Morality in perioperative nurses

AORN Journal,  March, 2002  by Aileen R. Killen

• E-mail
• Print
• Link

Respondents were primarily female (92.1%) and Caucasian (87.3%). They ranged in age from 23 to 71 years (mean = 43.9, standard deviation = 8.68). Almost 90% reported being raised in the Catholic (43.9%) or Protestant (42.5%) traditions. More than one-half (54.1%) reported that current spiritual beliefs strongly or completely influence their lives.

Seventy-three percent of respondents received their basic education at the diploma or associate degree level. More than one-third (38.5%) held baccalaureate degrees, and 3% held master's degrees or higher. Almost one-third (31%) reported never having received ethics education. Of those with some type of ethics education, 44% received this education in a basic nursing program, 14% in an additional degree program, 27% in a continuing education program, and 15% in various other educational settings.

Respondents' years of perioperative nursing experience ranged from zero to five years (14.6%) to more than 21 years (27.3%). More than one-third (36.3%) identified themselves as competent practitioners, and 22% identified themselves as expert practitioners. Fifty-three percent held CNOR certification. The majority (76.4%) worked full time. More than one-half (56%) worked in OR suites that contained between six and 10 ORs, and 70% worked in institutions that were affiliated with medical or nursing schools. The majority indicated that they were extremely likely to remain in nursing for the next year (86.7%) and the next five years (66.7%).

Respondents reported varying degrees of moral motivation and moral character, moderate to high levels of moral action, and relatively low levels of perceived work-related stress. Table 2 contains ranges, means, and standard deviations for the major model variables.

The researcher performed multiple regression to test the original premise that moral motivation and moral character are related directly to moral action. Variables measured at the nominal and ordinal level were coded to allow for proper interpretation in regression analysis. (24) Variables were dropped from the analysis if their respective regressions were not significant at P [less than or equal to] .05. Three subscale measures of moral motivation (ie, fantasy, perspective taking, and personal distress) and the measure of moral character accounted for 13% of the variance in moral action ([F.sub.5,785] = 23.44, P < .001).

Pearson's product moment correlation suggests that the nurse characteristics of self-perceived level of nursing practice, years in perioperative nursing, importance of spiritual beliefs, ethics education, and unit characteristics had the potential to alter the relationship between moral motivation, moral character, and moral action (Table 3). Additional regression analysis revealed that the subscales of moral motivation and moral character, as well as two nurse characteristics (ie, ethics education, level of nursing practice) contributed significantly to the prediction of moral action. These five variables accounted for 14% of the variance in moral action as measured by the NEIS. This model is depicted in Figure 1. This revised model contains one cognitive (ie, perspective taking) and one emotive (ie, fantasy) indicator of moral motivation. Moral character remained a strong predictor of moral action. The revised model also suggests a direct relationship between characteristics of nurses and moral action. No correlation was revealed between moral action and nurse outcomes as measured by the BM (R = -.05, P > .05) or between moral action and patient outcomes as measured by overall quality of care (R = .01, P > .05).