Strategies and challenges in addressing ethical issues in the hospital context: A phenomenological study of nurse team leaders

Background: Nurse team leaders encounter considerable ethical challenges that necessitate
using effective strategies to overcome them. However, there is a lack of research exploring
the experiences of nurse team leaders in Indonesia who face ethical dilemmas in their
professional duties.
Objective: This study aimed to explore nurse team leaders’ experiences regarding strategies
and challenges in dealing with ethical problems in hospital settings in Indonesia.
Methods: This qualitative study employed a hermeneutic phenomenology design. Online
semi-structured interviews were conducted between November 2021 and February 2022
among 14 nurse team leaders selected using a snowball sampling from seven hospitals (three
public and four private hospitals). Van Manen’s approach was used for data analysis.
Results: The strategies for overcoming ethical dilemmas included (i) seeking the facts, (ii)
stepping back, (iii) considering support, and (iv) standing by patients. The challenges for the
nurse team leaders in resolving ethical problems consisted of (i) seniority, (ii) trust issue, and
(iii) lack of reflection and ethics training.
Conclusion: Nurse team leaders recognize their specific roles in the midst of ethical
challenges and seek strategies to deal with them. However, a negative working environment
might impact ethical behavior and compromise the provision of quality care. Therefore, it is
imperative for hospital management to take note of these findings and address issues related
to seniority by providing regular ethics training and group reflection sessions to maintain
nurses' ethical knowledge in hospital practice. Such interventions can support nurse team
leaders in resolving ethical dilemmas and provide a conducive environment for ethical
decision-making, ultimately improving patient outcomes.