Nurses' Negotiation Processes in Facilitating Ethical Decision-making in Patient Care
Review TypeNone: Degree-based Submission
Repository Posting Date2019-12-16T18:59:44Z
Author(s)Savage, Teresa A.
Author DetailsDr. Teresa A. Savage, PhD, RN
Lead Author Sigma AffliationAlpha Lambda
Level of EvidenceOther
Research ApproachQualitative Research
CINAHL HeadingsDecision Making, Ethical; Morale; Patient Care; Nurses; Decision Making, Ethical--Evaluation; Morale--Evaluation; Patient Care--Ethical Issues
The literature on ethical decision-making by nurses presents both prescriptive and descriptive decision-making models. The processes nurses use to move through the step-wise models has not been described. An atheoretical approach was taken using naturalistic inquiry methodology to explore the processes further. Eighteen nurses working in a midwest, urban academic medical center were interviewed. The major themes focused on the moral agency of nurses and the processes by which nurses accomplish their objectives for their patients. Physician-nurse relationships and their interactions were critical in the expression of moral agency of the nurses. The main finding in the study was that nurses' moral work is invisible. Their clinical decision-making, their negotiation with others to meet their patients' needs, and their investment in their patients' welfare virtually goes unrecognized and unacknowledged. Implications for nursing practice are that the nurses must decide if they want to change the system in which they practice. They would need to be willing to accept visibility and the accompanying accountability. Nursing education should prepare nurses for "visible", accountable practice. Future research is needed to explore this aspect of ethical decision-making by nurses and their role in ethical decision-making in patient care.
DescriptionThis dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9612346; ProQuest document ID: 304289542. The author still retains copyright.
Degree GrantorUniversity of Illinois at Chicago
NotesThis item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
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