Values in Motion: an Axiological Account of Interprofessional Coordination Across Nursing, Social Work, and Medical Supply Services in Saudi Hospitals

Abstract

This study examines how “ethics-in-action” is produced through routine coordination between nursing, social work, and medical supply functions in Saudi hospitals. Rather than treating ethics as limited to exceptional dilemmas, the study approaches everyday coordination as a site where values are continuously prioritized and negotiated under time pressure and resource constraints. Using a qualitative interpretive design, semi-structured interviews were conducted with nurses, hospital social workers, and medical supply personnel involved in cross-unit coordination. Data were analyzed using reflexive thematic analysis to construct meaning-centered themes that capture how participants interpret and enact value-laden decisions in daily work. Four themes were developed. First, routine scarcity (delays, stock-outs, substitutions) transformed prioritization into moral work, where legitimacy depended on consistent and explainable rationales. Second, boundary ambiguity around ownership and escalation generated ethically consequential friction across roles. Third, workarounds emerged as culturally normalized solutions that sustained care but accumulated ethical costs through reduced documentation and opacity. Fourth, transparency and professional voice shaped whether coordination produced trust and learning or defensive practice and repeated checking. The findings suggest that strengthening ethical coordination requires procedural supports that make prioritization logic explicit, clarify handoffs and escalation pathways, and normalize speaking up across professional boundaries. The study contributes an axiological account of hospital culture by showing how values are operationalized through ordinary coordination practices in Saudi healthcare settings.