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According to obedience research, we may harm others under the forceful pressures of an authority figure (Milgram, 1974). How about if the inappropriate orders were delivered with less force? The increasing interdependence between nurses and physicians compelled Hofling and his colleagues to explore nurses’ reactions to a potentially harmful medical request made by the perceived authority figure, the doctor (Hofling, Brotzman, Dalrymple, Graves, & Pierce, 1966). In this situation, obedience...
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When nurses' vulnerability challenges their moral integrity: A discursive paper.

Anna-Henrikje Seidlein1, Eva Kuhn2

  • 1Institute of Ethics and History of Medicine, University Medicine Greifswald, Greifswald, Germany.

Journal of Advanced Nursing
|May 26, 2023
PubMed
Summary

Nurses' vulnerability and integrity are linked moral concepts. Understanding this relationship helps buffer threats to integrity and promote moral resilience in clinical practice.

Keywords:
decision-makingethicsnarrativenurse-patient interactionnurse-patient relationshipphilosophyself-care

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Area of Science:

  • Nursing Ethics
  • Moral Philosophy
  • Healthcare Professional Well-being

Background:

  • Vulnerability and integrity are key concepts in nursing, typically focused on patients.
  • These concepts are often studied in isolation, neglecting their interconnectedness in nursing practice.
  • The existing literature rarely addresses nurses' own vulnerability and integrity.

Purpose of the Study:

  • To define the moral dimensions of nurses' vulnerability and integrity.
  • To elucidate the relationship between these concepts within clinical nursing practice.
  • To enhance the nuanced understanding of nurses' moral experiences.

Main Methods:

  • A discursive analysis of the relationship between vulnerability and integrity in nursing.
  • Application of established vulnerability concepts (Mackenzie et al., 2014) to nurses.
  • Expansion of moral integrity concepts (Hardingham, 2004) to the nursing context.
  • Illustrative scenarios and cross-case discussion to examine vulnerabilities and their impact on moral integrity.

Main Results:

  • Vulnerability and integrity are complementary moral concepts with theoretical and practical significance.
  • Not all vulnerabilities threaten moral integrity; specific forms pose a risk.
  • The interplay between vulnerability and integrity is influenced by moral distress.

Conclusions:

  • Joint consideration of vulnerability and integrity offers valuable insights for nursing.
  • Identifying specific threats to nurses' integrity is crucial for targeted interventions.
  • Strategies to buffer threats and promote moral resilience are essential at multiple healthcare system levels.