Principled thinking: a comparison of nursing students and experienced nurses.
BACKGROUND
A descriptive study was used to compare ethical reasoning abilities in senior baccalaureate nursing students and experienced registered nurses. The effects of environmental factors and previous experience with ethical dilemmas in regard to nursing principled thinking were also examined.


RESULTS
Findings on the Nursing Dilemma Test indicated a significant difference in the level of nursing principled thinking in the two groups, with nursing students scoring higher than experienced nurses. There was a significant negative correlation between years of experience and level of nursing principled thinking. The level of nursing education (e.g., associate degree of nursing, diploma, bachelor of science in nursing, masters degree, or doctorate) did not appear to have an effect on nursing principled thinking. In addition, subjects who were most affected by practical considerations demonstrated less use of higher level moral reasoning. The effect of previous experience with ethical dilemmas on nursing principled thinking was found to be nonsignificant.


CONCLUSIONS
Ethical dilemmas continue to create much confusion and uncertainty for practicing nurses. Suggestions are made regarding individual analysis of personal and professional values in nurses. In addition, recommendations include ongoing educational offerings and nursing administration support to assist nurses during times of moral distress.
Ham
Kathy
K
Department of Nursing, Southeast Missouri State University, One University Plaza-MS 8300, Cape Girardeau, MO 63701, USA.
D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003220:Conflict, Psychological; D004507:Education, Nursing, Associate; D004508:Education, Nursing, Baccalaureate; D004510:Education, Nursing, Diploma Programs; D004511:Education, Nursing, Graduate; D007722:Health Knowledge, Attitudes, Practice; D006803:Human Development; D006801:Humans; D008128:Logic; D008875:Middle Aged; D015146:Midwestern United States; D009014:Morals; D015402:Nursing Education Research; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000193:education / Q000523:psychology; D028662:Principle-Based Ethics; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires; D013850:Thinking / Q000941:ethics*