Solving work-related ethical problems

Laukkanen, Laura; Suhonen, Riitta; Leino‐Kilpi, Helena

doi:10.1177/0969733015584966

Cited by 15 publications

(11 citation statements)

References 34 publications

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“…The disciplinary decisions showed that organizational supervision varied, nurse managers has a central role in the process but very little detail was documented. In line with earlier studies, nurse managers had used a number of methods to tackle work-related problems (Aitamaa et al, 2019;Laukkanen et al, 2016). Our findings showed that the majority of these supervision procedures involved terminating the nurse's working contract.…”

Section: Systematic Structures For Organizational Supervisionsupporting

confidence: 87%

Disciplinary processes for nurses, from organizational supervision to outcomes: A document analysis of a regulatory authority's decisions

Papinaho

Häggman‐Laitila

Pasanen

et al. 2022

J Nursing Management

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Aim: This study aims to explore the disciplinary processes for nurses, from organizational supervision to final decisions by the Finnish regulatory authority.Background: Regulatory authorities are responsible for protecting the public, by ensuring that they receive safe, competent and ethical nursing care, but little is known about the disciplinary processes for nurses.Methods: This is a retrospective document analysis of 296 disciplinary decisions by the Finnish regulatory authority from 2007 to 2016. The data were analysed using a quantitative design with descriptive statistics.Results: We studied 204 disciplined nurses (81.4% female) with a mean age of 43.5 years. The disciplinary process comprised organizational supervision, complaints, investigations and decisions. Nurses with substance abuse issues were more likely to face criminal investigations and receive temporary decisions. The process lasted from under 1 month to years and could have profound effects on nurses, colleagues and nurse managers and compromise patient safety. Conclusion:This study identified key factors that could inform the disciplinary processes for nurses. More knowledge is needed about how organisations ensure patient safety when unprofessional conduct is suspected.Implications for Nursing Management: Retaining nursing professionals is vital due to global shortages, and more attention should be paid to organizational supervision and support for nurses during disciplinary processes.

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Section: Systematic Structures For Organizational Supervisionsupporting

confidence: 87%

Disciplinary processes for nurses, from organizational supervision to outcomes: A document analysis of a regulatory authority's decisions

Papinaho

Häggman‐Laitila

Pasanen

et al. 2022

J Nursing Management

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“…Therefore, at the moment, it may seem that healthcare professionals do not suffer from burnout, but if these consequences of moral distress are underestimated and not addressed in a timely manner, they might do so in the future. Healthcare professionals, 45 – 47 including leaders and managers, 48 , 49 face many ethical dilemmas, problems and challenges in their daily work. Research has reported several situations where individual professionals are faced with unethical behaviour of others, or witness abuse or neglect committed by professionals in healthcare settings (older people care settings), 50 by other patients (in care homes for people with memory disorders) or by family members (e.g.…”

Section: Discussionmentioning

confidence: 99%

Moral injury in healthcare professionals: A scoping review and discussion

et al. 2021

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Moral injury emerged in the healthcare discussion quite recently because of the difficulties and challenges healthcare workers and healthcare systems face in the context of the COVID-19 pandemic. Moral injury involves a deep emotional wound and is unique to those who bear witness to intense human suffering and cruelty. This article aims to synthesise the very limited evidence from empirical studies on moral injury and to discuss a better understanding of the concept of moral injury, its importance in the healthcare context and its relation to the well-known concept of moral distress. A scoping literature review design was used to support the discussion. Systematic literature searches conducted in April 2020 in two electronic databases, PubMed/Medline and PsychInfo, produced 2044 hits but only a handful of empirical papers, from which seven well-focused articles were identified. The concept of moral injury was considered under other concepts as well such as stress of conscience, regrets for ethical situation, moral distress and ethical suffering, guilt without fault, and existential suffering with inflicting pain. Nurses had witnessed these difficult ethical situations when faced with unnecessary patient suffering and a feeling of not doing enough. Some cases of moral distress may turn into moral residue and end in moral injury with time, and in certain circumstances and contexts. The association between these concepts needs further investigation and confirmation through empirical studies; in particular, where to draw the line as to when moral distress turns into moral injury, leading to severe consequences. Given the very limited research on moral injury, discussion of moral injury in the context of the duty to care, for example, in this pandemic settings and similar situations warrants some consideration.

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“…NMs have identified some activities they use to solve work-related ethical problems: using discussion, cooperation, the work organisation, intervention, personal values, an operational model, statistics and feedback, and personal examples. Discussion and cooperation were the most commonly used activities [7]. When solving ethical problems, NMs’ own personal values have been found to be the most useful aid [8–10], or at least among the three most useful ones [7, 10].…”

Section: Introductionmentioning

confidence: 99%

“…Discussion and cooperation were the most commonly used activities [7]. When solving ethical problems, NMs’ own personal values have been found to be the most useful aid [8–10], or at least among the three most useful ones [7, 10]. Discussions are also among the most frequently used resources in ethical problem-solving [7, 10, 11].…”

Section: Introductionmentioning

confidence: 99%

“…When solving ethical problems, NMs’ own personal values have been found to be the most useful aid [8–10], or at least among the three most useful ones [7, 10]. Discussions are also among the most frequently used resources in ethical problem-solving [7, 10, 11]. NMs discuss ethical problems most often with nursing colleagues and administrative colleagues [10, 11], but also with patient’s physician [1, 11] and other professionals [11] or different parties involved in the problematic issue [7].…”

Section: Introductionmentioning

confidence: 99%

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Ethical problems in nursing management – a cross-sectional survey about solving problems

Aitamaa

Suhonen

Puukka

et al. 2019

BMC Health Serv Res

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Background Nurse managers encounter a wide range of ethical problems related to patients, staff, the organisation and themselves. However, little is known about the methods they use to try to solve these problems. In this study, our goal is to fill this knowledge gap by investigating the ethical problems encountered by nurse managers, the frequency of use and usefulness of different methods to solve these problems, and the background factors associated with the use of the methods. Methods A cross-sectional survey study was conducted in November 2014–May 2015 in Finland. The data were collected from nurse managers in strategic, middle and ward management ( n = 214) using a questionnaire developed for this study. The questionnaire consisted of four parts: socio-demographic background factors, frequency and difficulty of ethical problems in nursing management, frequency of use and usefulness of the methods in solving ethical problems, and work-related background factors. Results Discussions with nurses was the most frequently used method, used by 94% of the nurse managers either often or always in the case of ethical problems, followed by the use of personal values (74%) and discussions with manager colleagues (70%). However, almost all methods in the different groups – discussion and deliberation, use of outside experts, written instructions and ethical principles, acts and degrees as well as work arrangements – were considered somewhat or very useful by more than half of the respondents. The use of outside experts was the least used and the least useful method. Conclusions When solving ethical problems, nurse managers use most frequently the same methods as a few decades ago. A more diverse range of methods would be helpful in ethical problem-solving. The use of outside experts, ethics literature and codes of ethics should be combined with ethical reasoning and decision-making to get new dimensions and outside knowledge.

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Solving work-related ethical problems

Cited by 15 publications

References 34 publications

Disciplinary processes for nurses, from organizational supervision to outcomes: A document analysis of a regulatory authority's decisions

Disciplinary processes for nurses, from organizational supervision to outcomes: A document analysis of a regulatory authority's decisions

Moral injury in healthcare professionals: A scoping review and discussion

Ethical problems in nursing management – a cross-sectional survey about solving problems

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