The aim of this study was to identify the ethical problems that nurse managers encounter in their work and the role of codes of ethics in the solutions to these difficulties. The data were collected using a structured questionnaire and analysed statistically. The target sample included all nurse managers in 21 specialized health care or primary health care organizations in two hospital districts in Finland (N = 501; response rate 41%). The most common ethical problems concerned resource allocation as well as providing and developing high quality care. This was the case in different managerial positions as well as in types of organization. Professional codes of ethics were used more often for problems related to patients’ care compared with issues of resource allocation. Nurse managers at middle or strategic management levels used codes of ethics more often than those in charge of a ward. More research is required to investigate ethical decision making in nursing management, especially with regard to problem solving. In addition, new guidelines and continuing education in ethics are important for management personnel.
Schank MJ, Weis D., Ancona J.Reflecting professional values in the philosophy of nursing. J Nurs Adm1996; 26(7-8): 55-60.
6.
Shirey MREthical climate in nursing practice: the leader’s role. JONAS Healthc Law Ethics Regul2005; 7: 59-67.
7.
Sietsema MR , Spradley BWEthics and administrative decision making . J Nurs Adm1987; 17(4): 28-32.
8.
American Organization of Nurse Executives.AONE nurse executive competencies. Nurse Leader2005; (Feb): 50-6.
9.
Esterhuizen P.Is the professional code still the cornerstone of clinical nursing practice?J Adv Nurs1996 ; 23: 25-31.
10.
Kane-Urrabazo C.Management’s role in shaping organizational culture. J Nurs Manag2006; 14: 188-94.
11.
Rees J., King L., Schmitz K.Nurses’ perceptions of ethical issues in the care of older people . Nurs Ethics2009; 16: 436-52.
12.
Gallagher E. , Alcock D., Diem E., Douglas A., Medves J.Ethical dilemmas in home care case management . J Healthc Manag2002: 47: 85-97.
13.
Rice EM, Rady MY, Hamrick A., Verheijde JL, Pendegast DKDeterminants of moral distress in medical and surgical nurses at an adult acute tertiary care hospital. J Nurs Manag2008; 16: 360-73.
14.
Wilson DMAdministrative decision making in response to sudden health care agency funding reductions: is there a role for ethics?Nurs Ethics1998; 5: 319-29.
15.
Schluter J. , Winch S., Holzhauser K., Henderson A.Nurses’ moral sensitivity and hospital ethical climate: a literature review. Nurs Ethics2008; 15: 304-21.
16.
Cooper RW, Frank GL, Gouty CA, Hansen MCKey ethical issues encountered in healthcare organizations: perceptions of nurse executives. J Nurs Adm2002; 32: 331-7.
17.
Gaudine AP, Beaton MREmployed to go against one’s values: nurse managers’ accounts of ethical conflict with their organizations. Can J Nurs Res2002; 34(2): 17-34.
18.
Cooper RW, Frank GL, Hansen MC, Gouty CAKey ethical issues encountered in healthcare organizations: the perceptions of staff nurses and nurse leaders. J Nurs Adm2004; 34: 149-56.
19.
Breslin MJ, MacRae SK, Bell J., Singer PA and the University of Toronto Joint Centre for Bioethics Clinical Ethics Group. Top 10 health care ethics challenges facing the public: views of Toronto bioethicists. BMC Med Ethics2005 ; 6(5): 1-8.
20.
Brosnan J., Roper JMThe reality of political ethical conflicts: nurse manager dilemmas . J Nurs Adm1997; 27(9): 42-6.
21.
International Council of Nurses.The ICN code of ethics for nurses. http://www.icn.ch/icncode.pdf (2006, accessed March 2010).
22.
Meulenbergs T., Verpeet E., Schotsmans P., Gastmans C.Professional codes in a changing nursing context: literature review. J Adv Nurs2004; 46: 331-6.
23.
European Council of Nursing Regulators.FEPI Working Group on Ethical Codes. http://www.fepi.org/en/working-groups.php (2009, accessed March 2010).
24.
Lasso L., Stievano A., Gonzales Jurado MG, Rocco G.Code of ethics and conduct for European nursing. Nurs Ethics2008; 15: 821-36.
25.
Heikkinen A. , Lemonidou C., Petsios K., et al. Ethical codes in nursing practice: the viewpoint of Finnish, Greek and Italian nurses. J Adv Nurs2006; 55: 310-9.
26.
Tadd W., Clarke A., Lloyd L., et al. The value of nurses’ codes: European nurses’ views . Nurs Ethics2006; 13: 376-93.
27.
Edgar A.How effective are codes of nursing ethics? In: Tadd W (ed.) Ethical and professional issues in nursing: perspectives from Europe. Basingstoke: Palgrave Macmillan, 2004: 155-74.
28.
Pattison S.Are nursing codes of practice ethical?Nurs Ethics2001; 8: 5-18.
29.
Downie RS, Calman KCHealthy respect. Oxford: Oxford University Press, 1998.
30.
National Health Service, United Kingdom.Code of Conduct for NHS managers. http://www.dh.gov.uk/prod_con-sum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4085904.pdf (2002, accessed March 2010).
31.
American College of Healthcare Executives.ACHE codes of ethics. http://www.ache.org ( 2007, accessed March 2010).
32.
Terveystieteiden akateemiset johtajat ja asiantuntijat ry (Taja ry).(Association of Health Science Academic Leaders and Experts.) Hoitotyön johtajan, ylihoitajan eettiset ohjeet. (Code of ethics for nurse managers.)Ylihoitajalehti2003: 31(2); 15 (in Finnish).
33.
Borawski DBResources used by nurse administrators in ethical decision-making. J Nurs Adm1994 ; 24(3): 17-22.
34.
Camunas C.Codes of ethics as resources for nurse executives in ethical decision making . J NY State Nurs Assoc1994; 25(4): 4-7.
35.
Cooper RW, Frank GL, Gouty CA, Hansen MMEthical helps and challenges faced by nurse leaders in the healthcare industry . J Nurs Adm2003; 33: 17-23.
36.
Ryynänen O-P., Myllykangas M.Terveydenhuollon etiikka. Arvot monimutkaisuuden maailmassa. (Ethics in health care. Values in a complicated world.)Juva: WSOY, 2000 (in Finnish).
37.
Pasternak A.Hoitovirheet ja hoidon aiheuttamat haitat. (Medical errors and adverse events in medical care.)Duodecim2006; 122: 2459-70 (in Finnish).
38.
Burns N., Grove S.The practice of nursing research: conduct, critique, and utilization . Philadelphia, PA: Elsevier/ Saunders, 2005.
