Abstract
Nursing students face various ethical issues, which may cause stress, that require coping strategies. This study investigated the thoughts and feelings underlying the coping behaviors adopted by nursing students when addressing ethical issues. Semi-structured interviews were conducted from September to October 2011 with 11 students enrolled at University A who had completed basic nursing and specialty (by field) practicums and consented to participate in the study. Data were analyzed using qualitative methods. The participant narratives about ethical issues encountered during clinical practicums were organized into four themes and 20 scenarios. The ethical issues concerned the attitudes and conduct of nurses, doctors, physical therapists, and other medical professionals. Seven coping behaviors were identified. The results revealed that nursing students waver between valuing their relationships with nurses and their relationships with patients when they encounter an ethical issue. When their relationships with nurses were emphasized, their ethical values were restructured. These findings suggest the need to address the affective domain early on in lectures and in-class practice, and to create an environment in which students taking practicums can easily express their feelings and internal value system changes.
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Notes
“Chan” is an expression used in the Japanese language to affectionately refer to close friends or other familiar people.
References
Benner, Patricia, Christine Tanner, and Catherine Chesla, eds. 2009. Expertise in nursing practice: Caring, clinical judgment, and ethics. New York: Springer Publishing Company.
Cornine, Amanda. 2020. Reducing nursing student anxiety in the clinical setting: An integrative review. Nursing Education Perspectives 41: 229–234. https://doi.org/10.1097/01.NEP.0000000000000633.
Davis, AnneJ. 1999. Global influence of American nursing: Some ethical issues. Nursing Ethics 6: 118–125. https://doi.org/10.1177/096973309900600204.
Davis, Anne J., and Katsumasa Ota. 1999. Concise kangoron, kango to wa nanika—Kango no genten to kango rinri [A concise theory of nursing/defining nursing—origins of nursing and nursing ethics]. Tokyo: Shorinsha.
Gergerich, Erika, Daubney Boland, and Mary A. Scott. 2019. Hierarchies in interprofessional training. Journal of Interprofessional Care 33: 528–535. https://doi.org/10.1080/13561820.2018.1538110.
Kawai, Terumi, Nakata Tomoko, Eriko Koide, and Miyoko Sakai. 2016. The structure of education about ethical considerations in critical care practicums for nursing students. Synergetic Welfare Science 11 (1): 13–18.
Konishi, Emiko, Michiko Yahiro, Naoko Nakajima, and Miki Ono. 2007. The good nurse perceived by Japanese patients: A virtue ethics approach and the implication in Asian health care. Journal of Japan Association for Bioethics 16: 46–51. Retrieved from http://search.jamas.or.jp/link/ui/2008139679
McCarthy, Bridie, Joan McCarthy, Anna Trace, and Pamela Grace. 2018. Addressing ethical concerns arising in nursing and midwifery students’ reflective assignments. Nursing Ethics 25: 773–785. https://doi.org/10.1177/0969733016674767.
Mochizuki, Noriko, Mariko Shiramizu, and Tomoko Miyashiba. 2020. Collaboration with training instructors led by nursing teachers in nursing practice. Journal of Kanagawa University of Human Services 17: 27–37.
Muramatsu, Taeko, and Katayama Harumi. 2021. Examination of the usefulness of the Ethical Sensitivity Questionnaire (ESQ-NS) for Nursing Students. Journal of Japanese Nursing Ethics 1: 32–41. https://doi.org/10.32275/jjne.20200612.
Oermann, Marilyn H., and Kathleen B. Gaberson. 1998. Evaluation and testing in nursing education. New York: Springer Publishing Company.
Park, Mihyun, Diane Kjervik, Jamie Crandell, and Marilyn H. Oermann. 2012. The relationship of ethics education to moral sensitivity and moral reasoning skills of nursing students. Nursing Ethics 19: 568–580. https://doi.org/10.1177/0969733011433922.
Poorchangizi, Batool, Jamileh Farokhzadian, Abbas Abbaszadeh, Moghaddameh Mirzaee, and Fariba Borhani. 2017. The importance of professional values from clinical nurses’ perspective in hospitals of a medical university in Iran. BMC Medical Ethics 18: 1–7. https://doi.org/10.1186/s12910-017-0178-9.
Sakamoto, Sabrina R., Magda C. Q. Dell’Acqua, Luciana P. F. Abbade, Silvia M. Caldeira, Fátima B. Fusco. de Suzimar, and Marla A. G. de Avila. 2020. Team-Based Learning: A randomized clinical trial in undergraduate nursing. Revista Brasileira de Enfermagem 73: e20180621. https://doi.org/10.1590/0034-7167-2018-0621.
Salah, Akram A., Mohamad Aljerjawy, and Akram Salama. 2018. Gap between theory and practice in the nursing education: The role of clinical setting. Emergency 24: 17–8. https://doi.org/10.19080/JOJNHC.2018.07.555707.
Takagi, Kaori, Katsumasa Ota, Naoya Mayumi, and Naoko Arakawa. 2021. Perception of ethical problems by nursing students on and related Factors. Journal of Japanese Nursing Ethics 1: 42–50. https://doi.org/10.32275/jjne.20200805.
Tatsuno, Chitoshi, and Kaneko Takayoshi. 1995. Psychology, 2nd ed. Tokyo Japan: Japan Cultural Science Company.
Tobise, Terue, and Keiko Sakai. 2012. Nurses’ perceptions about ethics conference. Journal of Japanese Nursing Ethics 4: 15–21. https://doi.org/10.32275/jjne.4.1_15.
Tsuruwaka, Mari. 2015. Crucial ethical problem for Japanese nursing students at clinical settings. Journal of Nursing Education and Practice 5: 17. https://doi.org/10.5430/jnep.v5n12p17.
Weaver, Kathryn, Janice Morse, and Carl Mitcham. 2008. Ethical sensitivity in professional practice: Concept analysis. Journal of Advanced Nursing 62: 607–618. https://doi.org/10.1111/j.1365-2648.2008.04625.x.
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The author would like to sincerely thank all the participants who willingly contributed to this study and Professor Diana Jennings of Samuel Merritt University for her helpful instruction.
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This study was approved by the ethics review committee of the Nagano College of Nursing before data collection. The principal investigator was a faculty member at the College of Nursing, and the participants were nursing students.
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Tanaka, M. Thoughts and feelings that determine how Japanese nursing students deal with ethical issues: A qualitative study. International Journal of Ethics Education 6, 323–337 (2021). https://doi.org/10.1007/s40889-021-00127-1
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DOI: https://doi.org/10.1007/s40889-021-00127-1