Ethical Dilemma Experiences of Nurses in a Tertiary Hospital, Kingdom of Bahrain: A Cross-sectional Survey

Background: Nurses constitute the vast majority of the healthcare workers, but it is unclear how frequently they encounter ethical dilemmas in Bahrain. Thus, there is a need for nurse administrators in Bahrain to understand the ethical dilemmas their nursing staff may face. Purpose: The study aimed to explore the ethical dilemmas experienced by nurses in Bahrain and to identify any associations between ethical dilemmas with nurse characteristics. Methods: A descriptive cross-sectional survey design was undertaken. The setting was inpatient nursing units and the emergency department of a tertiary hospital in Bahrain. Data were collected from nurse participants through convenience sampling from July to August 2020 by using an online 24-item Ethical Dilemma Questionnaire (EDQ) on a 7-point (0-6) Likert scale. Ethical approval for the study was obtained from the hospital's institutional review board. Results: Among the 390 participating nurses, the mean (SD) EDQ score was 1.24 (0.80), indicating a low overall frequency of ethical dilemmas (between less than a few times per year and up to once per month). The subdomains were patients' actions and decisions, nursing care provisions, personal and collegial actions and decisions, and sharing of information. The participants' characteristics that were found to be statistically significant were gender, nationality, and department of work. Age was found to be negatively correlated. However, nurses' EDQ scores based on job category and years of experience were not found to have a statistically significant difference. Conclusion: Although nurses had infrequent encounters with ethical dilemmas, they reported more dilemmas when facing low nurse-patient ratios, contesting a prescription order, working with nonresponsive physicians, dealing with patients' lifestyle choices, and handling nonnursing tasks.