This study examined the real-world implementation of nursing ethics guidance by surveying nurses involved in clinical training instruction. We conducted semi-structured interviews with nine clinical practice nurses and generated 12 categories from 156 codes. In developing instructional content with an ethical nursing perspective, we generated categories addressing “the importance of practicing patient-centered nursing” and “the importance of being receptive to various ideas.” Additionally, we developed categories related to teaching nursing ethics, including “deepening students’ understanding of patients” and “weaving the meaning of nursing with students.” The clinical nursing instructors approached nursing from a perspective aligned with that of the students, emphasizing the significance of patient care and prompting the students to reflect on its importance. The guiding practice of the clinical nursing instructors was centered on valuing patient-centered nursing care, emphasizing preserving the patient’s dignity. Timely and effective coaching, including ethically-oriented questioning, aimed to encourage students to perceive and act ethically.

This study aims to identify how psychiatric nurses with high moral sensitivity are able to perceive ethical issues, and how they make decisions and respond to ethical issues. Semi-structured interviews were conducted with nine nurses working in a psychiatric hospital, and qualitative inductive analysis identified 248 codes, 32 subcategories, and 11 categories. The participants felt discomfort when there was a lack of patient respect, and this made them realize that it was an ethical issue. Next, the participants clarified the various values in patients and healthcare professionals, and understood that establishing relationships of mutual trust was the basis of treatment when deciding how to respond to ethical issues. The participants responded to ethical issues based on a caring relationship between patients and nurses. The findings show new perspectives in responding to ethical issues in psychiatry.

The present study aimed to clarify the nursing practice to assist family members’ emancipated decision-making(EDM)in choosing treatment options for patients facing terminal stages in the intensive care unit. Eleven nurses with Level IV and higher certifications from the “Clinical Ladder for Nurses Attending Intensive Care Practice” underwent a series of semi-structured interviews. Subsequently, ten categories were generated, including 〈Assessing family members’ understanding regarding patient’s condition from their appearances〉, 〈Grasping the relationships among those involved in choosing treatment options〉, 〈Understanding circumstances where family members hesitate to discuss treatment options〉, 〈Explaining patient’s current conditions clearly to deepen the family members’ understanding〉, 〈Coordinating family meeting with doctors to help family members to understand the patient’s conditions〉, 〈Providing family members with a space and opportunity for honest discussion〉, 〈Attending to family members’ concerns〉, 〈Assisting all family members to help each other to reach the treatment decision〉, 〈Accepting family members’ sufferings and encourage them〉, and 〈Assessing from family members’ speech and behavior if they reached decisions with confidence〉. As this study demonstrated, medical teams must actively use the above-mentioned support contents in case conferences and nursing practice to aid patients’ and their families’ EDM.

Purpose: This study aimed to describe the experiences of nurses caring for patients with COVID-19 during the end-of-life process. Methods: We conducted unstructured interviews with three nurses who had 5 years of clinical experience and cared for patients infected with COVID-19.Their narrated experiences were analyzed using a phenomenological approach. Result: Participants reflected on their regrets, such as “I feel regret for having done something unforgivable, not only as a nurse, but also as a person.” and “I was surprised and perplexed that even I, who had accumulated so much experience, was having end-of-life care for the first time.” The experiences also provided an opportunity for the nurses to “Thinking again about nursing that is not work” and to “reaffirm my strengths as a nurse.” Conclusion: Nurses expressed regrets and distress for being unable to maintain patients’ dignity during the end-of-life care of patients with COVID-19. Therefore, it is necessary to consider the approach to caring for a patient’s dignity even under unusual situations. It was suggested that this experience was also an opportunity for nurses to reconsider the essence of nursing and the importance of recapturing negative emotions, and to grow as a nurse.

This study sought to classify ethical, morally troubling, and unethical situations experienced by nursing students during their practice. The study included 84 fourth-year nursing students from University A. They wrote reports on their practical experiences in a nursing ethics class, and each experience was considered one unit of record for content analysis. Fifty-nine students consented to the analysis, resulting in 211 units of record. The students felt were ethical, such as “I was involved flexibly, understanding the true needs of the patients”. Morally troubling situations included “I felt unsure about my care because I could not understand the patient’s reaction”, “I worried about reasonable and good care that respected the patient’s autonomy and dignity”, and “I wanted to provide care but could not because I was not capable”. The students felt were unethical such as “Care was provided that did not consider patient’s wishes”. This study’s results could be useful for educational activities, such as helping teachers envision teaching materials for practical situations and preparing students for nursing practice.

The purpose of this study was to describe the practice of CNS toward social justice and emancipation in the Japanese health care setting. Case studies were developed based on data from interviews with 14 CNSs with at least three years of post-licensure practice experience and analyzed from an emic and etic perspective. The results revealed social justice issues in the Japanese healthcare setting, including 1)prejudice and discrimination, roles and cultural norms, 2)uneven distribution of resources, and institutional and organizational divides, 3)organization and ideology of healthcare, and 4)perspectives, beliefs and values that govern nursing practice. In addition, professional nurses were practicing to emancipate and advocate for people, and to transform organizations and society, using approaches such as working together, being aware of relationships rather than dichotomies, persuading with language, and modeling and practicing. Future work was suggested to further clarify the sociopolitical factors influencing people’s health and the care provided, and to explore approaches to appropriately share and improve the findings.

Purpose: This study aimed to provide an overview of research outcomes in Japan regarding the thinking processes that lead nurses to choose clinical conduct and to elucidate the associated issues, focusing on daily nursing practice scenarios involving ethical conflicts. Method: We selected relevant literature from CiNii Research and the “Igaku Chuo Zasshi (ICHUSHI)” web version, based on eligibility and exclusion criteria. We then extracted, summarized, and examined descriptions of nurses’ decision making processes in ethical conflict situations and the thinking processes leading to them. Results: A total of 21 studies were selected for analysis. Discussion: Previous research has shown that nurses’ choices regarding clinical conduct in daily practice situations involving ethical conflicts follow a circular thinking process centered on patients and their families. This process is influenced by nurses’ experiential knowledge, values, beliefs, thoughts, feelings, and the organizational environment, including the nursing and healthcare teams. The challenge lied in developing a research methodology that ensured reproducibility and validity.

The purpose of this study is to explore the ethical challenges and ethical support environment regarding activities of a community general support center, and to discuss improved ethical practices for the residents. The study was based on a qualitative descriptive design using semi-structured interviews. The ten subjects included public health nurses/registered nurses, certified social welfare specialists, and chief care managers working at the center. The analysis revealed the following complex ethical challenges: “situations where the individual or the family members did not wish to receive support,” “conflicts owing to differences in intentions among the individual, family members, and other people around them,” “situations threatening dignity of the individual,” and “difficulties in building connections with the community.” Additionally, counseling difficulties extracted were “difficulty in ascertaining the truth,” and “difficulty in providing counseling beyond the scope of work.” Moreover, the professionals were aware of collaborative work respecting each other’s expertise, and we believe this will help create a workplace environment where seeking counseling is easier and contribute to improved ethical practices.

A total of 147 valid responses were obtained from a stratified random sample of nursing managers working in general hospitals and qualified managers working in visiting nursing stations were surveyed through a self-administered, unmarked questionnaire with the purpose of clarifying their perceptions of ethical behavior when handling nursing information. The survey was conducted using qualitative descriptive analysis of free-response statements regarding perceptions of ethical behavior when handling nursing information, and six core categories were extracted. It is desirable to make preventive behavior a habit with the clear purpose of “preventing information leaks”, and to implement countermeasures with this in mind. It is necessary to cultivate “honest attitude toward information and patients”, “cultivate an ethical sense of handling information” and “share information appropriately”. In addition, we believe that it is important as an ethical behavior to not only focus on keeping information confidential, but also to “ensure the integrity of the information” while also being able to “utilize it for nursing care”.