Thoughts and feelings that determine how Japanese nursing students deal with ethical issues: A qualitative study

Nursing students face various ethical issues, which may cause stress, that require coping strategies. This study investigated the thoughts and feelings underlying the coping behaviors adopted by nursing students when addressing ethical issues. Semi-structured interviews were conducted from September to October 2011 with 11 students enrolled at University A who had completed basic nursing and specialty (by field) practicums and consented to participate in the study. Data were analyzed using qualitative methods. The participant narratives about ethical issues encountered during clinical practicums were organized into four themes and 20 scenarios. The ethical issues concerned the attitudes and conduct of nurses, doctors, physical therapists, and other medical professionals. Seven coping behaviors were identified. The results revealed that nursing students waver between valuing their relationships with nurses and their relationships with patients when they encounter an ethical issue. When their relationships with nurses were emphasized, their ethical values were restructured. These findings suggest the need to address the affective domain early on in lectures and in-class practice, and to create an environment in which students taking practicums can easily express their feelings and internal value system changes.