Ethical Conflicts Experienced by Nurses in Geriatric Hospitals in South Korea: “If You Can’t Stand the Heat, Get Out of the Kitchen”
Abstract
:1. Introduction
2. Methods
2.1. Design
2.2. Participants
2.3. Data Collection
2.4. Data Analysis
2.5. Trustworthiness
3. Results
3.1. Confusing Values for Good Nursing
Uncertainty about the Right or Wrong Action for a Good Nurse: “I Don’t Know What Makes Good Nursing in the Real World”
3.2. Distress Resulting from Not Acting the Right Way Despite One’s Knowledge
3.2.1. Fear Originating from Seeing Oneself Violating One’s Nursing Values: “How Could I Call Myself a Nurse?”
When I first witnessed the passing of a patient, it was really sad. But after seeing it many times, it just feels like part of work. Now, I’m more concerned about the paperwork I have to do. Work comes first now. I get insensible to death as it happens often at geriatric hospitals. And I get afraid of myself. How could I call myself a nurse? I wasn’t like that before, what happened to me?(Participant 3)
3.2.2. Anger Resulting from Failures in Playing a Role as an Advocate: “The Most Annoying Thing Is, I Had to be Still”
The most annoying thing is, I had to be still despite realizing senior nurses’ unethical behaviors. Nobody brings up those problems in my ward for the patients. I mean, as a junior nurse, I have no choice but to have options. If I do that, I might be treated as a rude junior nurse or a freaky one… I just have to follow the group rules.(Participant 4)
The policy allows hiring nursing assistants instead of nurses. So, which hospital would hire an expensive nurse? Of course, they would hire nursing assistants. I’m trying to care for my patients as much possible as I can though, I’m busy. But, I can’t handle even so many nursing assistants with problems. They are not capable of delivering appropriate care for my vulnerable and weak patients. In my hospital, most older patients need to be taken care of very carefully but many nursing assistants seem to have little knowledge of caring for older patients or (follow) necessary ethical rules as care workers.(Participant 7)
3.2.3. Being Exhausted by Hospitals’ Unchanging Unethical Attitude: “I Am Only One of Their Employees”
The top priority for healthcare professionals is honesty. The patients have rights to know the truth. But, that’s the hardest part here… (exasperated sigh). The hospital and its manager never want to make a big deal out of it. I’m sick of them, they merely treat patients as money… but, it’ll be hard to continue working as a whistleblower. Anonymity is not guaranteed. No one is willing to come forward to report to the manager or management. How could I change that? I am only one of their employees.(Participant 1)
3.3. Avoiding Ethical Conflicts as a Last Resort
Helplessly Leaving the Job when Repetitive Unmanageable Ethical Problems Occur Beyond One’s Control: “If You Can’t Stand the Heat, Get Out of the Kitchen”
Because of that hospital, I couldn’t abandon my ethical beliefs as a nurse. I’m just an employee. A regular employee cannot make changes that will happen hospital-wise. The hospital will not give up profits just because I told them what they’re doing is wrong. You know the proverb—If you can’t stand the heat, get out of the kitchen. That’s why. Many hospitals are still like that.(Participant 6)
4. The Essential Structure of Ethical Conflicts by Nurses in Geriatric Hospitals in South Korea
5. Discussion
5.1. Implications
5.2. Limitations
6. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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No. | Age | Gender | Marital Status | Religion | Education * | Current Position | Years of Experience as a Nurse | Years of Experience in a Geriatric Hospital |
---|---|---|---|---|---|---|---|---|
1 | 32 | Female | Single | No religion | ADN | Staff nurse | 8 | 4 |
2 | 38 | Female | Married | No religion | ADN | Staff nurse | 4.3 | 3.3 |
3 | 35 | Female | Married | No religion | ADN | Staff nurse | 8 | 3 |
4 | 28 | Female | Single | No religion | BSN | Staff nurse | 3.5 | 3.5 |
5 | 33 | Female | Single | Buddhist | ADN | Staff nurse | 11 | 8 |
6 | 36 | Female | Married | Christian | ADN | Head nurse | 14 | 10 |
7 | 40 | Female | Married | No religion | ADN | Staff nurse | 15 | 4 |
8 | 38 | Female | Married | No religion | ADN | Staff nurse | 14 | 4 |
9 | 52 | Female | Married | Christian | BSN | Head nurse | 20 | 10 |
Categories | Theme Clusters | Themes |
---|---|---|
Confusing values for good nursing | Uncertainty about the right or wrong action for a good nursing |
|
Distress resulting from not acting the right way despite one’s knowledge | Fear originating from seeing oneself violating one’s nursing values |
|
Anger resulting from failures in playing a role as an advocate |
| |
Being exhausted by the hospital’s unchanging unethical attitude |
| |
Avoiding ethical conflicts as last resort | Having no choice but to leave the job |
|
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Kim, M.; Oh, Y.; Kong, B. Ethical Conflicts Experienced by Nurses in Geriatric Hospitals in South Korea: “If You Can’t Stand the Heat, Get Out of the Kitchen”. Int. J. Environ. Res. Public Health 2020, 17, 4442. https://doi.org/10.3390/ijerph17124442
Kim M, Oh Y, Kong B. Ethical Conflicts Experienced by Nurses in Geriatric Hospitals in South Korea: “If You Can’t Stand the Heat, Get Out of the Kitchen”. International Journal of Environmental Research and Public Health. 2020; 17(12):4442. https://doi.org/10.3390/ijerph17124442
Chicago/Turabian StyleKim, Moonok, Younjae Oh, and Byunghye Kong. 2020. "Ethical Conflicts Experienced by Nurses in Geriatric Hospitals in South Korea: “If You Can’t Stand the Heat, Get Out of the Kitchen”" International Journal of Environmental Research and Public Health 17, no. 12: 4442. https://doi.org/10.3390/ijerph17124442
APA StyleKim, M., Oh, Y., & Kong, B. (2020). Ethical Conflicts Experienced by Nurses in Geriatric Hospitals in South Korea: “If You Can’t Stand the Heat, Get Out of the Kitchen”. International Journal of Environmental Research and Public Health, 17(12), 4442. https://doi.org/10.3390/ijerph17124442