A descriptive analysis of ethical issues faced by public health nurses in southern California

Background

There is no doubt that ethical dilemmas are a source of stress for nurses globally. One of the greatest sources of stress that nurses face is ethical dilemmas. There is extensive literature on ethics in nursing practice that focuses on nurses working in the acute care setting such as hospitals, clinics, nursing homes and other health care facilities that provide care for the individual patient. But very little research has been conducted to identify the ethical issues that public health nurses (PHNs) face in their practice. Public health nurses in addition of working with the individual; they also work with the family and the community and therefore are faced with totally different ethical dilemmas that those nurses working in the acute care.

Objectives

The objectives of this study was to identify the ethical dilemmas faced by public health nurses, to investigate some differences between the ethical dilemmas faced by public health nurses and those faced acute care nurses, and to identify what ethical decision making methods public health nurses are presently using to make ethical decisions.

Method

An exploratory, descriptive approach using quantitative research methods was used as a guiding framework for this research. A literature search and review of primary data on ethics and public health nursing was conducted. Data was collected through an unstructured survey of public health nurses working in the Los Angeles County Public Health Department, one of the largest public health departments in the United States. Three hundred phns were surveyed and a content analysis was completed.

Outcomes

This survey only confirmed what we, public health nurses and other professional working in public health already knew; that the work that public health nurses do is unique and much different than the work of the acute care nurse. Therefore, the ethical dilemmas faced by public health nurses are different than those faced by acute care nurses. The survey also indicates that despite the differences of their ethical dilemmas, both groups of nurses are using the same ethical tools to make their ethical decisions.