Welcome to the Journal of Nursing Safety, Ethics, and Well-being (JNSEW) archive. This section offers access to our latest issue and previously published volumes, reflecting a rich collection of scholarly contributions in the areas of nursing safety, professional ethics, and caregiver well-being.
Featured Articles in the Latest Issue
- Volume 2 (Issue 1) JANUARY- JUNE 2026
Research Articles
Multicenter Cross-Sectional Analysis of Ethical Climate and Medication Error Reporting in Acute Care Settings
Vol.2(1); Pages:1-8. Published on February-2026
Abstract
It is believed that an amicable ethical atmosphere forms the core of clear patient safety practices, and empirical data on ethical workplace conditions in reference to reporting medication errors is not much. This is a multicenter cross-sectional survey that was conducted to determine the impact of the perception of ethical climate on nurses in their intentions to report medication errors in acute care hospitals. Validated measures of ethical climate perception (six measures), psychological safety (three measures), and self-reported reporting behaviors (six measures) were used to gather data on 412 registered nurses in six tertiary hospitals in North America. Multivariate regression and mediation modeling were provided by the statistical analysis. Findings showed that nurses in units that exhibited collaborative leadership, open communication and ethical accountability scored significantly higher in reporting voluntary errors. Ethical climate and reporting behavior had a partial relationship which was mediated by psychological safety. On the other hand, underreporting and emotional distress were reported more frequently among nurses who worked in hierarchical environments with punitive responses to errors. The results highlight that patient safety programs should go further than the formal guidelines in their procedures and seek to include ethical leadership and supportive reporting cultures. Hospital administrators need to focus more on ethical climate measurement and introduce leadership training that would facilitate openness and non-admonitive reaction to clinical errors. Ethical work environments can be strengthened to achieve better patient safety results and nurse well-being in high-pressure clinical environments at the same time.
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Qualitative Exploration of Ethical Challenges and Burnout in Critical Care Nursing
Vol.2(1); Pages:9-17. Published on March-2026
Abstract
The critical care nurses are often faced with complex ethical dilemmas that are likely to cause moral distress and professional burnout. The current qualitative phenomenological research investigated the lived experience of moral distress in intensive care nurses and the impact of ethical conflict on emotional and professional orientation. Semi-structured interviews were conducted with twenty-five nurses working in three hospitals located in metropolitan areas on ethical dilemmas, barriers to communication, and coping strategies. The tools applied in the analysis of data were thematic phenomenological analysis. The respondents gave scenario descriptions that included repetitive situations such as end-of-life decision-making conflicts, perceived futile treatments, and lack of participation in ethical decision making. These events commonly created a sense of helplessness, remorse and emotional drainage. Nurses pointed out that institutional procedures occasionally made it difficult to advocate the full development of patient-centered care, which caused moral tension. Nonetheless, supportive colleagues, structured ethics consultations and forums of reflective practice were also noted to play a protective role by the participants. The results indicate that the moral distress in critical care settings is not only a psychological problem of an individual but also an organizational problem. Ethics support programs, interdisciplinary communication training and the availability of counseling services can be used to alleviate distress and create a more ethically responsive care environment that safeguards the interests of the patient and well-being of the nurse.
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Integrating Safety Culture and Nurse Well-Being Programs in Hospitals: Evidence from a Mixed-Methods Implementation Study
Vol.2(1); Pages:18-26. Published on March-2026
Abstract
The healthcare systems are starting to acknowledge that patient safety outcomes are deeply connected to the well-being of nurses, but the coordinated actions addressing the two areas are under-researched. This implementation research study was a mixed-methods work, which assessed the effectiveness of a hospital intervention that aimed to support the culture of safety and sustain well-being among nurses at the same time. The intervention involved organized safety huddles, resilience training sessions, and communication training about ethics that was provided in six months in two hospitals at the tertiary level. Validated safety culture and occupational well-being scales were used to gather quantitative data of 286 nurses prior to and after the implementation of the programs. To examine the experiences of the participants along with the perceived barriers, qualitative focus groups were held. The quantitative findings showed a strong increase in the teamwork climate, perceived management support to safety and self reported scores of psychological well-being. The qualitative data identified interdisciplinary communication as the core aspect of maintaining changes and open leadership interaction. It was also observed that the participants experienced less hesitation in reporting near-miss events as a result of participating in the program. Regardless of these advantages, workload stress and staffing were obstacles to regular involvement. The paper indicates that organizational interventions on ethical communication and organizational resilience could deliver quantitative changes in the safety culture. Staff well-being initiatives should be incorporated into wider quality and safety models by health systems that are aiming at sustainable patient safety outcomes.
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Strengthening Incident Reporting and Psychological Safety Through Ethical Leadership Training in Nursing
Vol.2(1); Pages:27-35. Published on May-2026
Abstract
Behaviors of leaders have a significant impact on the way medical workers react to safety events and ethical situations. This quasi-experimental design was an assessment of whether nurse managers undergoing structured ethical leadership training could enhance incident reporting and psychological safety of staff nurses. The intervention involved a 3 month leadership skill training program that focused on ethical decision models, effective communication models, and non-punitive approach to clinical mistakes. The intervention was applied to two hospital units and the two similar units were the controls. The 168 nurses were surveyed using validated surveys to determine the psychological safety, leadership trust, and the frequency of reporting. Post intervention analysis showed that the units with trained manager had a high reported rate of voluntary incident reporting and near-miss documentation. The perceptions of fairness, openness, and ethical accountability of the leadership behaviours were also higher among staff nurses. The post-intervention interviews indicated the willingness of managers to talk about errors decreased fear and stigma attached to error disclosure. These results are of critical importance to the leadership development program explicitly incorporating the ethical principles and the patient safety practices. The enhancement of ethical leadership competencies can become one of the effective organizational strategies to enhance the level of safety transparency and help nurses to experience the emotional safety in complicated clinical conditions.
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Hospital-Based Ethics Support Programs and Nurse Well-Being: Evidence from a Systematic Review
Vol.2(1); Pages:36-43. Published on May-2026
Abstract
Healthcare institutions increasingly implement ethics support mechanisms such as ethics committees, consultation services, and moral distress rounds; however, their influence on nurse well-being has not been systematically synthesized. This systematic review examined global evidence on how institutional ethics support systems affect nurses’ psychological well-being, ethical confidence, and patient safety engagement. Electronic databases including PubMed, Scopus, and CINAHL were searched for studies published between 2005 and 2025. Thirty-two peer-reviewed studies met inclusion criteria. The findings indicate that accessible ethics consultation services and regular ethics dialogue sessions significantly reduce reported levels of moral distress and emotional exhaustion among nurses. Several studies also reported improvements in ethical competence and collaborative decision-making following implementation of structured ethics rounds. Nevertheless, inconsistent program availability and limited awareness among staff were identified as common barriers to utilization. The review highlights that ethics infrastructure is most effective when integrated with organizational leadership support and interdisciplinary participation. Hospitals aiming to strengthen both patient safety and staff well-being should invest in accessible, well-resourced ethics support systems that actively involve nursing professionals in ethical deliberations and policy development.
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