BACKGROUND: The ethics and human rights issues experienced by psychiatric-mental health and substance-abuse registered nurses (P-MH and SA RNs) and how disturbed they are by the issues are not known.
OBJECTIVE: The purpose of this study was to identify the frequency of ethics and human rights issues experienced by P-MH and SA RNs and how disturbing the issues are to them.
STUDY DESIGN: Using Dillman’s (1978) Total Design Method, a survey of more than 8,000 RNs in six New England states was conducted. From the final sample size of 2,090 New England RN participants, responses from 162 participants who identified themselves as P-MH(n = 145) or SA (n = 17) RNs were further analyzed using descriptive statistics.
RESULTS: Protecting patients’ rights and human dignity and providing nursing care with possible health risks to the RN were identified as the most frequently experienced ethics and human rights issues. Staffing patterns that limit patient access to nursing care and implementing managed care policies that threaten the quality of patient care were identified as the most disturbing issues. Forty-one percent of the RNs reported experiencing ethics and human rights issues daily or one to four times per week in their clinical practices.
CONCLUSIONS: P-MH and SA RNs in New England encounter ethics and human rights issues in practice more frequently than all other RNs practicing in New England.
Get full access to this article
View all access options for this article.
References
1.
American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Washington, DC: Author.
2.
American Nurses Association. (2000). Scope and standards of psychiatric/mental health nursing practice. Washington, DC: Author.
3.
Berger, M.C., Seversen, A., & Chvatal, R. (1991). Ethical issues in nursing. Western Journal of Nursing Research, 13, 514-521.
4.
Corley, M.C. (1995). Moral distress of critical care nurses. American Journal of Critical Care, 4, 280-285.
5.
Corley, M.C., Elswick, R.K., Gorman, M., & Clor, T. (2001). Development and evaluation of a moral distress scale. Journal of Advanced Nursing, 33, 250-256.
6.
Crisham, P. (1981). Measuring moral judgment in nursing dilemmas. Nursing Research, 30, 104-116.
7.
deCasterle, B.D., Janssen, P.J., & Grypdonck, M. (1996), The relationship between education and ethical behavior of nursing students. Western Journal of Nursing Research, 18, 330-350.
8.
Dillman, D.A. (1978). Mail and telephone surveys—The Total Design Method. New York: Wiley.
9.
Doka, K., Rushton, C.H., & Thorstenson, T.A. (1994). Heath Care Ethics Forum ’94: Caregiver distress: If it is so ethical, why does it feel so bad? AACN Clinical Issues in Critical Care Nursing, 5, 346-352.
10.
Fisher, A. (1995). The ethical problems encountered in psychiatric nursing practice with dangerous mentally ill persons. Scholarly Inquiry for Nursing Practice: An International Journal9, 193-208.
11.
Flannery, J., & Van Gaasbeek, D.E. (1998). Factors in job satisfaction of the psychiatric clinical nurse specialist. Nursing Connections11(4), 27-36.
12.
Forchuk, C. (1991). Ethical problems encountered by mental health nurses. Issues in Mental Health Nursing, 12, 375-383.
13.
Freed, P.E., & Drake, V.K. (1999). Mandatory reporting of abuse: Practical, moral, and legal issues for psychiatric home healthcare nurses. Issues in Mental Health Nursing, 20, 423-436.
Fry S.T., & Damrosch S. (1994). Ethics and human rights issues in nursing practice: A survey of Maryland nurses. The Maryland Nurse, 13(7), 11-12.
16.
Fry, S.T., & Duffy, M.E. (2001). The development and psychometric evaluation of the Ethical Issues Scale. Journal of Nursing Scholarship, 33, 273-277.
17.
Fry, S.T., & Duffy, M.E. (2000). Ethical issues in nursing practice: How they are experienced and handled by New England RNs. Retrieved January 9, 2003 from http://www.bc_org/avp/son/ethics/abstracts/ab07.html
18.
Gibson, C. (1997). Ethical dilemmas faced by mental health nurses. Nursing Standard, 11(48), 38-40.
19.
Ketefian, S. (2001). The relationship of education and moral reasoning to ethical practice: A meta-analysis of quantitative studies. Scholarly Inquiry for Nursing Practice: An International Journal15, 3-18.
20.
Lanza, M.L. (1992). Nurses as patient assault victims: An update, synthesis, and recommendations. Archives of Psychiatric Nursing, 6, 163-171.
21.
Lanza, M.L. (1995). Patient assault: A comparison of patient and staff perceptions. Issues in Mental Health Nursing, 16, 129-141.
22.
Oberle, K., & Hughes, D. (2001). Doctors’ and nurses’ perceptions of ethical problems in end-of-life decisions. Journal of Advanced Nursing, 33, 707-715.
23.
Olofsson, B., Gilje, F., Jacobsson, L., & Norberg, A. (1998). Nurses’ narratives about using coercion in psychiatric care. Journal of Advanced Nursing28, 45-53.
24.
Redman, B.K., & Fry, S.T. (2000). Nurse’ ethical conflicts: What is really known about them? Nursing Ethics, 7, 360-366.
25.
Thomas, M.D., Beaven, J., Blacksmith, J., Ekland, E., Hein, J., Osborne, O.H., et al. (1999). Meanings of state hospital nursing I: Facing challenges. Archives of Psychiatric Nursing, 13, 48-54.
26.
Wilkinson, J.M. (1987/1988). Moral distress in nursing practice: Experience and effect. Nursing Forum, 23, 16-29.
