Indonesian Nurses’ Experiences with Ethical Problems and Challenges and the Need for an Ethical Supervision Model: A Qualitative Descriptive Study

Yanis Kartini; Yurike  Septianingrum; Imamatul Faizah

doi:10.60099/prijnr.2026.278612

Authors

Yanis Kartini Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Indonesia. https://orcid.org/0000-0001-7683-0834
Yurike Septianingrum Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Indonesia. https://orcid.org/0000-0002-7206-6389
Imamatul Faizah Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Indonesia. https://orcid.org/0000-0001-7568-4572

DOI:

https://doi.org/10.60099/prijnr.2026.278612

Keywords:

Decision making, Ethical challenges, Ethical problems, Ethical Supervision Model, Nurses

Abstract

Nurses frequently encounter ethical problems and challenges in clinical practice, highlighting the need for an ethical supervision model. This study explored nurses' experiences with ethical problems and challenges, and identified requirements for developing an ethical supervision model suitable for clinical practice. A qualitative descriptive design was used, with focus group discussions involving 28 nursing managers, ward heads, and staff nurses at a private hospital in Surabaya, Indonesia, conducted between June and August 2025. Participants with at least one year of work experience participated in six focus group sessions. The discussions were transcribed and analyzed thematically using NVivo 11 software. The analysis revealed three themes: (1) emotional and practical ethical challenges in daily nursing practice; (2) ethical supervision as a catalyst for caring and professional integrity; and (3) expectations regarding ethical supervision. Findings emphasize that ethical supervision is vital for promoting professionalism and patient-centered care. A structured model, such as the Proctor framework with the 4S approach (Structure, Skills, Support, Sustainability), is recommended to ensure consistent implementation and long-term sustainability.

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