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Ethical problems encountered by public health nursing administrators

University of British Columbia

The intent of this study was to explore the ethical problems encountered in public health nursing administration. A qualitative study, incorporating critical incident design, was conducted. The data was collected during audio-taped interviews with twenty public health nursing administrators. The data were analyzed, utilizing the technique of content analysis, to identify common themes. Themes were identified in relation to the ethical problems experienced, the public health administrators' responses to the ethical problem, and the variables which influenced the public health administrators' experience of the problem. The themes which emerged in relation to the ethical problems experienced were categorized according to the sources of nursing obligations, as identified by the Canadian Nurses Association [CNA] (1991). These obligations included clients, nursing roles and responsibilities, nursing ethics and society, and the nursing profession. The majority of ethical problems related to nursing obligations to clients and nursing roles and responsibilities. One ethical problem was identified in relation to nursing ethics and society; no problems were identified in relation to the nursing profession. Three of the participants did not perceive that they had experienced an ethical problem in their administrative practice in the past year. The participants' responses were categorized according to how they acted, felt or thought about the ethical problem they experienced. The responses included stress, regret and uncertainty, utilization of a decision making approach, values clarification, failure to act, and the use of personal and external resources. The variables which influenced the participants' experience of the ethical problem were categorized according to personal, professional, organizational, and system variables. The findings indicated that: the public health nursing administrators who participated in this study were able to identify ethical problems in their practice and to retrospectively analyze their experiences; the majority of public health nursing administrators in this study identified ethical problems related to lack of autonomy and conflicting role obligations; the public health nursing administrators all found the experience of the ethical problem difficult; the majority of public health nursing administrators did not feel supported in their experience of the ethical problem; the responses of public health nursing administrators showed a lack of systematic referral to ethical principles as they worked to resolve the problem; and organizational factors existed which made the experience of the ethical problem particularly difficult for public health nursing administrators who held their position on an acting basis. Implications for nursing practice, education and research arising from these findings were outlined.

Thesis/Dissertation

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2008-12-16

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http://hdl.handle.net/2429/2946

Nursing

University of British Columbia

UBCV

DSpace