[Nursing management in conflict between ethics and economy: a qualitative study in institutional and semi community care of older people].
The starting point of this explorative study is the current problematic development in institutional and semi community care of older people. The relationship between economy and ethics is a permanent tug of war for nursing managers, who have to fulfil not only the needs of inhabitants and professional standards, but also the restrictive financial framework. This study was based on the following questions: Which are the relevant values for decisions of nursing managers and which are important ethical principles to direct their behaviour? Which dilemmas are significant? The examination group consisted of eleven nursing managers from the field of institutional and semi community care. Qualitative, problem-based interviews were taken with them. The results show the high sensibility of this group in context with ethical questions, which express the following principles: The principle of untouchable dignity, the principle of caring, the principle of assurance of the inhabitants' economic rights and the principle of openness and transparency. The significant dilemmas concern business management, employees, medical service of health insurance companies and doctors. Initial stages of an integrative business-ethical approach could be found in the majority of care centres. By contrast, a classical division into economy and ethics was found in the other care centres.
Evangelische Fachhochschule Berlin.
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Dibelius
D000368:Aged; D003220:Conflict, Psychological; D005851:Geriatric Nursing / Q000191:economics / Q000941:ethics*; D005858:Germany; D006801:Humans; D015401:Nursing Administration Research