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Background: Cultivating internal whistleblowing among nurses is of paramount importance to nurse leaders. Yet, the literature on how nurse leaders can foster this phenomenon among nurses is limited. Additionally, the underlying mechanisms linking leadership behaviors to internal whistleblowing intentions remain underexplored. Aim: This study aimed to examine how ethical leadership is linked to internal whistleblowing intentions among nurses through the mediating effect of psychological safety. Research design: A multicenter cross-sectional research design was used for this study. Participants and research context: (...) This study involved 201 nurses working in three tertiary governmental hospitals across three cities in Egypt. Data were collected between October and December 2023, using an introductory information form, the Ethical Leadership Scale, the Psychological Safety Scale, and the Internal Whistleblowing Intentions Scale. Structural equation modeling was used to evaluate study hypotheses. Ethical consideration: Research Ethics Committee of Faculty of Nursing, Port Said University, Egypt approved the study (reference number: NUR (6/8/2023)(28)), and each participant signed the informed consent form before participation in the study. Results: Ethical leadership was positively linked to nurses’ psychological safety and internal whistleblowing intentions. Psychological safety mediated the link between ethical leadership and nurses’ internal whistleblowing intentions. Conclusion: Our study suggests that nurse leaders can foster nurses’ intentions to blow the whistle internally by adopting ethical leadership behaviors and enhancing psychological safety among nurses. (shrink)

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Background Home care nurses are central in providing holistic and compassionate care to patients in home-based palliative care. Ethical caring competency is essential for home care to sustain nurses’ integrity in the face of moral adversity. Interprofessional collaboration is vital for ensuring ethical decision-making and providing patient-centered care in home-based palliative care settings. Aim This study explored the predictive roles of interprofessional collaboration and moral resilience on ethical caring competency among home care nurses in home-based palliative care. Methods A cross-sectional (...) survey of 400 nurses was conducted from October to December 2023, utilizing standardized scales to measure interprofessional collaboration, moral resilience, and ethical caring competency. A convenience sample of 400 home care nurses was also included in this study. Correlation and linear regression analysis were used to clarify the associative and predictive findings. Ethical Considerations Ethical approval from the ethics committee, institutional permission, and informed consent from the participants were obtained for data collection. Results Correlation analysis showed significant positive correlations between the ethical caring competency, interprofessional collaboration, and moral resilience constructs, with coefficients ranging from 0.482 to 0.967. Linear regression revealed that management of collaborative systems and total moral resilience significantly predict ethical caring competency, explaining 14.6% and 36.6% of its variance, respectively. Other variables, such as the effects of collaboration and communication, did not significantly influence ethical caring competency. Conclusion The study highlights the significant impact of interprofessional collaboration, particularly the management of collaborative systems and moral resilience, on enhancing ethical caring competency among nurses. Implications Enhancing interprofessional collaboration and moral resilience through targeted strategies in nursing practice and education can significantly improve ethical caring competencies. These efforts are essential for delivering high-quality, patient-centered care and for fostering a healthcare environment that respects the ethical principles guiding nursing practice. (shrink)

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Background Although research has established that the work environment significantly shapes nurses’ ethical behavior, it’s less clear whether decent work could influence ethical ideologies of nurses. Aim To investigate the decent work conditions and ethical ideologies of nurses, and to analyze whether decent work influences their ethical ideologies. Methods A multicenter cross-sectional survey was conducted among 203 nurses working in three tertiary governmental hospitals across two cities in Egypt. We utilized the Scale of Decent Work, which consists of 15 items (...) distributed across five dimensions, to assess the level of decent work conditions. Additionally, the Ethics Position Questionnaire, containing 20 items divided into two categories—idealism and relativism—was used to evaluate the ethical ideologies of nurses. Pearson correlation and linear regression analyses were applied to analyze the data. Ethical considerations Ethical approval from the ethics committee, institutional permission, and informed consent from the participants were obtained for data collection. Results The findings indicated that the levels of decent work conditions were moderate, while the ethical ideologies of nurses were relatively high. Stepwise multiple linear regression analyses revealed that the idealism of nurses was significantly predicted by two dimensions of decent work—organizational values, and hours allowing for free time and rest—along with the overall decent work score. Meanwhile, the relativism of nurses was significantly predicted by the presence of physically and interpersonally safe working conditions. Conclusions Nurses experiencing decent work conditions characterized by high organizational values and adequate hours for free time and rest are more inclined to adopt idealistic ethical ideology. Meanwhile, those experiencing physically and interpersonally safe working conditions tend to embrace relativistic ethical ideology. Implications for clinical practice Identifying the relationship between decent work conditions and the ethical ideologies of nurses can assist hospital administrators in fostering work conditions that promote appropriate ethical ideologies among nurses. (shrink)

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