Factors influencing ethical decision making among Psychiatric nurses at Mathari Hospital in Nairobi

Abstract

Ethical decision making is the process of trying to distinguish right from wrong in situations without clear guidelines. While ethical dilemmas confront nurses in all areas of nursing practice, those that occur in psychiatric nursing care settings are more challenging than those occurring in other areas of nursing. This is because the decrease in mental ability of psychiatric patients leads to vulnerability which evokes ethical difficulties for the psychiatric nurses. This was a descriptive cross-eecttonal study aimed at identifying the factors that influence ethical decision making among psychiatric nurses in Kenya. It was carried out at Mathari Hospital in Nairobi. The study aimed at identifying factors that influence the process of ethical decision making by the psychiatric nurses in their clinical practice. The study hypothesis was that there is no relationship between nurses' demographic characteristics and the way they make ethical decisions. Quantitative data was collected using a self administered questionnaire which was developed and distributed to 152 randomly sampled psychiatric nurses at Mathari hospital. Qualitative data was collected via a focused group discussion which comprised of eight nurse managers. Data was categorized and coded according themes. Data entry was done by use of statistical package for social sciences (version 16.0) Descriptive and inferential statistics were used as appropriate for data analysis. Qualitative data from focused group discussions was analyzed manually. Overall the results of this study showed that factors influencing nurses ethical decision making were professional experience (r = 0.0.40, p=O.Ol), workload (rho=0.227, p=0.042), psychiatric nursing experience(r= 0.037, p= 0.01) and gender (rho=0.277,p= 0.013). Knowledge and skills obtained through psychiatric care specializations should be considered when posting nursing staff to the psychiatric care areas. Further ethnographic research is re co m m errd e d to identify what other aspects of the clinical environment affect ethical decision making by the care givers.