Empowering Nurses With Ethics Education: A Focus Group Study to Understand Clinical Nurses' Perceptions of the “Moral Spaces” Program

ABSTRACT

Background

Ethics education for pre- and post-licensure nurses is inconsistently delivered. In clinical practice, nurses report feeling inadequately prepared to address ethical challenges, which decreases their ability to take ethical action and creates moral distress.

Aims

To understand nurses' perceptions of an innovative, experiential ethics education program, its benefits, and limitations to enhancing ethical patient care.

Methods

Using a descriptive qualitative design and focus group interviews, data were collected from 2 cohorts of hospital-based nurses who completed a multimodal ethics education program (the Moral Spaces program). Participants were recruited from a quaternary care medical center and nine small- to -mid-size regional acute care hospitals within one healthcare system in the Midwest United States. Data were analyzed using conversation analysis.

Results

Eleven nurses participated. Three themes were identified: 1. Recognition of Diverse Values and Perspectives, 2. Critical Distance to Neutralize Strong Negative Emotions and Address Burnout, and 3. Enhanced Advocacy Prompting Greater Expectations.

Linking Evidence to Action

Ethics education programs can positively influence nurses and their clinical practice. By empowering nurses with ethical knowledge and communication skills, they describe a greater ability to identify and address ethical issues, thereby mitigating moral distress and burnout. When empowered to advocate more effectively for patient values, the ethical delivery of patient care can be optimized. However, if interprofessional collaboration and practices are not aligned, nurses may encounter barriers to enhancing ethical patient care and positively influencing unit culture. Leadership support for ethics education programs is crucial for participation and implementation.