Access Type

Open Access Dissertation

Date of Award


Degree Type


Degree Name




First Advisor

Samuel Stone


The hospital nurse is required to make decisions that affect the lives of patients. The American Nurses Association Code for Nurses ought to be the framework used by nurses in making those ethical decisions. The Code is not the primary basis for ethical decision making as has been shown in this and previous research. In this research the role of hospital employer, personal and professional values of staff nurses has been examined for their influence on the ethical decisions made by nurses. The nurses completed the Health Care Work Powerlessness Scale, and the Nursing Dilemmas Test and Ethical Behavior Inventory. The test scores were analyzed using the Pearson Product-Moment Correlation Coefficient (r). Demographic characteristics of the nurses, such as age, religion, religious education, basic and current educational preparation for practice and ANA membership were also obtained. Test scores were recoded into categorical data so that the data could be analyzed using Chi Square. In a convenience sample of 231 registered nurses practicing as staff nurses in hospital in-patient settings significant negative relationship was identified between the Health Care Work Powerlessness Score and the Code Congruency score on the Ethical Behavior Inventory (R = -0.1363, p = .019). An additional significant relationship was identified between educational preparation for practice outside the United States and Code Congruency scores. It was found that as powerlessness increases Code congruency decreases and that Code congruency was lower in nurses educated outside the United States. ((chi)('2) = 20.50102, df = 2, p < .05). Recommendations are made for further research.

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Nursing Commons