursing. RELEVANCE TO CLINICAL PRACTICE: Priority given to professionalism over altruism reflects concerns highlighted in the international literature around overly task-oriented care in which compassion gets lost. Also, when loyalty supersedes honesty, problems with accountability in health care may emerge. Uncertainty around religiosity in health care may reflect limitations in competence in nurses to relate to patients with religions or spirituality other than their own.

Privacy at end of life in ICU: A review of the literature.

AIMS AND OBJECTIVES: To explore the issues surrounding privacy during death in ICU. BACKGROUND: While the provision of ICU care is vital, the nature and effect of the potential lack of privacy during death and dying in ICUs have not been extensively explored. DESIGN: A literature search using CINAHL and Pubmed revealed articles related to privacy, death and dying in ICU. METHOD: Keywords used in the search were "ICU," "Privacy," "Death" and "Dying." A combination of these terms using Boolean operators "or" or "and" revealed a total of 23 citations. Six papers were ultimately deemed suitable for inclusion in the review and were subjected to code analysis with Atlas.ti v8 QDA software. FINDINGS: The analysis of the studies revealed eight themes, and this study presents the three key themes that were found to be recurring and strongly interconnected to the experience of privacy and death in ICU: "Privacy in ICU," "ICU environment" and "End-of-Life Care". CONCLUSIONS: Research has shown that patient and family privacy during the ICU hospitalisation and the provision of the circumstances that lead to an environment of privacy during and after death remains a significant challenge for ICU nurses. Family members have little or no privacy in shared room and cramped waiting rooms, while they wish to be better informed and involved in end-of-life decisions. Hence, death and dying for many patients takes place in open and/or shared spaces which is problematic in terms of both the level of privacy and respect that death ought to afford. RELEVANCE TO CLINICAL PRACTICE: It is best if end-of-life care in the ICU is planned and coordinated, where possible. Nurses need to become more self-reflective and aware in relation to end-of-life situations in ICU in order to develop privacy practices that are responsive to family and patient needs.