February 25, 2020

Honesty and Ethical Standards Among Nurses, Part 2: Study Design

Last week, I discussed some initial thoughts on the December 2018 Gallup poll of U.S. public opinion concerning the honesty and ethical standards of various occupations. One of the major takeaways from the results of that survey is the ongoing placement of nursing as the occupation thought to be most honest and ethical. My first reactions had much to do with the ways in which such polling results may be utilized in health care organizations. I also broached the subject of transcending ideals or standards, which I believe are prerequisite for honesty and ethical behavior. This week, I would like to discuss the meaning of the data as presented as well as dig a little deeper to learn a bit more about the meaning of the poll.

The announcement of the results on Gallup’s website displays the data grouped according to the categories “Very high/High,” “Average,” and “Low/Very low,” along with “No opinion.” The first and third categories actually represent something like “Above average” and “Below average.” As they are, the results are interesting, but because the raw data are available from Gallup with the individual categories left uncombined, it is worth the effort to examine the data for ourselves.

First, the study was carefully designed to account for national demographics, including such factors as gender, age, race, Hispanic ethnicity, education, region, population density, and phone status. Phone status refers to the available means of contact: by cell phone only, by landline only, or by either means. The researchers implemented criteria to avoid Spanish language bias as well. The random sample of 1,025 adults, ages 18+, living in the U.S. states and the District of Columbia, produced results with a margin of sampling error of ±4% at the 95% confidence level.

Looking at the raw rating counts, it appears the top three occupations that received a plurality of their ratings in the “High” category rather than “Average” are health care-related (nurses, medical doctors, and pharmacists). Two other occupations, police officers and high school teachers, also received their pluralities in the “High” category. Every other occupation received its plurality in the “Average” category, with the notable exceptions of members of Congress and telemarketers, which received their pluralities in the “Low” category. So, it seems we have heath care, first responders, and educators as the three most trusted areas of occupation. Those would seem intuitively obvious to many people in our society.

Visualizing the five rating categories on a continuum with a shape that approximates a Bell curve, a person could think of the location of the plurality as the peak of the curve with a tail extending to each side. In this way, one might think of any asymmetry in the curves about their peaks as a visual indicator of the general sense of public opinion related to the various occupations.

Nursing is the only occupation that received no “Very low” ratings and no responses of “No opinion.” In other words, “everyone” has an opinion of nurses, and the general consensus is that nurses are of above average honesty and ethical standards.

One might wonder whether or not the taking of an oath as an aspect of entry into an occupation would impact public opinion.  Examples of such professions include clergy, lawyers, medical doctors, members of Congress, nurses, pharmacists, and police officers. There is apparently no strong correlation, given the positions of these professions at the extreme ends of the rankings. In reality, just because a person utters an oath to practice a profession with honesty and ethical integrity does not mean that public perception will refrain from judging that person in those terms. Despite that, it is intriguing that four out of five occupations with ratings peaks in the “High” category are found in this list of oath-taking professions.

There are other subtleties of interpretation that could be gleaned from these survey results, but I hope these have piqued your interest. At one time, I had a strong desire to attend seminary, and I later found that many of the reasons for that desire were echoed in my reasons for entering the field of nursing. Next week, I would like to discuss what Gallup polls seems to suggest about our country’s opinions of healthcare and clergy. Please join me next week.

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