923 Occupational health and safety issues of ethical dilemmas faced by nurses in clinical practice settings: a qualitative study

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IntroductionDuring their practice, nurses regularly encounter ethical dilemmas. The sources of these dilemmas, according to the literature, seem mainly related to clinical practice settings, such as emergency, intensive, palliative, oncology, etc. However, as part of a graduate clinical ethics course for nurses, we also noticed that the sources of nurse ethical dilemmas seem to be very much related to occupational safety and health (OSH) considerations as opposed to clinical situations. This research aimed to highlight these sources of ethical dilemmas that can be attributed to contexts and aspects other than those found in the literature, particularly those related to OSH.MethodsEthical dilemmas were assessed qualitatively by analysing 250 written descriptions presented by students in the graduate clinical ethics course for nurses. Each description was analysed using the continuous comparison technique in order to produce an emergent model, which reconstructed the nurses’ representations of ethical dilemmas pertaining to OSH.ResultsThe results provide a much broader picture of the ethical dilemmas faced by nurses. The model shows that the majority of ethical dilemmas described has underlying dynamics related to OSH. They described ethical dilemmas arising from an explicit risk to their physical or psychological health such as exposure to biological agents, bullying or threats from the patient‘s family. Moreover, many of the ethical dilemmas are expressed by the nurses primarily in terms of consequences for herself and not for the patient.ConclusionThis model emphasises that OSH issues have a significant impact on ethical dilemmas experienced by nurses. Consequently, these issues should be part of the discussions regarding ethical climate in nursing management and education.

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