Ladder | Code | Reference | Level |
Ladder I | Art. 1 | *Feeling resistance to the situation where nursing work takes precedence over the respect for human life [6] | Awareness |
Art. 4 | *Feeling the dilemma of having to carry out a procedure by holding down the patient because of family consent, even when the patient is refusing the procedure [7] *Sufficiently recognize “Informed Consent” as knowledge [8] | Awareness Awareness | |
Art. 5 | *Feeling that a walking conference does not protect privacy [7] *Sufficiently recognize confidentiality, protection of a patient’s personal information, and disclosure of information as knowledge [8] | Awareness Awareness | |
Art. 6 | *Feeling the dilemma over having to hold down a patient due to risk of self-extubation or falling [7] | Awareness | |
Art. 8 | *Recognizes the importance of continuing to learn as a professional person [7] *Attitude towards patient safety becomes more positive after receiving an educational program related to safety ethics using a DVD [6] | Awareness Action | |
Art. 10 | *Identify desirable nursing care using senior nurses as a model [9] | Awareness | |
Ladder II | Art. 1 | *Knowledge related to protection of privacy is being used actively in clinical practice [10] | Awareness |
Ladder IV | Art. 2 | *Nurses regard the discriminatory behavior of TB patients as an ethical problem because of infringement of rights [11] | Judgment |
Art. 4 | *Nurses regard the refusal of treatment of disabled newborns by parents to be a problem because the patient’s will is not being respected [11] | Judgment | |
Art. 6 | *Nurses regard excessively holding down patients to prevent risks as an ethical problem [11] | Judgment | |
Art. 11 | *Nurses are providing care using methods that do not harm patient rights, based on knowledge gained from the literature [11] | Action | |
*No classification by years of experience | Art. 1 | *Nurses feel the dilemma with treatments that restrict physical activity among older adult patients [12] *Nurses regard inappropriate speech and conduct towards patients as a problem, due to lack of respect for patient dignity [13] *Nurses recognize the need for “Respecting the patient” and “Paying attention to the patient’s value” as a way to respect the human being while providing palliative care for cancer patients [14] | Awareness Judgment Awareness |
Art. 2 | *Nurses recognize matters relating to resource allocation and equity in care as a problem [15] *Nurses harbor doubts that patients whose conditions become severe due to treatment complications have clear differences in content and frequency of care compared to other patients and that this may be a cause for special treatment [16] | Awareness Awareness | |
Art. 3 | *Nurses feel the dilemma when communication with older adults, patients, and families is not smooth [12,17] *Nurses feel an ethical dilemma after recognizing a difference between the necessity of treatment and the patient's feelings [16] *Nurses engage with patients with an empathic attitude when patients are suffering or in pain [16] | Awareness Awareness Action | |
Art. 4 | *Nurses feel an ethical dilemma with strong family requests asking not to tell or express the family’s will to the patient [16] *Nurses regard the signing of consent form(s) by patients, that do not sufficiently understand the explanations, as an ethical problem [18] | Awareness Judgment | |
Art. 5 | *Nurses value patient confidentiality and protection of privacy [19] | Awareness | |
Art. 7 | *Looking back to when they were only able to make records of physician’s instructions at the time of sudden changes in a patient’s condition, nurses recognized that they had not been able to fulfill the loyalty and duty of their profession [16] | Awareness | |
Art. 8 | *By learning from experience the ways to analyze the everyday scene of nursing practice from an ethical viewpoint, nurses had improved their knowledge needed to reach a particular resolution in situations that they felt were “odd” [21] *Nurses are aware that arrangement of an organizational system, as well as the implementation and continuation of ethical education for all staff, is necessary so that actions to resolve ethical problems can be taken by all staff [22] *By discussing the cases related to ethical problems that occur in sessions to which they are affiliated, nurses raised their awareness related to nursing ethics and had gained many ways of thinking and solving problems [23] | Awareness Awareness Awareness | |
Art. 9 | *Nurses deal with ethical problems by consulting a colleague [24] *Despite having the dilemma of potentially interfering with a patient’s will or desire, nurses had the experience of not being able to tell their opinion to senior nurses [25] | Awareness Judgment | |
Art. 10 | *Nurses regard the situation of not being able to sufficiently provide nursing care to patients as a problem [24] | Judgment |