The purposes of the proposed research are (1) to identify and develop an inventory of recurrent ethical dilemmas experienced by occupational health nurses, (2) to develop and administer an instrument to measure occupational health nurses' actions responsive to each dilemma, and (3) to determine if specific variables, i.e., type of employment, work experience, educational level, support systems, and previous familiarity with the ethical dilemmas are associated with nurse responses to dilemmas. The ultimate goal of this research is to identify nursing actions which are beneficial to workers in helping to resolve ethical dilemmas in occupational health. Three Phases of research are proposed: Phase I, the descriptive study, is designed to develop and provide an inventory of recurrent ethical dilemmas experienced by 150 practicing occupational health nurses through use of a four-round Delphi technique. In Phase II, twelve practicing occupational health nurses representing regions of the country will develop nursing actions responsive to each ethical dilemma. These actions will be evaluated, by nurse ethicists, as to their relative congruence with the Code of Ethics. The instrument which will contain the ethical dilemmas and nursing actions will be pilot tested on 30 OHNs representative of large and small industries and hospitals for internal consistency, stability, content and construct validity, and clarity. Subjects will be asked to specify actions as being both realistic and ideal. In Phase III, the instrument will be administered to 200 practicing OHNs to measure their responses to ethical dilemmas. Reliability and validity measures will be assessed. Descriptive analyses of nursing actions across dilemmas will be provided. Responses will be analyzed on variables identified in (3) above and actions as idealistic versus realistic behaviors. Data from this research will be used to examine and develop strategies to deal with ethical dilemmas and ethical decision- making in occupational settings.
