A study of nurses' ethical climate perceptions: Compromising in an uncompromising environment.
BACKGROUND
Acting ethically, in accordance with professional and personal moral values, lies at the heart of nursing practice. However, contextual factors, or obstacles within the work environment, can constrain nurses in their ethical practice - hence the importance of the workplace ethical climate. Interest in nurse workplace ethical climates has snowballed in recent years because the ethical climate has emerged as a key variable in the experience of nurse moral distress. Significantly, this study appears to be the first of its kind carried out in New Zealand.


AIM/OBJECTIVE
The purpose of this study was to explore and describe how registered nurses working on a medical ward in a New Zealand hospital perceive their workplace ethical climate.


RESEARCH DESIGN/PARTICIPANTS/CONTEXT
This was a small, qualitative descriptive study. Seven registered nurses were interviewed in two focus group meetings. An inductive method of thematic data analysis was used for this research.


ETHICAL CONSIDERATIONS
Ethics approval for this study was granted by the New Zealand Ministry of Health's Central Regional Health and Disability Ethics Committee on 14 June 2012.


FINDINGS
The themes identified in the data centred on three dominant elements that - together - shaped the prevailing ethical climate: staffing levels, patient throughput and the attitude of some managers towards nursing staff.


DISCUSSION
While findings from this study regarding staffing levels and the power dynamics between nurses and managers support those from other ethical climate studies, of note is the impact of patient throughput on local nurses' ethical practice. This issue has not been singled out as having a detrimental influence on ethical climates elsewhere.


CONCLUSION
Moral distress is inevitable in an ethical climate where the organisation's main priorities are perceived by nursing staff to be budget and patient throughput, rather than patient safety and care.
['Humphries|Anne|A|', 'Woods|Martin|M|']
D002055:Burnout, Professional D004991:Ethics, Institutional D004993:Ethics, Nursing D005260:Female D017144:Focus Groups D006801:Humans D009014:Morals D009741:Nursing Staff, Hospital D015279:Organizational Culture D010465:Perception D036301:Qualitative Research
Ethical climate moral distress medical nursing nursing ethics thematic analysis