Abstract

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.

Description

This 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.

Author Details

Teresa A. Savage, PhD, RN

Sigma Membership

Alpha Lambda

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Qualitative Research

Keywords:

Nursing Ethics, Nurse Control over Decision-making, Physician-Nurse Relationships

Advisor

Beverly McElmurry

Degree

PhD

Degree Grantor

University of Illinois Chicago

Degree Year

1995

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2019-12-16

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