Conflicts in nurse educators' role obligations.

Nurse educators face conflicting obligations to nursing students, patients, and agencies/institutions that require weighing and prioritizing values and choosing a course of action. Several hypotheses are explored about judgements commonly made in the pediatric clinical setting. These judgements are whether to permit a student to perform a procedure for the first time, make a potentially dangerous mistake, or provide patient care despite limited knowledge and skills. The hypotheses address the ranking of values of safety and student learning, the differences in value hierarchies of nurse educators and practicing nurses, and the use of patients as a means to an end--the education of nursing students. Although patients can be viewed as experiencing some actual or potential loss because students are learning while providing care, a concern is whether the patient "suffers greatly" or is "deprived of essentials." Case analyses suggest that for nurse educators: client safety appears to be the primary value, student learning takes precedence over the fullest achievement of most nursing practice values, the values hierarchy differs somewhat from that of the practicing nurse, and important nursing practice values may appear to be compromised to secure appropriate learning experiences for the student.