Primary Care Nurse Practitioners' Integrity When Faced With Moral Conflict

Primary care presents distressful moral problems for nurse practitioners (NPs) who report frustration, powerlessness, changing jobs and leaving advanced practice. The purpose of this grounded theory study was to describe the process NPs use to manage moral problems common to primary care. Twenty-thr...

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Bibliographic Details
Main Author: Laabs, Carolyn Ann (Author)
Format: Electronic Article
Language:English
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Published: Sage 2007
In: Nursing ethics
Year: 2007, Volume: 14, Issue: 6, Pages: 795-809
Further subjects:B Ethics
B nurse practitioners
B Moral Integrity
B Moral Distress
B Primary Care
B Grounded Theory
Online Access: Volltext (lizenzpflichtig)

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520 |a Primary care presents distressful moral problems for nurse practitioners (NPs) who report frustration, powerlessness, changing jobs and leaving advanced practice. The purpose of this grounded theory study was to describe the process NPs use to manage moral problems common to primary care. Twenty-three NPs were interviewed, commenting on hypothetical situations depicting ethical issues common to primary care. Coding was conducted using a constant comparative method. A theory of maintaining moral integrity emerged consisting of the phases of encountering conflict, drawing a line, finding a way without crossing the line, and evaluating actions. The NPs varied in their awareness and the discord encountered in conflict, and in clarity, flexibility and justification of the line drawn. A critical juncture occurred when NPs evaluated how well integrity had been maintained. Some experienced no distress while others experienced self-doubt, regret, outrage and frustration at external constraints, and attempted to reconcile through avoiding, convincing themselves, and compensating. 
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