Abstract
ABSTRACT Objective: to identify the elements of moral sensitivity held by nurses working in a medical clinic unit. Method: this exploratory-descriptive study with a qualitative approach addressed 18 nurses from a medical clinic of a university hospital located in southern Brazil using semi-structured interviews, which were analyzed using discursive textual analysis. Results: data were structured into six categories: relational orientation; experiencing moral dilemmas; following rules; benevolent motivation; structuring moral meaning; and autonomy. These categories enabled the identification of important elements of moral sensitivity, such as acknowledging the ethical dimension of one’s attitudes, acknowledging the uniqueness of each patient, dealing with conflict between workers and patients and/or their companions, adapting to the workplace, empathy, dialogue, clinical decision-making, meeting the needs of patients, understanding patients’ health condition, respect, welcoming patients’ desires and providing guidance that concerns patients’ requests and refusals. Conclusion: the elements of moral sensitivity identified in this study contribute to support nurses when making clinical decisions, especially when facing ethical issues arising in a medical clinic setting.
Highlights
The philosophical concept of moral sensitivity has been explored with the idea of “moral sense”, involving factors such as moral knowledge, moral behavior, and benevolent motivation.[1]
This study enabled identifying elements of moral sensitivity that concern professional relationships, especially in terms of relational orientations established among workers, the organization, patients and family members, reflecting the way nurses address conflicts between workers and companions and adapt to the work environment
This study shows that nurses seek to recognize the moral dimension of their attitudes regarding clinical decision-making, which can be identified in a study addressing nurses working in an intensive therapy unit, which highlighted that workers are more sensitive in recognizing the moral dimension of their behaviors, enabling them to critically and ethically reflect on how they are performing their tasks.[17]
Summary
The philosophical concept of moral sensitivity has been explored with the idea of “moral sense”, involving factors such as moral knowledge, moral behavior, and benevolent motivation.[1] In this context, moral sensitivity is the ability of a worker to identify conflict situations and understand the moral consequences of a decision for a patient, being aware of one’s responsibilities.[2] ethical decision-making, in turn, involves being sensitive to a patient’s vulnerability and express such sensitivity.[3]. Healthcare settings, especially clinical settings, are characterized by various ethically vulnerable situations.[6,7] nurses are constantly confronted with conflicting situations in which their knowledge and skills are put to test. Moral sensitivity is considered a characteristic that enables nurses to fully recognize the ethical challenges of a clinical setting, providing them a good understanding of their work situation.[9,10]
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