A replication study of neonatal intensive care unit nurses participation in ethical decision making
The purpose of this study was to determine the extent to which Neonatal Intensive Care Unit (NICU) nurses participate in ethical decision making, and to describe the role NICU nurses have in the ethical decision making process.This study replicated a 1991 study conducted by Elizondo. According to Lowe, 1991, replication research is the repeating of a study for the purposes of validating the findings of the original investigation. The traditional theory of utilitarianism provides the theoretical framework for this study, a goal-based approach to ethical decison making that focuses on consequences of actions. Findings provide information about satisfaction and conflicts related to nurse participation in ethical deecision making in the NICU.The Nurse Participation in Ethical Decision Making (NPEDM) questionnaire (Elizondo, 1991) was used for data collection. Of fifty NICU nurses, seventeen (34%) of the sample completed the questionnaire. Confidentiality was maintained. Results showed that all respondents were able to identify methods that are used for participation in ethical decision making. Informal conversations with physicians was identified as the primary method of participation. Forty-one percent of respondents were satisfied with the nurse's role in ethical decision making. Forty-seven percent were only somewhat satisfied.An indication of satisfaction demonstrated by 100% of the study sample was that nurses' ideas are respected by other health care professionals.Findings indicated that a significant positive relationship exists between role satisfaction and study variables. Eighty-eight percent of respondents stated that conflicts related to participation were experienced. Overwhelmingly, respondents felt that the primary source of conflicts were with physicians. These findings are consistent with results reported in the original study.When asked what factors impact on how decisions are made, 40% of respondents indicated that ethical decisions are often impacted by generalized decisions based on viability of the neonate as determined by the gestational age, and "quality of life."Seventy-six percent of respondents believed nurses should be more involved in the ethical decision making. Conferences with physicians and parents was identified by 69% of the study sample. This study found that the older the nurse, the more satisfied with role in the ethical decison making process. Length of employment also contributed positively to satisfaction in ethical decision making. The more educated the nurse, the more satisfied with role in the ethical decision making process. Nurses were less satisfied if conflicts were experienced or identified.Findings suggest that collaborative relationships exist between nurses and other health team members and that nurses feel some sense of fulfillment with their role in the ethical decision making process. It was concluded that many issues were unsolved and need to be discussed.