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Open Access Values That Matter, Barriers That Interfere: The Struggle of Canadian Nurses to Enact Their Values Les infirmières canadiennes face à la difficulté de mettre en pratique les valeurs qui leur sont chères

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Qualitative interviews were conducted with 20 nurses in a Canadian city to explore the moral experience of nurses in their working lives. The participants were asked what they valued in their profession and how well their work lives enabled them act on their values. Almost uniformly, they expressed commitment to the values of helping others, caring, making a difference, patient-centredness, advocacy, professional integrity, holistic care, and sharing knowledge for patient empowerment. They identified several challenges and frustrations experienced in attempting to enact these values. System-level challenges included professional hierarchies, organizational structures, issues in the health-care system, and power dynamics. Removing these barriers cannot be left to nurses alone. It requires complex, wide-ranging strategies: system change, power restructuring, and the creation of ethical climates and cultures that support values that are essential to good patient care.

Les chercheuses ont mené des entretiens qualitatifs auprès de 20 infirmières d'une ville canadienne dans le but d'analyser leur expérience morale au travail. Elles ont demandé à celles-ci d'indiquer ce qu'elles valorisaient dans leur vie professionnelle et de préciser en quoi leur travail leur permettait de mettre leurs propres valeurs en pratique. Les répondantes sont quasi unanimes à évoquer leur adhésion à des valeurs comme l'aide, la sollicitude, le besoin d'être utile à la société, la relation axée sur le patient, la défense des droits, l'intégrité professionnelle, les soins holistiques et la volonté de transmettre des connaissances qui permettront aux patients de se prendre en main. Elles relèvent les difficultés et les frustrations qu'elles éprouvent lorsqu'elles tentent de mettre ces valeurs en pratique. Les obstacles de nature systémique comprennent notamment les hiérarchies professionnelles, la structure organisationnelle, les problèmes que connaît le système de santé et les dynamiques de pouvoir. Les faire tomber n'est pas une tâche qui appartient aux seules infirmières. Elle nécessitera un éventail de stratégies complexes : changements systémiques; restructuration des relations de pouvoir; et création d'une culture fondée sur l'éthique et propice au respect des valeurs essentielles à la prestation de soins infirmiers de qualité.

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Document Type: Research Article

Publication date: 2007-12-01

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