Pajakoski Elina, Leino-Kilpi Helena, Čartolovni Anto, Stolt Minna, Suhonen Riitta
Department of Nursing Science, University of Turku, Turku, Finland.
The Wellbeing Services County of Southwest Finland, University Hospital, Turku, Finland.
Scand J Caring Sci. 2025 Sep;39(3):e70095. doi: 10.1111/scs.70095.
To holistically illustrate the consequences of nurses' morally courageous acts for patients, nurses, and work communities.
Narrative inquiry was used to explore the topic in the context of encountering ethical conflicts in nursing care. Consequences of nurses' morally courageous acts were illustrated to understand the significance of the acts for the good of patients, nurses, and work communities.
Ethical approval was received from the University's ethical committee. The participants were registered nurses who gave their informed consent to participate voluntarily.
Individual in-depth interviews with fourteen registered nurses of varying working experience were conducted in January-February 2023. Data were analysed inductively with holistic content analysis. This report follows the Consolidated criteria for reporting qualitative research (COREQ).
Nurses demonstrated moral courage in ethical conflicts such as disrespectful behaviour, collaboration issues, missed care, and privacy violations. In doing so, they initiated discussions, completed written reports, admitted mistakes, and provided attentive patient care. Morally courageous acts helped mitigate the ethical conflicts, although some remained unresolved. The direct and indirect consequences were positive and negative for nurses who acted, and positive for patients and the work community.
The nurses considered the consequences of morally courageous acts for themselves and others, expressing their experiences, which excluded other people's perspectives. The complexity of the topic posed challenges in reporting the findings coherently, with only a few concepts.
Nurses act morally courageously in varying ethical conflicts, indicating that they can defend morally responsible conduct. The consequences identified in this study highlight the potential for nurses who act morally courageously to promote well-being among patients and professionals. However, complex ethical conflicts cannot always be resolved with one courageous act. Thus, healthcare organisations can aim to develop processes that facilitate nurses acting morally courageously and that enhance multi-professional collaboration in ethical conflicts.
全面阐述护士道德勇气行为对患者、护士及工作群体的影响。
采用叙事探究法在护理过程中遇到伦理冲突的背景下探讨该主题。阐述护士道德勇气行为的影响，以理解这些行为对患者、护士及工作群体福祉的重要性。
获得了大学伦理委员会的伦理批准。参与者为注册护士，他们自愿给予知情同意参与研究。
于2023年1月至2月对14名具有不同工作经验的注册护士进行了个人深度访谈。采用整体内容分析法对数据进行归纳分析。本报告遵循定性研究报告的统一标准（COREQ）。
护士在诸如不尊重行为、协作问题、护理缺失及侵犯隐私等伦理冲突中展现出道德勇气。在此过程中，他们发起讨论、完成书面报告、承认错误并提供悉心的患者护理。道德勇气行为有助于缓解伦理冲突，尽管有些冲突仍未得到解决。对于采取行动的护士而言，直接和间接后果既有积极的也有消极的，而对患者和工作群体则是积极的。
护士们考虑了道德勇气行为对自身和他人的影响，并分享了他们的经历，这排除了其他人的观点。该主题的复杂性给连贯报告研究结果带来了挑战，且涉及的概念较少。
护士在各种伦理冲突中表现出道德勇气，表明他们能够捍卫符合道德责任的行为。本研究中确定的影响凸显了道德勇气行为的护士在促进患者和专业人员福祉方面的潜力。然而，复杂的伦理冲突并非总能通过一次勇敢行为得到解决。因此，医疗保健机构可以致力于制定促进护士道德勇气行为并加强伦理冲突中多专业协作的流程。
