1. Introduction of Dilemma and professionalism of nursing hospital nurses
The professionalism of nursing hospital nurses in The need for research The rapid increase in the elderly population caused health problems such as the increase in senile and chronic diseases, and long-term care facilities for the elderly with severe disabilities have been activated since the long-term care insurance was implemented in July 2008. According to the “Status of Nursing Hospital Institutions in the Third Quarter of 2017” released by the Health Insurance Review and Assessment Service, the number of nursing hospitals nationwide stood at 1,519 and the number of 361 in December 2006 increased nearly five-fold in 10 years . The number of nurses working at nursing homes has nearly increased eightfold from 3,186 in 2006 to 24,299 in 2017.
Unlike ordinary acute patients, many elderly people are preparing for the end of their lives and tend to be alienated from their families, so nurses who take care of them face various ethical problems. An ethical dilemma refers to a dilemma that arises in situations in which nurses have to choose between two or more difficult ethical issues that seem to be unsatisfactory in the clinical field or equal but unsatisfactory . Recent healthcare sites continue to have ethical dilemma problems, such as various values, increased patient sense of rights, and the inability of medical staff and patients to have the same close relationship as before when unexpected choices are needed in berea.
Ethical problems nurses face in clinical practice include problems caused by a lack of adequate nursing staff, conflicts caused by uncooperative relationships with medical staff, nursing knowledge, and lack of experience , studies have shown that nurses experience numerous ethical dilemmas without a clear solution to ethical dilemmas. [4-7] These ethical dilemmas do not have a firm answer to the problem, so nurses tend to avoid it or spill it out of indifference rather than boldly bumping into it , which leads to frustration, dissatisfaction, physical illness, etc.
. In particular, the environment of nursing hospitals often places nurses in situations where moral judgment is required, and they often face having to make decisions by distinguishing legal and ethical responsibilities. Therefore, in order to solve the ethical dilemma of nursing hospital nurses, they must first be able to clearly identify the ethical dilemma. Professionalism is the ability to solve problems with knowledge and skills gained through professional practice and experience  to call one’s work, to pursue common interests, to trust in self-control, to recognize one’s work as an expert with exclusive and exclusive authority, and to make autonomous decisions on its contents .
As a professional, nurses should exercise professionalism more than anything to effectively meet their health needs and provide high-quality nursing, and be in a position to encourage, help and support patients through the decision-making process [10-12]. Until now, studies on ethical dilemmas and professionalism have been conducted on nurses, but they have been conducted at the level of senior general hospitals and general hospitals, and there are no studies that confirm ethical dilemmas and professionalism at the same time. Nursing hospitals are mainly targeted at elderly patients in their lifecycles, so the nursing work, working environment, and organizational characteristics are different from those of higher general hospitals.
Ⅱ. Research methods
Research Design This study is a descriptive research study to understand the relationship between ethical dilemmas and professional occupational of nursing hospital nurses. 2. The research subjects and data collection methods This study is a nurse who has been working at 14 nursing hospitals in G Metropolitan City and J region from May 10 to June 19, 2017. The number of subjects studied was determined by the G*power 3.1 analysis program, and the number of subjects for correlation was significant α=.Based on 05, power (1-β) = 0.90, and effect size = 0.3, the number was at least 109. In this study, a total of 250 questionnaires were distributed in anticipation of the elimination, and a total of 210 copies were used for analysis, except for 32 copies that were not recovered and 8 copies that were inappropriate to utilize the data in Nursing hospitals expenses.
- Research Tools
1) Ethical dilemmas In this study, we used tools developed by Han . The tool consists of 34 questions, including respect for life and respect for human rights (7 questions), subjects (6 questions), professional work (13 questions), and nurse and cooperator (7 questions), each with a Likert 4-point scale of “nothing” and a higher score of “very severe” means higher ethical dilemma. At the time of Han ’s development, the reliability of the tool was Cronbach’s α= .97 and Cronbach’s α= .95 in this study.
2) Professional Vocationality In this study, based on Hall’s tools, Choo used tools modified to suit nurses’ professionalism. The tool consists of 28 questions, including autonomy (6 questions), belief in self-control (4 questions), public service (6 questions), quasi-giity (6 questions), and calling ceremony (6 questions) on the Likert 5-point scale, and the higher the score, the higher the professionalism of the subject. In Hall’s study, the reliability of the tool was Cronbach’s α= .86; in Choo’s study, the reliability of the tool was Cronbach’s α= .91, and in this study, Cronbach’s α= .92. 4. Data analysis method The collected data were statistically processed using the SPSS/WIN 24.0 program according to the purpose of the study. Technical statistics of frequency, percentage, mean, and standard deviation were used to identify the general characteristics, ethical dilemmas, and professionalism of the subjects, and analyzed with t-test and ANOVA to verify differences in ethical dilemmas and professionalism according to general characteristics. The correlation between ethical dilemmas and professional performance is analyzed by Pearson’s Correlation Coefficients. 5. Ethical considerations this study explained to subjects the purpose of the study, the possibility of rejection of the survey, the protection of privacy, and the time required for the survey before collecting data for their rights and ethical protection. If the purpose of the study and the method of participation were understood and voluntarily agreed to participate, the consent form for participation in the study was prepared and a survey was conducted.