Application of Nursing Ethical Principles in Clinical Practice: Evidence from Undergraduate Nurses in Rivers State University

Abstract

Background: Ethical principles form the cornerstone of professional nursing practice, guiding nurses in upholding patient autonomy, beneficence, non-maleficence, justice, veracity, fidelity, and confidentiality during clinical interactions. Undergraduate nursing students often encounter ethical challenges in clinical postings, yet limited evidence exists on how they apply these principles in resource-constrained settings like Nigeria.

Objective: This study assessed the application of nursing ethical principles in clinical practice among undergraduate nursing students at Rivers State University, Nigeria.

Methods: A descriptive cross-sectional design was employed. The population comprised 410 undergraduate nursing students (Years 2–4) in the Department of Nursing Science. Using the Taro Yamane formula, a sample size of 202 was determined, with convenience sampling. Data were collected via a researcher-designed electronic questionnaire (Cronbach’s α = 0.68) over seven days. Analysis utilized SPSS version 27 with descriptive statistics (frequencies, percentages, means, and standard deviations).

Results: Of 202 distributed questionnaires, 191 (95.6%) were returned. Respondents were predominantly female (67.5%) and under 20 years old (49.2%). The grand mean score for application of ethical principles was 3.35 (SD = 0.75) on a 4-point Likert scale, indicating strong self-reported adherence. Highest scores were for truth-telling (x̄ = 3.42, SD = 0.67), respect for patient rights (x̄ = 3.40, SD = 0.75), and enhancement of care quality (x̄ = 3.40, SD = 0.75). Lower (though positive) scores appeared for autonomy-related items, such as no involuntary admission (x̄ = 3.27, SD = 0.88) and no restraint against will (x̄ = 3.28, SD = 0.80).

Conclusion: Undergraduate nursing students at Rivers State University demonstrate high perceived application of ethical principles in clinical practice, reflecting effective ethics education aligned with Nursing and Midwifery Council of Nigeria standards. However, subtle variations in autonomy items suggest potential contextual barriers or emerging moral distress. Findings support curriculum enhancements, including simulation-based ethical training and moral resilience strategies, to better prepare students for real-world dilemmas and promote sustained ethical competence