CHAPTER


DOI :10.26650/B/CH17CH24.2024.002.33   IUP :10.26650/B/CH17CH24.2024.002.33    Full Text (PDF)

Nursing Managament and Ethical Decision Making

Ebru Özen Bekar

The main responsibility of nursing managers is to meet the needs of patients and to ensure that their rights to receive quality care are met. Another responsibility is of nurses to their patients to create a safe and ethical working environment where they can provide quality care. However, when one looks at nurses’ rights in today’s complex healthcare system, they are expected to make ethically correct decisions which may clash with their rights and the rights of patients to receive quality healthcare. In this choice, the nursing manager must take into consideration ethical values such as justice, honesty, impartiality, and responsibility. This is a requirement of the management. In any nursing manager’s decision ethical values must be used and this gains importance if there is a possibility of the decision bringing benefit or harm either to themselves or to someone else. At this stage, nursing managers should use ethical principles in every stage of the decision-making process and make their decisions accordingly. In making an ethical decision fundamental competence is important. In order to gain this competence, nursing managers should have a basic theoretical knowledge of ethical theories and ethical principles and then apply this knowledge in their decision-making processes. An ethical work environment should be created and efforts should be made to prevent problems from occurring in the first place. Also, nursing managers should be involved in the provision of health policies that aim at ensuring justice within the system for nurses. 


DOI :10.26650/B/CH17CH24.2024.002.33   IUP :10.26650/B/CH17CH24.2024.002.33    Full Text (PDF)

Hemşi̇reli̇k Yöneti̇mi̇ ve Eti̇k Karar Verme

Ebru Özen Bekar

Yönetici hemşirelerin temel sorumluluğu, hastaların gereksinimleri ve kaliteli bakım alma haklarının karşılanmasını sağlamaktır. Diğer sorumlulukları da, hemşirelerin hastalarına kaliteli bakım sağlayabilecekleri güvenli ve etik bir çalışma ortamı oluşturmaktır. Ancak günümüz karmaşık sağlık sistemi içerisinde, hemşirelerin hakları hastaların kaliteli bakım alma haklarıyla çatıştığında, yönetici hemşirelerin etik açıdan doğru kararı vermesi beklenmektedir. Yöneticinin bu şeçimde adalet, doğruluk, tarafsızlık ve sorumluluk gibi etik ilke ve değerleri göz önünde bulundurulması hemşirelik yönetimin gerekliliğidir. Yönetici hemşirenin verdiği kararın kendisine ya da başka birisine fayda ya da zarar getirme olasılığı varsa, etik ilke ve değerler bu karar da önem kazanmaktadır. Bu aşamada, yönetici hemşireler karar vermenin tüm süreçlerinde etik ilkeleri kullanmalı ve buna göre bir karar vermelidir. Yönetimsel olarak karar verme süreci, bilimsel sorun çözme yöntemine dayanmaktadır ve bu süreç sorunu tanımlama, durumu değerlendirme, seçenekleri belirleme ve seçim yapma aşamalarından oluşmaktadır. Etik karar verme sürecinde, yönetici hemşirelerin temel yetkinliği sağlanması önemlidir. Bu yetkinliğin kazanılabilmesi için, ilk olarak yönetici hemşireler etik teoriler ve etik ilkeler hakkında temel bilgiye sahip olmalı ve daha sonra bu bilgiyi karar verme süreçlerinde uygulamalıdır. Yönetici hemşirelerin, etik bir çalışma ortamı oluşturma ve etik sorunların ortaya çıkmasını önlemeye yönelik çalışmalar yapma sorumlulukları vardır. Ayrıca sağlık sisteminin içindeki adaleti sağlamaya yönelik sağlık politikalarının sağlanmasın da yönetici hemşireler rol almalıdır.



References

  • Aaron, B., Glover, A., Sterling, E., Downs, S., & Lesandrini, J. (2021). Impact of a novel method of ethics education on nurse leaders’ capacity for moral decision-making: An exploratory qualitative study. Nurse Leader, 19(6), 639-645. https://doi.org/10.1016/j.mnl.2021.03.014 google scholar
  • Aitamaa, E., Leino-Kilpi, H., Iltanen, S., & Suhonen, R. (2016). Ethical problems in nursing management: The views of nurse managers. Nursing Ethics, 23(6), 646-658. https://doi.org/10.1177/0969733015579309 google scholar
  • Aitamaa, E., Suhonen, R., Puukka, P., & Leino-Kilpi, H. (2019). Ethical problems in nursing management-a cross-sectional survey about solving problems. BMC Health Services Research, 19(1), 1-11. https://doi. org/10.1186/s12913-019-4245-4 google scholar
  • Alan, H., Gül, D., & Baykal, Ü. (2022). The relationship between the conflict management strategies and ethical leadership behaviours of nurse managers perceived by nurses. Journal of Nursing Management. 30(7), 23702378 https://doi.org/10.1111/jonm.13840 google scholar
  • Alba, B. (2018). Factors that impact on emergency nurses’ ethical decision-making ability. Nursing Ethics, 25(7), 855- https://doi.org/866. 10.1177/0969733016674769 google scholar
  • Alhourani, F., Opinion, F.B., Sudha, A.R., Mihdawi, M.O., & Renjith, V. (2022). Ethical dilemma experiences of nurses in a tertiary hospital, Kingdom of Bahrain: A Cross-sectional Survey. Journal of Nursing Regula-tion, 13(2), 40-48. https://doi.org/10.1016/S2155-8256(22)00066-7 google scholar
  • Ali Awad, N.H., & Al-anwer Ashour, H.M. (2022). Crisis, ethical leadership, and moral courage: Ethical climate during COVID-19. Nursing Ethics, 29(6), 1441-1456. https://doi.org/10.1177/09697330221105636 google scholar
  • Babalola, S.S. (2016). The effect of leadership style, job satisfaction and employee-supervisor relationship on job performance and organizational commitment. Journal of Applied Business Research (JABR), 32(3), 935-946. https://doi.org/10.19030/jabr.v32i3.9667 google scholar
  • Barkhordari-Sharifabad, M., Ashktorab, T., & Atashzadeh-Shoorideh, F. (2018). Ethical leadership outcomes in nursing: A qualitative study. Nursing Ethics, 25(8), 1051-1063. https://doi.org/10.1177/0969733016687157 google scholar
  • Bahçecik, A.N. ve Özçelik, S.K. (2022). Yönetsel etik. Tatar Baykal, Ü. ve Türkmen, E. (Ed.), Hemşirelikte yönetim kitabı içinde (s. 507-534). İstanbul: Akademi Basın ve Yayıncılık. google scholar
  • Burkhardt, M.A, Nathaniel, A. K. (2013). Çağdaş hemşirelikte etik (Ecevit Alpar, Ş., Bahçecik, A.N. ve Karabacak, Ü. Çev. Ed.). İstanbul: İstanbul Tıp Kitabevi. google scholar
  • Cao, L., Bian, J., Xiao, J., & Jia, Y. (2022). Trust crisis: New frontline nurse managers’ ethical experience in their units. Journal of Nursing Scholarship, 54(2), 250-257. https://doi.org/10.1111/jnu.12727 google scholar
  • Cerit, B., & Dinç, L. (2013). Ethical decision-making and professional behaviour among nurses: a correlational study. Nursing Ethics, 20(2), 200-212. https://doi.org/10.1177/0969733012455562 google scholar
  • Chisengantambu-Winters, C., Robinson, G.M., & Evans, N. (2020). Developing a decision-making dependency (DMD) model for nurse managers. Heliyon, 6(1), p. e03128. https://doi.org/10.1016/j.heliyon.2019.e03128 google scholar
  • Du, J., Huang, S., Lu, Q., Ma, L., Lai, K., & Li, K. (2022). Influence of empathy and professional values on ethical decision-making of emergency nurses: a cross-sectional study. International Emergency Nursing, 63, 101186. https://doi.org/10.1016/j.ienj.2022.101186 google scholar
  • Ejder Apay, S., Gürol, A., Gür, E.Y., & Church, S. (2020). Midwifery students’ reactions to ethical dilemmas en-countered in outpatient clinics. Nursing Ethics, 27(7), 1542-1555. https://doi.org/10.1177/0969733020922875 google scholar
  • Eduardo, E.A., Peres, A.M., Almeida, M.D.L.D., Roglio, K.D.D., & Bernardino, E. (2015). Analysis of the decision-making process of nurse managers: a collective reflection. Revista Brasileira de Enferma-gem, 68(4),582-588. http://dx.doi.org/10.1590/0034-7167.2015680414i google scholar
  • Effken, J.A., Verran, J.A., Logue, M.D., & Hsu, Y.C. (2010). Nurse managers’ decisions: fast and favoring reme-diation. The Journal of Nursing Administration, 40(4), 188. https://doi.org/10.1097/NNA.0b013e3181d40f7c google scholar
  • Emhan, A. (2007). Karar verme süreci ve bu süreçte bilişim sistemlerinin kullanılması. Elektronik Sosyal Bilimler Dergisi, 6(21), 212-224. google scholar
  • Erten, Z.K., Bayraktar, E., ve Açmaz, G. (2017). Etik ve etik liderlik. ERÜ Sağlık Bilimleri Fakültesi Dergisi, 4(1), 62-68. google scholar
  • Gedük, E.A. (2018). Hemşirelik mesleğinin gelişen rolleri. Sağlık Bilimleri ve Meslekleri Dergisi, 5(2), 253-258. google scholar
  • Gılıç, F., Çelikten, M., Çelikten, Y. ve Yıldırım, A. (2019). Karar verme süreci. Mersin Üniversitesi Eğitim Fakültesi Dergisi, 15(2), 581-592. google scholar
  • Gül, S. (2022). Hemşirelikte etik sorunlar ve etik karar verme süreci. Yalım, Y. ve Göçmen Baykara, Z. (Ed.), Hemşirelik ve etik kitabı içinde (s. 122-125). Ankara: Nobel Tıp Kitapevleri. google scholar
  • Hamric, A.B, Hanson, C.M, Tracy, M.F, & O’Grady, E.T. (2013). Advanced practice nursing: An integrative approach. Philadelphia, PA: Elsevier Health Sciences. google scholar
  • Harun-Or-Rashid, M., & Sakamoto, J. (2011). Nurse managers’ experience with ethical issues in six government hospitals in Malaysia: A cross-sectional study. BMC Medical Ethics, 12(1), 1-7. google scholar
  • Huber, D. (2017). Leadership and nursing care management. Missouri: Elsevier. google scholar
  • Ozmen, S., & Arslan Yurumezoglu, H. (2022). Nurse managers’ challenges and opportunities in the COVID-19 pandemic crisis: A qualitative descriptive study. Journal of Nursing Management, 30(7), 2609-2619. https:// doi.org/10.1111/jonm.13817 google scholar
  • Özdemir, A., ve Karakaya, A. (2021). Yöneticilerin etik karar verme durumları üzerine bir araştırma. Manisa Celal Bayar Üniversitesi Sosyal Bilimler Dergisi, 19(Armağan Sayısı), 110-120. https://doi.org/10.18026/ cbayarsos.678981 google scholar
  • Öztürk, H. (2014). Yönetim etiği. Baykal, Ü. ve Türkmen, E. (Ed.), Hemşirelik hizmetleri yönetimi kitabı içinde (s. 733-740). İstanbul: Akademi Yayıncılık. google scholar
  • Karabey, C.N. (2020). İşletmelerde etik karar verme. Konya: Eğitim Yayınevi. google scholar
  • Khan, S., Sultan, A., Hanif, J., Jamil, K., & Batool, Z. (2022). Nurses’ perception regarding barriers to use of health information system in the teaching hospital of Abbottabad. Pakistan Journal of Health Sciences, 3(4),183-187. https://doi.org/10.54393/pjhs.v3i04.87 google scholar
  • Khursheed, U., Sehar, S., & Afzal, M. (2019). Importance of ethical decision making; Application of james rest model. Saudi Journal of Nursing and Health Care, 2(12), 427-430. https://doi.org/10.36348/sjnhc.2019. v02i12.007 google scholar
  • Kıral, E. (2015). Yönetimde karar ve etik karar verme sorunsalı. Adnan Menderes Üniversitesi Eğitim Fakültesi Eğitim Bilimleri Dergisi, 6(2), 73-89. google scholar
  • Koçel, T. (2020). İşletme yöneticiliği. İstanbul: Beta Basım Yayım. google scholar
  • Lindy, C., & Schaefer, F. (2010). Negative workplace behaviours: An ethical dilemma for nurse managers. Jour-nal of Nursing Management, 18(3), 285-292. https://doi.org/10.1111/j.1365-2834.2010.01080.x google scholar
  • Lotfi, Z., Atashzadeh-Shoorideh, F., Mohtashami, J., & Nasiri, M. (2018). Relationship between ethical leader-ship and organisational commitment of nurses with perception of patient safety culture. Journal of Nursing Management, 26(6), 726-734. https://doi.org/10.1111/jonm.12607 google scholar
  • Maghsoudi, S., Mohsenpour, M., & Nazif, H. (2021). Comparison of ethical decision-making and interpersonal communication skills training effects on nurses’ ethical climate. Clin Ethics,17(2), 184-190. https://doi. org/10.1177/14777509211034139 google scholar
  • Markey, K., Ventura, C.A.A., Donnell, C.O., & Doody, O. (2021). Cultivating ethical leadership in the recovery of COVID-19. Journal of Nursing Management, 29(2), 351-355. https://doi.org/10.1111/jonm.13191 google scholar
  • Mauno, S., Ruokolainen, M., Kinnunen, U., & De Bloom, J. (2016). Emotional labour and work engagement among nurses: examining perceived compassion, leadership and work ethic as stress buffers. Journal of Advanced Nursing, 72(5), 1169-1181. https://doi.org/10.1111/jan.12906 google scholar
  • Nejat, N., Zand, S., Taheri, M., & Khosravani, M. (2023). Understanding lived experiences of nurse managers about managerial ethics. Nursing Ethics, 30(2), 162-179. https://doi.org/10.1177/09697330221130599 google scholar
  • O’Donnell, C., Markey, K., & O’Brien, B. (2022). Guiding nurse managers in supporting nurses in dealing with the ethical challenge of caring. Journal of Nursing Management, 30(7), 2357-2361. https://doi.org/10.1111/ jonm.13658 google scholar
  • Rizalar, S., & Baltaci, N. (2020). Ethical decision-making levels of nurses and it’s affecting factors. Int J Caring Sci, 13(1), 42-52. google scholar
  • Roshanzadeh, M., Vanaki, Z., & Sadooghiasl, A. (2019). Sensitivity in ethical decision-making: The experiences of nurse managers. Nursing Ethics, 27(5), 1174-1186. https://doi.org/10.1177/0969733019864146 google scholar
  • Sabancıoğulları, S., Kol, E.U., Arslantaş, A.T., Toğantemur, F. ve Ülker, F. (2018). Hemşirelerin etik karar verme düzeyi ile profesyonel benlik kavramları arasındaki ilişkinin incelenmesi. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 11(2), 105-112. google scholar
  • Shirey, M.R., Ebright, P.R., & McDaniel, A.M. (2013). Nurse manager cognitive decision-making amidst stress and work complexity. Journal of Nursing Management, 21(1), 17-30. https://doi.org/10.1111/j.1365-2834.2012.01380.x google scholar
  • Siirala, E., Peltonen, L.M., Lundgren-Laine, H., Salanterâ, S., & Junttila, K. (2016). Nurse managers’ decisi-on-making in daily unit operation in peri-operative settings: A cross-sectional descriptive study. Journal of Nursing Management, 24(6), 806-815. https://doi.org/10.1111/jonm.12385 google scholar
  • Sönmez, B. (2014). Sorun çözme ve karar verme. Baykal, Ü. ve Türkmen, E. (Ed.), Hemşirelik hizmetleri yönetimi kitabı içinde (s. 357-360). İstanbul: Akademi Yayıncılık. google scholar
  • Toren, O., & Wagner, N. (2010). Applying an ethical decision-making tool to a nurse management dilemma. Nursing Ethics, 17(3), 393-402. https://doi.org/10.1177/0969733009355106 google scholar
  • Türk Dil Kurumu. (2023). Güncel Türkçe Sözlük. Erişim adresi: https://sozluk.gov.tr/ google scholar
  • Wang, Y., & Ruhe, G. (2007). The cognitive process of decision making. International Journal of Cognitive Informatics and Natural Intelligence, 1(2), 73-85. https://doi.org/10.4018/9781605661704.ch009 google scholar
  • Yıldırım, B. ve Özkahraman, Ş. (2012). Hemşirelikte karar verme süreci. Ejovoc (Electronic Journal of Voca-tional Colleges), 2(1), 165-173. google scholar
  • Zappalâ, S., & Toscano, F. (2020). The Ethical Leadership Scale (ELS): Italian adaptation and exploration of the nomological network in a health care setting. Journal of Nursing Management, 28(3), 634-642. https:// doi.org/10.1111/jonm.12967 google scholar
  • Zhang, N., Li, M., Gong, Z., & Xu, D. (2019). Effects of ethical leadership on nurses’ service behaviors. Nursing Ethics, 26(6), 1861-1872. https://doi.org/10.1177/0969733018787220 google scholar
  • Zydziunaite, V., Suominen, T., Âstedt-Kurki, P., & Lepaite, D. (2010). Ethical dilemmas concerning decisi-on-making within health care leadership: A systematic literature review. Medicina, 46(9), 595. https://doi. org/10.3390/medicina46090084 google scholar
  • Zydziunaite, V., & Suominen, T. (2014). Leadership styles of nurse managers in ethical dilemmas: Reasons and consequences. Contemporary Nurse, 48(2), 150-167. https://doi.org/10.5172/conu.2014.48.2.150 google scholar
  • Zydziunaite, V., Lepaite, D., Âstedt-Kurki, P., & Suominen, T. (2015). Head nurses’ decision-making when managing ethical dilemmas. Baltic Journal of Management, 10(2), 166-187. https://doi.org/10.1108/BJM-12-2013-0194 google scholar


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