Araştırma Makalesi
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Dahili Kliniklerde Görev Yapan Hemşirelerin Karşılaştıkları Etik Sorunlar

Yıl 2025, Cilt: 10 Sayı: 2, 137 - 149, 31.08.2025
https://doi.org/10.25279/sak.1367579

Öz

Giriş: Bakım hizmetlerinin sunumu sırasında hemşirelerden her zaman hastayı koruyacak etik kararlar alması beklenmektedir. Fakat hemşirenin benimsediği mesleki ve kişisel değerleri ve uygulama arasındaki boşluk hemşirelerin hasta yararına karar alırken sıklıkla etik sorunlarla karşı karşıya kalmasına neden olur.
Amaç: Bu çalışmanın amacı dahili kliniklerde görev yapan hemşirelerin karşılaştıkları etik sorunların belirlenmesidir.
Gereç ve Yöntemler: Çalışma nitel araştırma deseninin kullanıldığı bir araştırmadır. Araştırmanın evrenini 24 hemşire oluşturmuştur. Veriler ‘hemşireler için yarı yapılandırılmış görüşme rehberi’ ile toplanmıştır. Veriler içerik analizi yöntemi ile analiz edilmiştir.
Bulgular: Hemşirelerin yaşadıkları etik sorunların; malzeme yetersizliği, sağlık çalışanı /zaman yetersizliği, hastaların ekonomik yetersizliği, mahremiyeti sağlamada yetersizlik /fiziki koşulların yetersizliği, hekim- hemşire çatışması, hasta yakını-hemşire çatışması, hasta-hemşire çatışması, hemşire-hemşire çatışması, hastanın yetersiz bilgilendirilmesi, iş tanımı belirsizliği, iletişim çatışmaları ve hekim istemi sorunları kaynaklı olduğu tespit edilmiştir.
Sonuç ve öneriler: Çalışma sonuçları literatür ile paralellik göstermektedir ve hemşirelerin karşılaştıkları etik sorunların çalışma yaşamlarında tükenmişliğe, etik duyarsızlığa ve bakım kalitesinde azalmaya neden olabileceğini bildirmektedir. Hemşirelerin karşılaştıkları etik sorunların yetersizlikler, çatışmalar, bireysel/kurumsal sorunlar nedeni ile ortaya çıktığı görülmüştür.

Kaynakça

  • Aitamaa, E., Leino-Kilpi, H., Puukka, P., & Suhonen, R. (2010). Ethical problems in nursing management: The role of codes of ethics. Nursing Ethics, 17(4), 469-482. https://doi.org/10.1177/0969733010364896
  • Brown, J., Lewis, L., Ellis, K., Stewart, M., Freeman, T. R., & Kasperski, M. J. (2011). Conflict on inter Professional primary health care teams – can it be resolved?. Journal of Inter professional Care, 25(1), 4–10. https://doi.org/10.3109/13561820.2010.497750
  • Burston, A. S., & Tuckett, A. G. (2013). Moral distress in nursing: Contributing factors, outco-mes and interventions. Nursing Ethics, 20(3), 312–324. https://doi.org/10.1177/0969733012462049
  • Chen, P. P., Lee, H. L., Huang, S. H., Wang, C. L., & Huang, C. M. (2018). Nurses’ perspecti-ves on moral distress: A Q methodology approach. Nursing Ethics, 25(6), 734–745. https://doi.org/10.1177/0969733016664976
  • Choe, K., Kang, Y., & Park, Y. (2015). Moral distress in critical care nurses: A phenomenologi-cal study. Journal of Advanced Nursing., 71(7), 1684–1693. https://doi.org/10.1111/jan.12638
  • Entwistle, V. A., Carter, S. M., Cribb, A, & McCaffery, K. (2010). Supporting patient autonomy: The importance of clinician-patient relationships. Journal of General Internal Medicine, 25(7), 741-745. https://doi.org/10.1007/s11606-010-1292-2
  • Fernandes, M. I. D., & Moreira, I. M. P. B. (2013). Ethical issues experienced by intensive care unit nurses in everyday practice. Nursing Ethics, 20(1),72–82. https://doi.org/10.1177/0969733012452683 Frisch, N., & Rabinowitsch, D. (2019). What’s in a definition? Holistic nursing, integrative health care, and integrative nursing: Report of an integrated literature review. Journal of Holistic Nursing, 37(3), 260-272. https://doi.org/10.1177/0898010119860685
  • Gale, N. K., Heath, G., Cameron, E., Rashid, S., & Redwood, S. (2013). Using the frame work method for the analysis of qualitative data in multi-disciplinary health research. BMC Medical Research Methodology, 13, 117. http://www.biomedcentral.com/1471-2288/13/117
  • Haahr, A., Norlyk, A., Martinsen, B., & Dreyer, P. (2020). Nurses experiences of ethical dilem-mas: A review. Nursing Ethics, 27(1), 258–272. https://doi.org/10.1177/0969733019832941
  • Hopia, H., Lottes, I., & Kanne, M. (2016). Ethical concerns and dilemmas of Finnish and Dutch health professionals. Nursing Ethics, 23(6), 659–673. https://doi.org/10.1177/0969733015579311
  • International Council of Nurses Revised 2021. The ICN code of ethics for nurses, 2021. (2021, Retrieved April 10, 2022, from https://www.nzno.org.nz/Portals/0/Files/Documents/Consultation/Sue%20Gasquoine%20Feedback%202020-08
  • Laukkanen, L., Suhonen, R., & Leino-Kilpi, H. (2016). Solving work-related ethical problems: The activities of nurse managers. Nursing Ethics, 23(8), 838–850. https://doi.org/10.1177/0969733015584966
  • Mahon, M. M., & Nicotera, A .M. (2011). Nursing and conflict communication avoidance as preferred strategy Nursing Administration Quarterly, 35(2), 152–163. https://doi:10.1097/NAQ.0b013e31820f47d5
  • McAndrew, N. S. & Hardin, J. B. (2020). Giving nurses a voice during ethical conflict in the Intensive Care Unit. Nursing Ethics, 27(8), 1631–1644. https://doi.org/10.1177/0969733020934148
  • McAndrew, N. S., Schiffman, R., & Leske, J. (2019). Relationships among climate of care, nur-sing family care and family well-being in ICUs. Nursing Ethics, 26(7–8), 2494–2510. https://doi.org/10.1177/0969733019826396 Muramatsu, T., Nakamura, M., Okada, E., Katayama, H., & Ojima, T. (2019). The development and validation of the Ethical Sensitivity Questionnaire for Nursing Students. BMC Medi-cal Education, 19:215 https://doi.org/10.1186/s12909-019-1625-8
  • Nora, C. R. D., Zoboli, E., & Vieira, M. M. (2017). Moral sensitivity of nurses assessed through scoping review. Cogitare Enfermagem, 22(2), e47162. https://dx.doi.org/10.5380/ce.v22i1.47162
  • Norlyk, A., Haahr, A., Dreyer, P., & Martinsen, B. (2017). Lost in transformation? Reviving ethics of care in hospital cultures of evidence-based health care. Nursing Inquiry, 24(3), e12187. https://doi.org/10.1111/nin.12187
  • Pishgooie, A. H., Barkhordari-Sharifabad, M., Atashzadeh-Shoorideh, F., & Falcó-Pegueroles, A. (2019). Ethical conflict among nurses working in the intensive care units. Nursing Ethics, 26 (78), 2225–2238. https://doi.org/10.1177/0969733018796686
  • Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An integrative review. Journal of Clinical Nursing, 27(19-20), 3446–3461. https://doi.org/10.1111/jocn.14542
  • Varcoe, C., Pauly, B., Webster, G., & Storch, J. (2012). Moral distress: Tensions as springboards for action. HEC Forum, 24(1), 51–62. https://doi:10.1007/s10730-012-9180-2

Ethical Problems Encountered by The Nurses Serving in The Internal Medicine Clinics

Yıl 2025, Cilt: 10 Sayı: 2, 137 - 149, 31.08.2025
https://doi.org/10.25279/sak.1367579

Öz

Introduction: While providing care services, the nurses are expected to make ethical decisions that will always protect the patient. However, due to the gap between the practice and the professional and personal values adopted by the nurses, the nurses are frequently confronted with ethical problems while making decisions in the patient’s favor.
Aim: This study aims to identify the ethical problems encountered by the nurses serving in the internal medicine clinics.
Matherials and Methods: The study was conducted as a descriptive qualitative study. The research population was 24 nurses were included in the research sample in light of the data saturation criterion. The research data were gathered via the ‘Semi-Structured Interview Form for the Nurses’. The research data were examined through the content analysis method.
Results: It was found that the ethical problems encountered by the participant nurses arose from the insufficiency of equipment and materials, the shortage of health employees/lack of time, the patients’ economic problems, the shortcomings in protecting privacy/inadequacy of physical conditions, the conflicts between doctors and nurses, the conflicts between patient relatives and nurses, the conflicts between patients and nurses, the conflicts between nurses, insufficient information presented to the patient, the uncertainty about the job description, the communication problems with other health professionals, and the problems about the doctor’s orders.
Conlusion and sugestions: The study results are in parallel to the findings in the relevant literature, and it is asserted that the ethical problems encountered by the nurses are likely to give rise to burnout and ethical insensitivity in their professional lives and fall in the care quality. It was ascertained that the ethical problems encountered by the nurses came into being due to certain shortcomings, conflicts, and individual/institutional problems.

Kaynakça

  • Aitamaa, E., Leino-Kilpi, H., Puukka, P., & Suhonen, R. (2010). Ethical problems in nursing management: The role of codes of ethics. Nursing Ethics, 17(4), 469-482. https://doi.org/10.1177/0969733010364896
  • Brown, J., Lewis, L., Ellis, K., Stewart, M., Freeman, T. R., & Kasperski, M. J. (2011). Conflict on inter Professional primary health care teams – can it be resolved?. Journal of Inter professional Care, 25(1), 4–10. https://doi.org/10.3109/13561820.2010.497750
  • Burston, A. S., & Tuckett, A. G. (2013). Moral distress in nursing: Contributing factors, outco-mes and interventions. Nursing Ethics, 20(3), 312–324. https://doi.org/10.1177/0969733012462049
  • Chen, P. P., Lee, H. L., Huang, S. H., Wang, C. L., & Huang, C. M. (2018). Nurses’ perspecti-ves on moral distress: A Q methodology approach. Nursing Ethics, 25(6), 734–745. https://doi.org/10.1177/0969733016664976
  • Choe, K., Kang, Y., & Park, Y. (2015). Moral distress in critical care nurses: A phenomenologi-cal study. Journal of Advanced Nursing., 71(7), 1684–1693. https://doi.org/10.1111/jan.12638
  • Entwistle, V. A., Carter, S. M., Cribb, A, & McCaffery, K. (2010). Supporting patient autonomy: The importance of clinician-patient relationships. Journal of General Internal Medicine, 25(7), 741-745. https://doi.org/10.1007/s11606-010-1292-2
  • Fernandes, M. I. D., & Moreira, I. M. P. B. (2013). Ethical issues experienced by intensive care unit nurses in everyday practice. Nursing Ethics, 20(1),72–82. https://doi.org/10.1177/0969733012452683 Frisch, N., & Rabinowitsch, D. (2019). What’s in a definition? Holistic nursing, integrative health care, and integrative nursing: Report of an integrated literature review. Journal of Holistic Nursing, 37(3), 260-272. https://doi.org/10.1177/0898010119860685
  • Gale, N. K., Heath, G., Cameron, E., Rashid, S., & Redwood, S. (2013). Using the frame work method for the analysis of qualitative data in multi-disciplinary health research. BMC Medical Research Methodology, 13, 117. http://www.biomedcentral.com/1471-2288/13/117
  • Haahr, A., Norlyk, A., Martinsen, B., & Dreyer, P. (2020). Nurses experiences of ethical dilem-mas: A review. Nursing Ethics, 27(1), 258–272. https://doi.org/10.1177/0969733019832941
  • Hopia, H., Lottes, I., & Kanne, M. (2016). Ethical concerns and dilemmas of Finnish and Dutch health professionals. Nursing Ethics, 23(6), 659–673. https://doi.org/10.1177/0969733015579311
  • International Council of Nurses Revised 2021. The ICN code of ethics for nurses, 2021. (2021, Retrieved April 10, 2022, from https://www.nzno.org.nz/Portals/0/Files/Documents/Consultation/Sue%20Gasquoine%20Feedback%202020-08
  • Laukkanen, L., Suhonen, R., & Leino-Kilpi, H. (2016). Solving work-related ethical problems: The activities of nurse managers. Nursing Ethics, 23(8), 838–850. https://doi.org/10.1177/0969733015584966
  • Mahon, M. M., & Nicotera, A .M. (2011). Nursing and conflict communication avoidance as preferred strategy Nursing Administration Quarterly, 35(2), 152–163. https://doi:10.1097/NAQ.0b013e31820f47d5
  • McAndrew, N. S. & Hardin, J. B. (2020). Giving nurses a voice during ethical conflict in the Intensive Care Unit. Nursing Ethics, 27(8), 1631–1644. https://doi.org/10.1177/0969733020934148
  • McAndrew, N. S., Schiffman, R., & Leske, J. (2019). Relationships among climate of care, nur-sing family care and family well-being in ICUs. Nursing Ethics, 26(7–8), 2494–2510. https://doi.org/10.1177/0969733019826396 Muramatsu, T., Nakamura, M., Okada, E., Katayama, H., & Ojima, T. (2019). The development and validation of the Ethical Sensitivity Questionnaire for Nursing Students. BMC Medi-cal Education, 19:215 https://doi.org/10.1186/s12909-019-1625-8
  • Nora, C. R. D., Zoboli, E., & Vieira, M. M. (2017). Moral sensitivity of nurses assessed through scoping review. Cogitare Enfermagem, 22(2), e47162. https://dx.doi.org/10.5380/ce.v22i1.47162
  • Norlyk, A., Haahr, A., Dreyer, P., & Martinsen, B. (2017). Lost in transformation? Reviving ethics of care in hospital cultures of evidence-based health care. Nursing Inquiry, 24(3), e12187. https://doi.org/10.1111/nin.12187
  • Pishgooie, A. H., Barkhordari-Sharifabad, M., Atashzadeh-Shoorideh, F., & Falcó-Pegueroles, A. (2019). Ethical conflict among nurses working in the intensive care units. Nursing Ethics, 26 (78), 2225–2238. https://doi.org/10.1177/0969733018796686
  • Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An integrative review. Journal of Clinical Nursing, 27(19-20), 3446–3461. https://doi.org/10.1111/jocn.14542
  • Varcoe, C., Pauly, B., Webster, G., & Storch, J. (2012). Moral distress: Tensions as springboards for action. HEC Forum, 24(1), 51–62. https://doi:10.1007/s10730-012-9180-2
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Tıp Etiği
Bölüm Derlemeler
Yazarlar

Berna Köktürk Dalcalı 0000-0002-2123-3386

Seçil Erden Melikoğlu 0000-0002-4931-3599

Zuhal Nas 0000-0002-5472-4720

Hatice Kaya 0000-0002-8427-0125

Yayımlanma Tarihi 31 Ağustos 2025
Gönderilme Tarihi 27 Eylül 2023
Kabul Tarihi 14 Mart 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 10 Sayı: 2

Kaynak Göster

APA Köktürk Dalcalı, B., Erden Melikoğlu, S., Nas, Z., Kaya, H. (2025). Ethical Problems Encountered by The Nurses Serving in The Internal Medicine Clinics. Health Academy Kastamonu, 10(2), 137-149. https://doi.org/10.25279/sak.1367579

Sağlık Akademisi Kastamonu, 2017 yılından itibaren UAK doçentlik kriterlerine göre 1-b dergiler (SCI, SSCI, SCI-expanded, ESCI dışındaki uluslararası indekslerde taranan dergiler) sınıfında yer almaktadır. SAĞLIK AKADEMİSİ KASTAMONU Dergi kapağı Türk Patent Enstitüsü tarafından tescil edilmiştir.