The relationship between organizational climate and moral decision -making in pediatric registered nurses

Kathleen Mary Kane, Fordham University


When employees share common perceptions of their work environment, their attitudes and behaviors can be influenced. The present study investigated the influence of the organizational climate of two pediatric hospital work settings on nurses' moral reasoning and level of moral distress. Nurses in pediatric acute care (n = 119) and rehabilitation ( n = 110) hospitals in the eastern and Northwestern sections of the country participated. Although nurses working in hospital settings are somewhat accustomed to the medical crises that occur on a daily basis, these crises have an effect. Recent changes in the health care system require nurses to deal with patients who require more intense care. In this study, acute care nurses' sense of greater work pressure and higher level of moral distress have very real and practical implications for nursing administrators who are in a position to develop organizational structures and processes that can alleviate the constraints that cause such work pressure and distress. Results also demonstrated that nurses working in these settings are more similar than different in terms of their level of moral reasoning in hypothetical and real-world situations. While differences in the number of continuing education programs on ethics existed, the fact that attendance at such programs predicted nurses' level of moral reasoning in real-world situations is an important finding for nursing educators. Finally, the Nurses' Opinions about Pediatric Situations (NOPS) test developed for the present study can be valuable in serving as a resource to assess pediatric nurses' level of moral reasoning. Additionally, it can serve as a framework for creating an exchange among nurses, nursing administrators, and nursing educators in order to have nurses become active participants, and not mere bystanders in the decision-making process.

Subject Area

Developmental psychology|Nursing

Recommended Citation

Kane, Kathleen Mary, "The relationship between organizational climate and moral decision -making in pediatric registered nurses" (2000). ETD Collection for Fordham University. AAI9964571.