title: A study of nurses' ethical climate perceptions: Compromising in an uncompromising environment.
abstract: BACKGROUND
  Acting ethically, in accordance with professional and personal moral values, lies at the heart of nursing practice. However, contextual factors, or obstacles within the work environment, can constrain nurses in their ethical practice - hence the importance of the workplace ethical climate. Interest in nurse workplace ethical climates has snowballed in recent years because the ethical climate has emerged as a key variable in the experience of nurse moral distress. Significantly, this study appears to be the first of its kind carried out in New Zealand.
  
  
  OBJECTIVE
  The purpose of this study was to explore and describe how registered nurses working on a medical ward in a New Zealand hospital perceive their workplace ethical climate.
  This was a small, qualitative descriptive study. Seven registered nurses were interviewed in two focus group meetings. An inductive method of thematic data analysis was used for this research.
  
  
  METHODS
  Ethics approval for this study was granted by the New Zealand Ministry of Health's Central Regional Health and Disability Ethics Committee on 14 June 2012.
  
  
  RESULTS
  The themes identified in the data centred on three dominant elements that - together - shaped the prevailing ethical climate: staffing levels, patient throughput and the attitude of some managers towards nursing staff.
  
  
  CONCLUSIONS
  While findings from this study regarding staffing levels and the power dynamics between nurses and managers support those from other ethical climate studies, of note is the impact of patient throughput on local nurses' ethical practice. This issue has not been singled out as having a detrimental influence on ethical climates elsewhere.
  
  
  CONCLUSIONS
  Moral distress is inevitable in an ethical climate where the organisation's main priorities are perceived by nursing staff to be budget and patient throughput, rather than patient safety and care.
authors.affiliation: Massey University, New Zealand Anne.Humphries@xtra.co.nz.
authors.forename: Anne
authors.initials: A
authors.lastname: Humphries
authors.affiliation: Massey University, New Zealand.
authors.forename: Martin
authors.initials: M
authors.lastname: Woods
mesh_terms: D002055:Burnout, Professional / Q000523:psychology*; D004991:Ethics, Institutional; D004993:Ethics, Nursing; D005260:Female; D017144:Focus Groups; D006801:Humans; D009014:Morals; D009741:Nursing Staff, Hospital / Q000941:ethics* / Q000458:organization & administration / Q000523:psychology; D015279:Organizational Culture; D010465:Perception; D036301:Qualitative Research
keywords: Ethical climate; medical nursing; moral distress; nursing ethics; thematic analysis