Perspectives of Ethical Care: A Grounded Theory Approach

Dissertation, Columbia University Teachers College (1991)
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The aim of following grounded theory study has been to discover processes nurses use when faced with ethical situations in practice. This led to the discovery processes of human connection, as well as processes which inhibit and facilitate human connection. These processes became the organizing framework for the substantive theory, the theory of human connection. Consistent with a grounded theory approach, the basic social process and basic social psychological problem were derived out of the social world of nurses faced with ethical situations. The focus or BSP became the exploration of the patterns and processes of human connection; its related problematic area, the BSPP became the exploration of how nurses are able to maintain a sense of personal integrity while achieving and maintaining human connection. Included in this theory is a description of three perspectives identified in the process of human connection: a reductionistic perspective, a humanistic perspective, and a humanistic contextual perspective. ;Multiple methods were used in this study including: three months of participant observation in a Medical Intensive Care Unit, stories written by nurses about their experiences in ethical situations, interviews with nurses who had submitted a personal story recounting an ethical situation, and three focus groups with nurses to explore themes. Using a constant comparison approach, data collection strategies overlapped, and sampling strategies were modified as the BSPP and the BSP were identified and conditions explored. As the study evolved, sampling became more focused on those nurses who had made a conscious decision to strive toward human connection nurses who frequently expressed a need or drive to "make a difference." ;This research study presents the use of grounded theory in discovering a descriptive theory of human connection, an ethic grounded in the core value, respect for human dignity, and self-determination. Recommendations for education, administration and future research are presented, with the hope that this study will spark critical response and dialogue, and will lead to a better understanding of the moral art of nursing



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