Perceived Adherence to Code of Ethics and Associated Factors Among Nurses Working at Governmental and Private Hospitals of Dessie City Administration, 2024: A Comparative Study

In the high-stakes environment of a hospital, where lives hang in the balance and decisions must be made in seconds, nurses rely on more than just medical training. They depend on a professional code of ethics, a set of agreed-upon rules that define what is right and wrong in their daily work. Think of this code not as a rigid rulebook, but as a moral compass that guides how they treat patients, protect their dignity, and handle difficult situations. This framework is essential because it ensures that care remains human and respectful, even when the technology and procedures are complex. However, knowing these rules is different from following them. In many parts of the world, including Ethiopia, there is a growing concern about whether healthcare workers are actually putting these ethical principles into practice, and what factors might help or hinder them.

Researchers in the city of Dessie, Ethiopia, set out to investigate this very question. They wanted to see if nurses working in government-run hospitals followed these ethical guidelines differently than those working in private facilities. To find the answer, they spoke with 253 nurses over the course of a month in 2024. The team used a straightforward approach, asking the nurses to fill out anonymous surveys about their knowledge of the code, their attitudes toward it, their job satisfaction, and their daily work experiences. They then compared the responses from the two groups to see who was adhering better to the ethical standards and why.

The results revealed a mixed picture. Overall, less than half of the nurses surveyed demonstrated a strong adherence to the code of ethics. When the researchers broke the numbers down by hospital type, a clear difference emerged. Nurses working in private hospitals were more likely to follow the ethical guidelines, with nearly 61 percent showing good adherence. In contrast, only about 43 percent of nurses in government hospitals met the same standard. This gap suggests that the environment in which a nurse works plays a significant role in how they apply their professional values.

The study dug deeper to understand what specific factors were driving these behaviors. It turned out that several key elements made a nurse much more likely to follow the code. For instance, nurses who felt satisfied with their jobs were significantly more likely to act ethically. Similarly, those who received supportive supervision from their leaders—meaning they felt guided and backed by management rather than just monitored—were far more likely to stick to the rules. The researchers also found that having a solid understanding of the ethical code itself was crucial; nurses who knew the material well were much more likely to practice it. Interestingly, working in an emergency unit was also linked to better adherence, perhaps because the high-pressure nature of that environment forces a clearer focus on core principles.

Conversely, the study identified factors that seemed to pull nurses away from ethical practice. Those who had ever consumed alcohol were less likely to adhere to the code, and nurses who lacked supportive supervision or felt unhappy with their jobs were also less likely to follow the guidelines. The data also showed that nurses who graduated from government academic institutions were more likely to follow the code than those from private institutions, a finding that adds another layer to the complex relationship between education and professional behavior.

Ultimately, the study paints a clear portrait of the challenges facing nurses in Dessie. While the majority of nurses are trying to do the right thing, the system often fails to support them fully. The findings suggest that improving ethical practice is not just about teaching nurses more rules, but about creating a workplace where they feel supported, satisfied, and well-equipped with knowledge. For the private hospitals that showed better results, the secret may lie in their ability to attract and retain staff who are ethically aligned, or in their management styles that foster a culture of care. For the government sector, the path forward involves addressing the gaps in supervision and job satisfaction that are currently undermining the very standards these professionals are sworn to uphold.