Wrongdoing and whistleblowing in health care

Pohjanoksa, Johanna; Stolt, Minna; Suhonen, Riitta; Leino‐Kilpi, Helena

doi:10.1111/jan.13979

Cited by 26 publications

(37 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…23,24 Whistle blowing as a form of moral courage can have a number of adverse consequences, such as criticism, bullying, or discrimination. 8 However, it should be noted here that the lowest levels of moral courage did not indicate clear lack of moral courage. For example, nurses’ ethical and responsible action during the present global Covid-19 pandemic in taking care of their patients at the same time risking their own health and even life manifests nurses’ generally morally courageous action.…”

Section: Discussionmentioning

confidence: 54%

“…Nursing environment is a complex system, also ethically. 7,8 Several organizational and individual factors are associated with ethical questions, which arise daily in different nursing contexts and levels of care. Moral courage is a way to address these ethical issues, and it is a manifestation of values which the nurse is not willing to compromise.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Nurses’ self-assessed moral courage and related socio-demographic factors

Hauhio

Leino‐Kilpi

Katajisto³

et al. 2021

Nurs Ethics

View full text Add to dashboard Cite

Background: Nurses need moral courage to ensure ethically good care. Moral courage is an individual characteristic and therefore it is relevant to examine its association with nurses’ socio-demographic factors. Objective: To describe nurses’ self-assessed level of moral courage and its association with their socio-demographic factors. Research design: Quantitative descriptive cross-sectional study. The data were collected with Nurses’ Moral Courage Scale and analyzed statistically. Participants and research context: A total of 482 registered nurses from a major university hospital in Southern Finland completed the Finnish language version of Nurses’ Moral Courage Scale in autumn 2017. Ethical considerations: Ethical approval was obtained from the university ethics committee and permission for the data collection from the participating hospital. Ethical principles and scientific guidelines were followed throughout the research process. Findings: Nurses’ self-assessed level of moral courage was rather high. On Visual Analogy Scale (0–10), the mean value was 8.20 and the mean score of the four dimensional, 21-item Nurses’ Moral Courage Scale was 4.09 on a 5-point Likert-type scale. Respondents’ gender, present work role, ethical knowledge base, additional ethics education, self-study as a means to acquire ethical knowledge, and frequency of work situations needing moral courage were statistically significantly associated with nurses’ moral courage. Discussion: Strongest association was found between nurses’ higher moral courage level and formal and informal ethics education. Honesty and patient’s humane and dignified encounter received the highest scores indicating respondents’ internalization of the core values of nursing. Conclusion: Although nurses were fairly morally courageous, moral courage should be a part of nurses’ basic and continuing education thus covering its theoretical and practical learning. Since moral courage is a virtue that can be taught, learnt, and practiced, education is a relevant way to maintain and further strengthen nurses’ moral courage.

show abstract

Section: Discussionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Nurses’ self-assessed moral courage and related socio-demographic factors

Hauhio

Leino‐Kilpi

Katajisto³

et al. 2021

Nurs Ethics

View full text Add to dashboard Cite

show abstract

“…In nursing practice, moral courage is needed due to many factors, such as increasing medicalization and focusing on technology or costs of care, which sometimes leave ethics to the side (Clarke, 2017; Nickitas, 2009). With moral courage, nurses can promote quality of care (Lachman, 2007b; Pohjanoksa, Stolt, Suhonen, & Leino‐Kilpi, 2019; Taraz et al, 2019) and patients’ quality of life (Fahlberg, 2015), improve patient safety (Kleemola et al, 2020; Lachman, 2007b), and advocate for their patients (e.g., Kleemola et al, 2020; Lachman, 2010; Numminen et al, 2017). Furthermore, nurses can support their colleagues and their own well‐being in work (S. M. Gallagher, 2012; Lachman, 2007b) as well as develop themselves as moral professionals (Sadooghiasl et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Nurses seem to behave courageously (Kleemola et al, 2020; Lachman, 2007b; Numminen et al, 2019), but sometimes they and nursing students also lack sufficient courage (Bickhoff et al, 2016; Lützén & Ewalds‐Kvist, 2013; Pohjanoksa et al, 2019). In addition, nurses (Kleemola et al, 2020; Lachman, 2007a) and students (Bickhoff, Sinclair, & Levett‐Jones, 2017; Lützén & Ewalds‐Kvist, 2013) appear to benefit from the strengthening of their moral courage.…”

Section: Introductionmentioning

confidence: 99%

Moral courage in nursing – An integrative literature review

Pajakoski

Rannikko

Leino‐Kilpi

et al. 2021

Nursing & Health Sciences

Self Cite

View full text Add to dashboard Cite

Moral courage and understanding of its meaning are essential when nurses face ethical conflicts in their practice. This integrative review aimed to explore moral courage in nursing and possible associated individual and organizational factors. A database search in January 2020 identified 1308 scientific articles of which 25 were selected for the review. Inductive analysis with clear steps for defining and synthesizing themes in research reviews revealed three categories concerning moral courage in nursing: definition and descriptions of moral courage, characteristics of the morally courageous nurse, and skills and acts of the morally courageous nurse. Individual and organizational factors, such as positive personal experiences, commitment to ethical principles, supportive work environment and teamwork, were associated with moral courage in nursing, contributing to a more comprehensive description of nurses' moral courage. Findings indicate that in nursing practice, there is a need for promoting multi‐professional collaboration and discussion of ethical dilemmas to provide opportunities to enhance moral courage. Developing care environments in which hierarchy does not inhibit nurses' moral courage seems justified. Further research on moral courage with varying methodologies and multi‐disciplinary and international approaches is needed.

show abstract

“…Nurses have reported troubled conscience due to occasional inadequacy in providing good care. 54 In addition, difficulties to act morally courageously have been reported, 55 , 56 especially when confronting physicians. 56 Although these are not unique features globally, they may be signals resulting from the working conditions of Finnish RNs.…”

Section: Discussionmentioning

confidence: 99%

Analysis of graduating nursing students’ moral courage in six European countries

Koskinen¹,

Pajakoski

Linares

et al. 2020

Nurs Ethics

View full text Add to dashboard Cite

Background: Moral courage is defined as courage to act according to one’s own ethical values and principles even at the risk of negative consequences for the individual. In a complex nursing practice, ethical considerations are integral. Moral courage is needed throughout nurses’ career. Aim: To analyse graduating nursing students’ moral courage and the factors associated with it in six European countries. Research design: A cross-sectional design, using a structured questionnaire, as part of a larger international ProCompNurse study. In the questionnaire, moral courage was assessed with a single question (visual analogue scale 0–100), the questionnaire also covered several background variables. Participants and research context: The sample comprised graduating nursing students (n = 1796) from all participating countries. To get a comprehensive view about graduating nursing students’ moral courage, the views of nurse managers (n = 538) and patients (n = 1327) from the same units in which the graduating nursing students practised were also explored, with parallel questionnaires. Ethical considerations: Ethical approvals and research permissions were obtained according to national standards in every country and all participants gave their informed consent. Results: The mean of graduating nursing students’ self-assessed moral courage was 77.8 (standard deviation 17.0; on a 0–100 scale), with statistically significant differences between countries. Higher moral courage was associated with many factors, especially the level of professional competence. The managers assessed the graduating nursing students’ moral courage lower (66.5; standard deviation 18.4) and the patients slightly higher (80.6; standard deviation 19.4) than the graduating nursing students themselves. Discussion and conclusions: In all countries, the graduating nursing students’ moral courage was assessed as rather high, with differences between countries and populations. These differences and associations between moral courage and ethics education require further research.

show abstract

Wrongdoing and whistleblowing in health care

Cited by 26 publications

References 27 publications

Nurses’ self-assessed moral courage and related socio-demographic factors

Nurses’ self-assessed moral courage and related socio-demographic factors

Moral courage in nursing – An integrative literature review

Analysis of graduating nursing students’ moral courage in six European countries

Contact Info

Product

Resources

About