title: Ethical conflicts experienced by certified pediatric nurse practitioners in ambulatory settings.
abstract: BACKGROUND
  The purpose of this descriptive study was to (a) identify the types of ethical conflicts and their resolutions reported by a group of certified pediatric nurse practitioners (CPNPs) in their ambulatory practice and (b) to examine demographic, educational, and practice-setting factors associated with these conflicts.
  
  
  METHODS
  Five hundred fifty-nine CPNPs, identified by the National Association of Pediatric Nurse Associates and Practitioners, received survey questionnaires in the mail and were asked to participate by describing an ethical conflict in their practice. Questionnaires were completed by 118 CPNPs. Each ethical conflict was analyzed according to a four content analysis classification system to capture multiple relevant meanings. The relationship between types of ethical conflicts and demographic, educational, and practice-setting variables was examined.
  
  
  RESULTS
  One third (34%) of the perceived ethical conflicts fell in the child/parent/practitioner relationship category. Most conflicts (31%) were experienced as a moral dilemma where 2 or more clear moral principles apply but they support mutually inconsistent courses of action. Most ethical conflicts (22%) were unresolved.
  
  
  CONCLUSIONS
  Understanding the nature of ethical conflicts that CPNPs are experiencing in ambulatory settings is important. Professional and institutions/agencies need to collaborate on how to initiate appropriate ethics education and consultation for professional staff to recognize, discuss, and resolve ethical conflicts in the workplace.
authors.affiliation: Johns Hopkins University Schools of Medicine and Nursing, Baltimore, Md. 21287-3144, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Butz
authors.forename: B K
authors.initials: BK
authors.lastname: Redman
authors.forename: S T
authors.initials: ST
authors.lastname: Fry
authors.forename: K
authors.initials: K
authors.lastname: Kolodner
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D001291:Attitude of Health Personnel; D002568:Certification; D003220:Conflict, Psychological; D004993:Ethics, Nursing; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000193:education / Q000523:psychology*; D015404:Nursing Methodology Research; D010371:Pediatric Nursing / Q000193:education / Q000379:methods*; D011795:Surveys and Questionnaires