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Jeong, Park, and Jeong: Case Development on Nurses' Ethical Dilemmas with Physicians' and Nurses' Decision Making
Original Article

Journal of Korean Academy of Nursing Administration 2013; 19(5): 668-678.

Published online: 31 December 2013

DOI: https://doi.org/10.11111/jkana.2013.19.5.668

Case Development on Nurses' Ethical Dilemmas with Physicians' and Nurses' Decision Making

Jeong-Mee Jeong, Jung-Hyun Park, Seok Hee Jeong

College of Nursing, Chonbuk National University, Korea.

Correspondence: Jeong, Seok Hee. College of Nursing, Chonbuk National University, 567 Baekje-daero, deokjin-gu, Jeonju 561-756, Korea. Tel: +82-63-270-3117, Fax: +82-63-270-3127, awesomeprof@jbnu.ac.kr

Received 26 October 2013       Revised 10 December 2013       Accepted 14 December 2013

Copyright © 2013 Korean Academy of Nursing Administration

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study was done to develop a realistic clinical case and investigate nurses' decision-making about nurses' ethical dilemmas with physicians in the fields of nursing practice.

Methods

Case development and a hypothetical case study were used. Participants were 52 nurses. Data were collected in 2012 and 2013 using an open-ended questionnaire and interviews and analyzed using content analysis and descriptive statistics.

Results

Various dilemma situations between nurses and physicians, such as violence, deathbed, medication·prescription, and physicians' incapacity·unfairness, were suggested. A clinical dilemma case about medication·prescription was developed based on nurses' experiences. Nurses' responses to the developed case situation and responses were classified into five types. Various reasons were given for making the decisions and about 56% of the nurses decided to notify their supervisor without deleting nursing records.

Conclusion

In this study, a realistic clinical dilemma case was developed, and nurses' ethical decision making was identified. These findings can be used in developing effective strategies for nurses to solve ethical dilemmas and to improve ethical decision-making abilities.

Keywords: Nursing ethics, Ethical dilemma, Decision making, Nurses

Figures and Tables

Table 1
Situations of Ethical Dilemma between Nurses and Physicians (N=15)*
jkana-19-668-i001

*Multiple answers possible.

Table 2
Coping Types according to Situation of Ethical Dilemma (N=15)*
jkana-19-668-i002

*Multiple answers possible.

Table 3
Content Validity Index based on Analysis Criteria for Problem Selection of PBL (N=8)
jkana-19-668-i003

PBL=Problem-based learning; CVI=Content Validity Index.

Total CVI: 0.85.

Table 4
General Characteristics of Participants (N=34)
jkana-19-668-i004
Table 5
Decision Making Reason for Coping (N=34)
jkana-19-668-i005

PS=Patient safety; OP=Obligation of the profession; NDO=Not making a decision by oneself; PPD=Primary physician's duty; NR=No response

Notes

This paper was supported by research funds of Chonbuk National University in 2013.

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