The research project received ethical approval from the Central Ethics Committee (Appendix VI). In addition, each of the five DHB‟s gave approval to recruit new graduates from within their organisations. The Massey University Code of Ethical Conduct for Research and Teaching involving Human Subjects (Massey University, 2006) guided the process. The code sets out eight major principles with which to base ethical conduct within a research study, and is discussed below:
Respect for persons: Respecting persons relates to respecting choices, recognising individual beliefs and allow people to withdraw from the research. This principle was addressed by nurses self presenting and making their own decision to be part of the research. Attesting to this was that the participants made the initial contact to the researcher and signed a written consent to participate. No judgments were made about the nurses‟ recounts of their ethical practice and they were aware by way of the consent form that they could refuse to answer any questions or withdraw from the study up until the data had been analysed. Inherent to the intent of the study participants were respected as co collaborators in the research.
Minimisation of harm: Every effort was made to prevent harm to the participants, including their physical and emotional wellbeing.
65 Although registered nurses are not a particularly vulnerable population, it was likely that they would be discussing potentially difficult and possibly distressing ethical events. The participants were aware that the tape recorder could be turned off at any point during the interview and restarted when they felt ready. Each of the DHB‟s had an Employee Assistance Programme that would have allowed participants access to supportive counselling if they had required it and this was pointed out on the information sheet. The nurses were also able to refuse to answer any particular question should they choose to, however this did not occur.
There was the possibility of unsafe or illegal practice being disclosed in the interviews and this was managed by the statement in the consent form that such disclosures would need to be referred to the team leader or manager where the nurse worked. No unsafe or illegal practice that required intervention was disclosed by the participants.
Informed and voluntary consent: All of the nurses self presented in response to the recruitment posters and the information sheet which were displayed in visible areas of the mental health services or distributed by the organisations clinical educators and nurse specialists. The nurses then contacted me, usually by email and gave an indication that they were willing to be part of the study. The information sheet, consent form, and a copy of the interview questions were then made available to the nurses before they consented to be in the study. This allowed them to make an informed decision about their participation. A mutually agreeable interview time and venue was then established and any further questions answered.
66 Written consent was then sought and this was further confirmed at the commencement of each interview on the audio tape. Interviews were transcribed verbatim and checked by each nurse to ensure their own authentic story was told in a truthful and accurate way.
Respect for privacy: The location for chosen for each interview was quiet and private, with no interviews taking place on DHB property or in work time. All participants choose a pseudonym, known only to them and myself, to ensure confidentiality and anonymity. All information gathered was kept in the strictest confidence and safely stored. The transcribers, my supervisors and I were the only people who had access to the tapes and transcriptions and, and the transcriber signed a confidentiality agreement (Appendix, VII). Tapes, consent forms, transcriptions and field notes are stored in a secured manner and will be held for five years (2013), for audit purposes and then destroyed.
Avoidance of unnecessary deception: The study was in no way covert or deceiving. All aspects of the research were made transparent by way of information given to participants and the Central Ethics Committee, with copies of all relevant material kept for audit proposes. All communication with the participants was honest and truthful and obliged the informants with any information they required.
Avoidance of conflict of interest: There was no direct power inequity within the relationship between the nurses and myself. Although I had been in a lecturer – student relationship with four of the nurses, this was historic.
67 When I returned to clinical practice I had no managerial or supervisory relationship with any potential or actual participants as approved by the amendment from the Central Ethics Committee. My own thoughts and feelings prior to commencing the study were explicated in written form as memos. This allowed me to consciously examine any preconceptions or bias that I held that may have affected the data collection and analysis.
Social and cultural sensitivity: Sensitivity and respect was afforded to each nurse who participated. The study was not specifically a Māori piece of research although has relevance as Māori are over represented users of the mental health services and rely on nurses being able to act ethically for them. Māori nurses were free to participate and the manager of the local IWI health authority was consulted with in relation to any Māori Tikanga needs that arose, however this did not occur. Ethnicity of the nurses is not disclosed in the work so as to ensure anonymity and confidentiality.
The overriding principles of Te Tiriti o Waitangi were applied to the study. The researcher participant relationship was based upon a partnership, whereby the contributions of both were equally valued. Participation was available for all nurses who meet the inclusion criteria and they were given sufficient information about the study with which to decide if they wanted to participate. The graduates had their privacy, rights and their own beliefs protected throughout the process.
Justice: This principle considered justice as fairness and equal access, and was addressed by allowing whoever wanted to participate in the study, to do so.
68 By utilising five DHBs the sample group was reasonably varied and not just chosen for convenience, thus giving fair representation of graduate nurses. Consistency and fairness was maintained as all participants were given the same information about the study and asked the same questions from the semi structured interview list. The study was held to be ethically sound by being approved by the Central Ethics Committee.