الفهرس 
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Abstract
Today’s nursing student is a nurse of tomorrow so it is very important to ensure the awareness of nurse student about the patients’ rights and how to practice them through fostering and developing ethically competent nurses through their curriculum because patients have become increasingly concerned and vocal about the level of care they expect to receive, and they became extremely knowledgeable about their own medical healthcare needs and what could be expected in healthcare, so it is important for nurses to be aware of the patients’ rights.
Patient’s rights are considered nurses’ duties. Nurses are the defenders of patients’ rights within the healthcare system. They must inform the patients about their rights, advocate about these rights and participate in carrying out all duties related to these rights.
Patients’ Bill of Rights was created to help patients feel more confident, stress the importance of a strong relationship between patients and their healthcare providers, and stress the key role patients play in staying healthy by declaring rights and responsibilities for all patients and healthcare providers.
Hence, it is important to prepare student nurses during internship year to carry out their role and to be more aware about patient’s rights. Successful internship programs should be those in which teaching and learning are provided to help the new graduate nurse make the transition from novice to advanced beginner who can demonstrate acceptable performance, cope with real situations and deal with patients without any conflict.
The present study aimed to assess nurse interns’ ethical awareness in relation to patients’ rights at the Faculty of Nursing, Damanhour University. The study followed a descriptive research design. It was conducted at the Faculty of Veterinarian Medicine, Damanhour University.
The study subjects comprised all nurse interns in the internship training program of the academic year 2016-2017, except those who were part of the pilot study (N = 294).
The present study used one assessment sheet for data collection, namely;
”Ethical Awareness of Nurse Interns in Relation to Patients’Rights”.
This tool was developed by Esmaeil (2010) in her investigation concerning ’Nurses’ Efficiency in Performing Patient’s Rights Duties’ based on the patients’ rights as described by The American Hospital Association (2002). It was then modified by the researcher to fulfill the present study’s aim. This tool included three parts; Part I: Personal and academic data of nurse interns, such as; age, gender and residence. Part II: It included a list of statements concerning the patients’ rights. It comprised 89 statements, and after modification they became 77 statements measured on a 4 point likert scale. Part III: One open ended question was used to investigate the nurse interns’ point of view regarding the importance of studying ethics in nursing curriculum.
This tool was tested for its content validity by a jury of five experts in the field of the study and the necessary modifications were done accordingly. It was also tested for its reliability using Cronbach’s alpha test and was found reliable with a value = 0.972.
A pilot study was carried out on 10 % of the sample (33 nurse interns) to assess the clarity and applicability of the study tool .Those participants were excluded from the actual study. The pilot study proved that the study tool was clear and feasible
Data collection was carried out during the internship orientation training program of the academic year 2016-2017 at Faculty of Veterinarian Medicine, from Tuesday 8/8/2017 to Thursday 10/8/2017; data was collected within two hours per day. Assessment sheets were distributed to the nurse interns who agreed to participate in the study, after consents of the participating subjects were obtained and confidentiality assured.
The following are the main results of the current study:
More than half of the nurse interns (57.1%) were less than 23 years old, and nearly half of them (42.9%) were above 23 years old.
The majority of the nurse interns (82.3%) were females, while the male nurse interns represented only 17.7% of the total sample.
Nearly three quarters of the nurse interns (71.1%) lived in rural areas, while only 28.9% of them lived in urban areas.
About two-thirds of the nurse interns (66.3%) were working in a private sector and about half of those who worked before (50.8%) worked for a duration ranging from 1 year to less than 5 years.
Three quarters of the nurse interns (75.2%) found that there were differences in respecting patients’ rights at private hospitals than governmental hospitals.
Less than half of nurse interns who found differences between private and general hospitals (44.3%) reported that in private hospitals there is respect for the patient’s rights, dignity, humanity and privacy.
Nearly three quarters of nurse interns (72.8%) strongly agreed on the right of calling the patient with his name with a calm voice and dealing with him kindly and gently, while a minority (0.7%) of them strongly disagreed on the previously mentioned rights.
3.7% of the nurse interns disagreed on the right of dealing with all patients equally regardless their religion, gender or position.
More than two-thirds of the nurse interns (68.7%) strongly agreed that the patient room should be properly ventilated; free from any bad odors and more than one third of them (36.7%) agreed that the patient room should be adequately lighted. Only a minority of them (0.7%) strongly disagreed that the patient room should be adequately lighted.
Nearly two-thirds of the nurse interns (63.3%) strongly agreed on giving the patient a simple, but thorough explanation about his diagnosis and his nursing care plan, while only 0.7% of them strongly disagreed on this right.
A minority of the nurse interns with the same percentage (3.1%) disagreed on the right of giving the patient the opportunity to participate in choosing the type of treatment, if possible and on the right of informing the patient of the nursing and medical team members responsible for his care program.
Nearly two-thirds of the nurse interns (59.2%) strongly agreed on the right of explaining the aim of performing laboratory investigations to the patient.
Nearly two-thirds of the nurse interns (61.6%) strongly agreed on the right of explaining to the patient the available treatment modalities to help him participate in choosing among them, while a minority of them with the same percentage (1.4%) strongly disagreed on the right of determining the steps of treatment in the form of a plan to be implemented and the right of explaining to the patient the consequences of refusing or stopping certain treatments.
Only a minority of the nurse interns with the same percentage (1.0%) disagreed on the rights of taking complete data concerning patient’s and family’s health history upon his admission to hospital and implementing of the patient’s nursing care plan to the optimum level.
Around two- thirds of the nurse interns (68.4%) strongly agreed on the right of maintaining patients’ privacy when performing any nursing care that needs exposure of the patient.
Nearly two-thirds of the nurse interns (64.6%) strongly agreed on the right of giving the patient a report concerning his medical condition to be used for continuity of care in any other agency, while only 0.3% of them disagreed on this right.
Nearly two-thirds of the nurse interns strongly agreed on the right of prioritizing the patient’s needs and requests and the right of daily assessing the quality of healthcare services and providers from patient’s opinion and providing changes according to hospital’s policies and resources with the percentages 63.6% and 62.2% respectively.
Slightly less than two-thirds of the nurse interns strongly agreed on the right of informing the patient of the objectives of the research before his participation and the right of respecting the patient’s desire for anonymity in the research with the percentages 60.2% and 59.2% respectively. While a minority of them (0.7%) strongly disagreed on the right of explaining to the patient all the steps of the research and its positive and negative aspects.
Around two-thirds of the nurse interns (63.3%) strongly agreed on informing the patient of the follow up schedule after his discharge, while only a minority of them (0.7%) disagreed on this right.
An equal percentage of nurse interns (11.2%) reported that the professional ethics course made them aware of the importance of informed consent, and that the patients have the right for respect and effective communication with them and their families.
1.4% of the nurse interns had low ethical awareness, while 3.1% of them had moderate ethical awareness, and 95.6% of them had high ethical awareness toward patients’ rights.
Based on the research’s findings, the following was concluded:
The majority of the nurse interns have high awareness towards the twelve patients’ rights described by The American Hospital Association (2002) as previously mentioned.
More than half of the nurse interns reported that the professional ethics course added to their information that the patients have the right to be respected regardless their religion or socioeconomic status, they have the right of respecting their complaints, needs, decisions and opinions and they also have the right for respect and effective communication with them and their families. In addition, the professional ethics course made a minority of them aware of their duties and rights, and aware of the importance of informed consent.
Moreover, nurse interns take into consideration the feelings of patients and their fear from the nature of Damanhour University Hospital as it is an educational hospital and the fact that the patients do not have another place suitable for their socioeconomic status.
Finally, we can conclude that if nurse interns are not aware of this patients’ bill of rights, they will not be able to establish an effective and trustful relationship with the patients, which is the cornerstone of the success of the nursing profession.
Based on the current study’s findings, the following is recommended:
I. Concerning nursing students:
1. Provide the nurse interns with a booklet focusing on their rights and responsibilities, and incentives and punishments regarding application of patients’ rights.
2. Hold periodical training programs for nursing students about the importance of respecting patients’ rights for themselves and for the patients.
II. Concerning faculty of nursing:
1. Establish a planned collaboration between faculty of nursing, Damanhur University and hospital personnel to provide regular educational sessions about patients’ rights.
2. Recommend to the curriculum committee to put it in their plan to teach the professional ethics course in the first year and reinforce it in every nursing specialty.
III. Concerning patients:
1. Patients should be given booklets (containing written and pictured instructions) to know their rights and responsibilities and the rules and regulations of the hospital on their admission.
2. Develop a system for patients’ complaints.
IV. Concerning nurses and hospitals:
1. Periodical in-service training programs should be conducted for nurses stressing the importance of performing patients’ rights
2. Periodical follow up for the barriers facing nurses during their application of patients’ rights and measures to deal with them or prevent their occurrence.
3. Build a positive relationship to gain patients’ confidence.
V. Concerning further studies:
1. Develop standards regarding patients’ rights in Egypt.
2. Evaluation of nurse interns’ performance of patients’ rights.
3. Assessment for barriers facing healthcare team in application of patients’ rights.
4. Assessment for the patient’s satisfaction toward nurses’ application of patients’ rights.
5. Assessment for the patients’ awareness of their own rights.