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Perceptions of ethical practices in Hong Kong public hospitals: inter- and intra-professional similarities and differences.

AIM
To investigate similarities and differences in the perception of hospital ethical practices using different seniority of doctors, nurses and administrators, and between these healthcare professionals (HCPs).


IMPORTANCE
Intra- and inter-professional similarities and differences had implications for HCPs' morale, hospital ethics climate and quality of patient care.


METHOD
HCPs (n = 1.910) with different levels of seniority in 14 Hong Kong public hospitals were randomly surveyed between November 2004 and April 2005.


RESULTS
Intra-professional differences in perception between senior and junior doctors or nurses were found in nine ethical themes including: quality of care, patient satisfaction, disagreements among HCPs and between HCPs and patient family, end-of-life care, professional incompetence and misconducts and communication. Inter-professional similarities in perception were also found among different HCPs in senior positions and as a group they differ from the perceptions of junior HCPs.


CONCLUSIONS
Significant intra-professional and inter-professional polarizations of perception of ethical practices between senior and junior HCPs were found and they potentially undermine the trusting relationships between HCPs.


IMPLICATIONS
As nursing managers were found to align with senior doctors and administrators, junior nurses might feel unsupported, isolated and frustrated, creating a nursing management challenge that must be faced.