An examination of ethical situations and nursing ethics education of clinical nurses from the perspective of hospital size

Abstract

This study sought to clarify the educational opportunities, level of ethical knowledge, and ethical issues experienced by clinical nurses based on hospital size. Subjects were 230 nurses employed at larger（301 beds or more）and small to medium-sized（300 beds or less）hospitals. Subjects completed a questionnaire containing items from the Japanese version of “Ethics and human rights in nursing practice.” The results showed that nurses in larger sized hospitals were more experienced in tackling ethical issues, with significantly greater experience with reference to “respecting/not respecting informed consent,” “respect for the patient’s rights and dignity,” “determining when death occurs,” “acting against personal/religious values,” and “patient care with a possible risk for health” as compared to nurses in small to medium sized hospitals. Larger hospitals presented more educational opportunities regarding ethics, and level of recognition of the understanding of the terminology and importance of ethics education. Furthermore, the level of interest in ethics was higher in larger hospitals. With more educational opportunities, there was an increased interest in the theoretical knowledge of ethics and it was easier to perceive ethical issues. It is necessary to enhance the educational content in order to heighten nurses’ sensitivity to ethical issues.