Moral Problems and Moral Courage in Nursing Practice of Nursing Students in Nursing Colleges, Southern Thailand:Critical Incident Technique

Abstract

This study explored critical incidents of moral problems in nursing practice by nursing students, reasons, and their demonstrated action of moral courage in dealing with those moral problems including outcomes from their actions of moral courage. There was fifty nursing students in the third year of five nursing colleges in Southern Thailand were recruited by researcher. The participants were interviewed and their interviews were transcribed to develop relevant themes by using the critical incident analysis technique. The result of this study composed of five themes of critical incidents related to moral problems in nursing practice were faced by nursing students; (1) Compromised Patient Safety, (2) Substandard Quality of Care, (3) Lack of Adequate of Information, (4) Lack of Concern for the Patient's needs, and (5) Privacy and Confidentiality Violation. The nursing students had moral reasons that encouraged the actions of moral courage in response to the critical incident, which included (1) Obligation to protect patient's rights, (2) Moral duty to provide quality of care, (3) Empathy, and (4) Honesty. They showed their action of moral courage, which included (1) Providing information in respect for patient's rights (2) Enhancing quality of care (3) Notifying health care team about patient's needs (4) Responding to the patient's need in accordance with patient's rights (5) Taking action to maintain patient privacy and confidentiality. The outcomes from their actions of moral courage were composed of (1) Quality of care (2) Patient safety (3) Patient's needs are met (4) Gain trust from patients. Moral courage is important for nursing students in dealing with ethical problems in their nursing practice effectively. Ethics education is an essential mechanism in fostering nursing students' moral courage which will result in positive outcomes to patients, nursing students, as well as the nursing profession.