A Thematic Analysis of Ethical Issues Faced by Nursing Students in Clinical Practice.

Abstract

Introduction: Ethical and moral complexities are common in clinical environments and shape nursing students' professional development. Ethics education supports the development of critical thinking and moral reasoning in nursing students, enabling them to recognize and effectively address ethical issues in their professional practice. Studies have highlighted ethical issues nursing students face during their clinical placements.

Objectives: This study aimed to explore the ethical issues nursing students faced during their four-year clinical training.

Methods: A qualitative study was conducted using deductive thematic analysis, following Braun and Clarke's framework. A purposive sample of fourth-year undergraduate nursing students at a University in Cyprus (academic year 2022-2023). Data derived from written responses to an open-ended question embedded in the Nursing Ethics and Professional Legislation module.

Results: With a response rate of 96.49% (55 students), analysis identified three themes: (1) Violation of Patients' Rights (autonomy, informed consent, equality/religious freedom, access to medical records, and privacy), (2) Moral Distress (anxiety/pressure, awareness of the ideal but constrained action), and (3) Professional Liability and Nursing Codes of Ethics (communication failures, neglect, and lapses in duty of care).

Conclusions: Nursing students observed violations of patient autonomy, informed consent, privacy, and equality, and experienced moral distress. Ethics education should emphasize core values, strengthen ethical decision making, and foster moral courage. In addition, academic and clinical settings need to provide emotional and professional support, to help students manage distress, and develop resilience as future professionals.