Narrative writing as a strategy for nursing ethics education in Japan

OBJECTIVES: The purpose of this study was to explore the effectiveness of learning ethics of nursing practice using narrative writing. METHODS: Study design was qualitative descriptive research. The participants were 90 graduate students who took nursing ethics classes, of whom 86 graduate students (4 males and 82 females) agreed to this study. The data gathered for analysis were their narratives described as feeling uncomfortable in clinical settings and their comment sheets after narrative group work in nursing ethics classes. We used qualitative content analysis to identify graduate students’ awareness gained through narrative writing and narrative group work. RESULTS: As a feature of the scenes described by graduate students, there were often conflicts that patients’ autonomy were not respected, or that they were not able to engage in sincere engagement. The narrative writing was effective to make graduate students aware of the following two aspects: 1) habits and trends in one’s own thoughts and 2) organizational and administrative issues related to ethical issues. CONCLUSIONS: Learning ethics of nursing practice using narrative writing that focused on nurses’ sentiments helped reveal nurses’ thoughts as well as their attitudes and approaches to patients. These findings suggest that narrative writing in nursing ethics education could lead to ethical practice. Additionally, our results indicate that narrative writing in research may be helpful as a strategy to clarify ethical issues and the awareness of nurses in clinical settings.