Leyla Dinç

Teaching Ethics in Nursing

Being a professional nurse requires ethical decision making and this in turn necessitates an effective learning process. The active participation of students in the teaching of ethics will contribute to this process. This study was conducted at Hacettepe University School of Nursing, Ankara, Turkey, to determine the views of students about the nursing ethics content in the curriculum, the examination system, and some educational characteristics of the teachers responsible for the course. The sample comprised 113 students who participated voluntarily. In general, the students expressed a positive view relating to the course content and the teachers. The majority stated that the discussions on case study analysis by using ethical principles, rights, legal aspects and the use of the International Council of Nurses Code of Ethics were very useful in developing ethical decision-making skills. We believe that the results of this study will enhance our efforts in amending this course and improving the ethical decision-making skills of our students.

Trust and trustworthiness in nursing: an argument‐based literature review

Caring requires nurses to establish trusting relationships with patients and to be trustworthy professionals. This article provides insight into the conceptual understanding of trust and trustworthiness in nursing through an argument-based literature review of 17 articles published between 1980 and 2010. Trust is characterized as an attitude relying with confidence on someone. The importance of trust relationships is considered by addressing the imbalances of power in nurse-patient relationships as they increase the vulnerability and dependency of the truster. Trust is considered as a process, and time, reliance on others, risk and fragility are identified as basic attributes of trust. However, trustworthiness is inadequately explored in the nursing ethics literature. Nurse educators have a responsibility to ensure that nurses are equipped with the attitudes and knowledge that are needed to establish trusting nurse-patient relationships.

Ethical decision-making and professional behaviour among nurses A correlational study

This study examined the relationship between nurses’ ethical decision-making levels and their professional behaviours. Data were collected from 225 nurses who were recruited from university hospitals in Ankara using proportionate sampling. Data were analysed using descriptive statistics and Pearson correlations. Most of the nurses were familiar with ethical dilemmas in nursing practice. The Nursing Principled Thinking level was above average, while the Practical Consideration level was average. Nurses’ professionalism level was low. There was a positive but weak correlation between professional behaviours of the nurses and their ethical decision-making levels. Increasing nurses’ professionalism level can provide a positive contribution to the ethical decision-making level.

Using Standardized Patients in Nursing Education: Effects on Students' Psychomotor Skill Development.

The present study used a quasi-experimental design to examine the effects of using standardized patients for the psychomotor skills development of nursing students. The performance of the experimental group in blood pressure measurement was significantly higher than that of the control group; however, there was no significant difference between the groups with regard to their administration of subcutaneous injections. The results indicated that standardized patients can be integrated into nursing education for developing psychomotor skills of students.

Evaluation of nursing documentation on patient hygienic care.

This study was conducted to evaluate nursing documentation on patient hygienic care and to analyze the consistency between actual care given by nurses and that of documented in nursing record. Data were collected from 85 nurses employed at critical care units, on whom 255 sets of observations were performed through a structured participant observation form, which could be used to record the observation episodes and to audit nursing records. Results indicated that the most frequent performed hygienic care was oral care, perianal care, hand washing and bed bathing. The consistency between actual patient hygienic care and its documentation was 77.6%. The quality of nursing records was poor and inadequate to reflect individualized nursing care. Results suggest that more emphasis is needed in nursing practice and nursing education on the quality of record keeping in nursing to increase its evidential value.

Ethical Issues Regarding Human Cloning: a nursing perspective

Advances in cloning technology and successful cloning experiments in animals have raised concerns about the possibility of human cloning in recent years. Despite many objections, this is not only a possibility but also a reality. Human cloning is a scientific revolution. However, it also introduces the potential for physical and psychosocial harm to human beings. From this point of view, it raises profound ethical, social and health related concerns. Human cloning would have an impact on the practice of nursing because it could result in the creation of new physiological and psychosocial conditions that would require nursing care. The nursing profession must therefore evaluate the ethics of human cloning, in particular the potential role of nurses. This article reviews the ethical considerations of reproductive human cloning, discusses the main reasons for concern, and reflects a nursing perspective regarding this issue.

Knowledge about anti‐tuberculosis treatment among nurses at tuberculosis clinics

Nurses are primary responsible for Direct Observation Therapy Strategy and administration of anti-tuberculosis (TB) medications. Lack of knowledge might result with medication errors and ineffective TB control. The purpose of this study was to assess knowledge of nurses about anti-TB treatment. A descriptive cross-sectional study was conducted in Turkey with 208 nurses employed at TB and lung disease clinics of health-care settings in Ankara. Data were collected through a questionnaire, which included questions about demographics and a knowledge test with true-false questions related to TB treatment. Overall scores were high with a mean score of 18.5 out of 24, but there was knowledge deficiency in effects and side-effects of anti-TB drugs. Knowledge is foundational for any practice and for TB control. Clinical experience and continuing education after graduation influence the level of knowledge.Nurses are primary responsible for Direct Observation Therapy Strategy and administration of anti-tuberculosis (TB) medications. Lack of knowledge might result with medication errors and ineffective TB control. The purpose of this study was to assess knowledge of nurses about anti-TB treatment. A descriptive cross-sectional study was conducted in Turkey with 208 nurses employed at TB and lung disease clinics of health-care settings in Ankara. Data were collected through a questionnaire, which included questions about demographics and a knowledge test with true–false questions related to TB treatment. Overall scores were high with a mean score of 18.5 out of 24, but there was knowledge deficiency in effects and side-effects of anti-TB drugs. Knowledge is foundational for any practice and for TB control. Clinical experience and continuing education after graduation influence the level of knowledge.

Authorship dispute of a doctoral thesis publication

Publications in international academic journals are the most important measure of scientific productivity and academic achievement. However, pressure from the requirement to publish articles sometimes entices scientists to indulge in unethical behaviours. Therefore, ethical problems surrounding authorship, particularly multiple-authorship, deserve further discussion. According to the guidelines of the International Committee of Medical Journal Editors (ICMJE), authorship credit should be based on substantial contributions to conception and design, acquisition of data or analysis and interpretation of data. Although this definition indicates what contributions qualify an individual to be an author, there is still no consensus on the sequence of author names in a by-line, particularly when it comes to publishing an article stemming from a doctoral dissertation or thesis. In Turkey, the faculty supervisor usually provides the idea for the dissertation and designs the study, while the student collects, analyses the data and writes the dissertation draft with the contribution of the supervisor. When the dissertation is to be published, usually the supervisor writes it as a research article, but his name is placed as co-author, whereas the student becomes the first author. Literature suggests that there is no consensus on authorship and the order of author names of a research article based on a doctoral dissertation. Morse draws attention to relationships of unequal power between graduate students and faculty advisors in authorship disputes. Aydin states that being a supervisor is one of the principal obligations of a faculty; it should not be regarded as being a co-author of an article based on a dissertation. Nguyen and Nguyen suggest that the owner of a dissertation research is the student and he or she must be the first author of its publication, whereas Burrows and Moore state that collecting, managing, analysing or interpreting data alone does not qualify for authorship. Recently, by virtue of being a member of the publication ethics commission of a university, I received a file from a court with a request to evaluate an authorship conflict and provide written expert witness opinion, which I believe has great relevance in publication ethics. In this editorial, because of the confidentiality of my expert witness report, I will only summarise the case. The plaintiff in this court case was the student, while the defendant was a university where the student started his doctoral dissertation research under the supervision of a professor. The student stated that this supervisor made significant intellectual contribution to the work, including the conception and designing of the work, and that he alone collected the data from the field without any financial support from the university. After 2 years, his supervisor had to retire and the student completed his dissertation research with another supervisor. After graduation, he started work at another university as an assistant professor. A few months later, his second supervisor requested from him the raw data of the dissertation research in order to publish an article, and following correspondences via e-mail, he received the first draft of the article. His name was in the last place in the line of authors, while his second supervisor was first author, and there were two other co-authors listed in the second and third line, with whom he never worked. The student objected to

Nursing students’ perceptions of faculty members’ ethical/unethical attitudes

Background: Through education, individuals acquire knowledge, skill and attitudes that facilitate professional socialization; it involves intellectual, emotional and psychomotor skill development. Teachers are role models for behaviour modification and value development. Objective: To examine students’ perceptions of faculty members’ ethical and unethical attitudes during interactions in undergraduate nursing. Research design: This descriptive study consisted of two phases. In Phase I, we developed an instrument, which was administered to nursing students to assess validity and reliability. Exploratory factor analysis yielded 32 items. Cronbach’s α was 0.83, and test–retest reliability was good. In Phase II, a 32-item version of the instrument was administered to nursing students from another university. Participants and research context: Participants included 219 nursing students from one university in Phase I and 196 from another university in Phase II. The study was conducted at the universities attended by the participants. Ethical considerations: Ethical approval was granted by the institutions involved, and all participants provided informed consent. Findings: In Phase I, the instrument demonstrated good psychometric properties for measuring nursing students’ perceptions of faculty members’ ethical and unethical behaviours. In Phase II, students considered certain professional and personal qualities, including respecting confidentiality and students’ private lives and assuming an impartial stance during interactions in the classroom, examinations, or clinical practice, ethical. They considered using obscene examples or unprofessional speech during teaching, selling textbooks in class, using university facilities for personal interests, engaging in romantic relationships with students, and humiliating students in front of patients or staff in clinical settings unethical. Conclusion: Results of this study suggest that nurse educators should be aware of their critical role in the teaching–learning process, and they must scrutinize their attitudes towards students from an ethical point of view.

Nursing students' opinions about the standardized patients and part task trainers used in the clinical skills training

Yöntem: Bu araştırma, yarı deneysel desenli bir çalışmadır. Araştırmanın evrenini 87 hemşirelik lisans birinci sınıf öğrencisi oluşturmuştur. Öğrenciler olasılıksal olarak kontrol grubu (n=43) ve deney grubu (n=44) olmak üzere iki gruba ayrılmıştır. Kontrol grubunda yer alan öğrenciler laboratuar uygulamalarını maketler üzerinde, deney grubu öğrencileri ise standart hasta üzerinde/hibrit simülasyon ile gerçekleştirilmiştir. Laboratuvar çalışmalarının ardından öğrencilerden Laboratuar Çalışması Değerlendirme Formu’nu doldurmaları istenmiştir. Verilerin değerlendirilmesinde sayı, yüzdelik, ortalama ile standart sapma kullanılmıştır.