Ethical practice in nursing: working the in-betweens |
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Authors: | Varcoe Colleen Doane Gweneth Pauly Bernadette Rodney Paddy Storch Janet L Mahoney Karen McPherson Gladys Brown Helen Starzomski Rosalie |
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Institution: | Associate Professor, School of Nursing, University of Victoria, Vancouver, British Columbia, Canada. cvarcoe@telus.net |
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Abstract: | BACKGROUND: While contemporary ethical theory is of tremendous value to nursing, the extent to which such theory has been informed by the concerns and practices of nurses has been limited. PURPOSE: With a view to complementing extant ethical theory, a study was undertaken to explore, from the perspective of nurses, the meaning of ethics and the enactment of ethical practice in nursing. DESIGN AND METHODS: Located in the interpretive/constructivist paradigm, using an emergent design, this inquiry employed focus groups to collect the data. Eighty-seven nurses from a wide range of practice settings were interviewed in 19 focus groups of three to nine nurses each. FINDINGS: The nurses described ethics in their practice as both a way of being and a process of enactment. They described drawing on a wide range of sources of moral knowledge in a dynamic process of developing awareness of themselves as moral agents. Enacting moral agency involved working in a shifting moral context, and working in-between their own values and those of the organizations in which they worked, in-between their own values and those of others, and in-between competing values and interests. CONCLUSIONS: Analysis of the experiences and concerns of the nurses offered new understanding of ethics in nursing and direction for the development of ethical theory pertinent to nursing practice. |
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Keywords: | moral agency ethical practice ethical theory nursing ethics moral identity |
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