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Exploring student nurses’ perceptions of ethical issues in clinical practice at a selected college in the Free State.

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Background: Ethics, according to the South African Nursing Council Code of Ethics, plays a vital role in the nursing profession by setting the standards for professional conduct and ethical values. As such, nursing tasks need to be carried out ethically in a manner that demonstrates quality patient care and professional obligation. Violation of this Code of Ethics may lead to sanction by the South African Nursing Council which may include caution or a reprimand or both, suspension for a specific period from practising or removal of individual’s name from the register, depending on the type of the transgression. Statistics showed an escalation in cases of misconduct reported by SANC of which newly qualified professional nurses are mostly affected. Moreover, there is increasing incidents of academic dishonesty reported among student nurses which may suggest a poor understanding of ethical issues. Although the existence of these ethical issues and their implications for the nursing profession have been expressed, the perceptions of student nurses who are expected to ultimately engage with patients regarding ethical issues in clinical practice are not known. Purpose: The purpose of this study was to explore and describe the ethical issues that student nurses report as frequently occurring in clinical practice. Methodology: Positivist and quantitative approach were adopted using a structured questionnaire adapted from a study conducted by Jill Sinclair on New Zealand nursing students’ experiences of ethical issues in clinical practice. A descriptive study. Permission to adapt the questionnaire was sought and granted by Professor Marshall. Moreover, an exploratory descriptive design was used in this study. This study targeted student nurses from the second year to fourth year levels, who were registered for Diploma in Nursing (General, Community and Psychiatry) and Midwifery at the college under study. The total population was 194 student nurses (N=194) with a sample size of (n=114). The content and the construct validity of the instrument was tested by examining the items in questionnaire against the objectives of the study and concepts in the conceptual framework to establish whether all elements to be investigated were fully measured. Test-retest reliability was also conducted and yield the score of .851. The study commenced after obtaining approval from the University of KwaZulu-Natal’s Research Ethics Committee, the Free State Department of Health, the Principal of the school, the Dean of the college where the study was conducted and the Management of the clinical practice where some of the students were placed during the data collection process. Data were collected and analysed using the Statistical Package for Social Sciences version 24.0. Findings: The main findings of this study were that the majority of the respondents, 46.5% very often encountered working conditions that were considered unsafe i.e. low staffing levels, lack of resources or equipment and a lack of staff training. This was followed by the provision of care for patients that have put the nursing students’ own safety at risk, which was reported by 40.4% of the respondents as occurring very often in the clinical practice under study. The third ethical issue reported as often occurring was an unhealthy dialogue between healthcare providers in the presence of patients, reported by 27.2% of the respondents Recommendations Nursing Education: Student nurses should be empowered on how to deal with ethical issues reported in clinical practice. This can be achieved through the use of innovative teaching strategies like case-based, problem-based learning and the use of reflective diaries. This will inturn help in the clinical practice areas and the nursing profession as a whole will be enhanced. Nurse educators, nursing management should work together to ensure the safety of students during clinical placement. Keywords: Ethical issue, Student nurses, clinical practice


Master of Nursing. University of KwaZulu-Natal, Durban 2018.