Ethically difficult situations in hemodialysis care: nurses' narratives

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Ethically difficult situations in hemodialysis care : nurses' narratives

Fischer Grönlund, Catarina (author): Umeå universitet,Institutionen för omvårdnad

Söderberg, Anna (author): Umeå universitet,Institutionen för omvårdnad

Zingmark, Karin (author): County Council of BD, Sweden

Sandlund, Mikael (author): Umeå universitet,Psykiatri

Dahlqvist, Vera (author): Ersta Sköndal högskola,Institutionen för vårdvetenskap

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2014-08-07
2015
English.
In: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 22:6, s. 711-722

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.1...; https://urn.kb.se/re...; https://urn.kb.se/re...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

BACKGROUND: Providing nursing care for patients with end-stage renal disease entails dealing with existential issues which may sometimes lead not only to ethical problems but also conflicts within the team. A previous study shows that physicians felt irresolute, torn and unconfirmed when ethical dilemmas arose.RESEARCH QUESTION: This study, conducted in the same dialysis care unit, aimed to illuminate registered nurses' experiences of being in ethically difficult situations that give rise to a troubled conscience.RESEARCH DESIGN: This study has a phenomenological hermeneutic approach.PARTICIPANTS: Narrative interviews were carried out with 10 registered nurses working in dialysis care.ETHICAL CONSIDERATIONS: The study was approved by the Ethics Committee of the Faculty of Medicine, Umeå University.RESULTS: One theme, 'Calling for a deliberative dialogue', and six sub-themes emerged: 'Dealing with patients' ambiguity', 'Responding to patients' reluctance', 'Acting against patients' will', 'Acting against one's moral convictions', 'Lacking involvement with patients and relatives' and 'Being trapped in feelings of guilt'.DISCUSSION: In ethically difficult situations, the registered nurses tried, but failed, to open up a dialogue with the physicians about ethical concerns and their uncertainty. They felt alone, uncertain and sometimes had to act against their conscience.CONCLUSION: In ethical dilemmas, personal and professional integrity is at stake. Mistrusting their own moral integrity may turn professionals from moral actors into victims of circumstances. To counteract such a risk, professionals and patients need to continuously deliberate on their feelings, views and experiences, in an atmosphere of togetherness and trust.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Omvårdnad (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nursing (hsv//eng)

Keyword

Dialogue
dialysis care
ethics
narratives
nursing
troubled conscience

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ref (subject category)
art (subject category)

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By the author/editor: Fischer Grönlund ...; Söderberg, Anna; Zingmark, Karin; Sandlund, Mikael; Dahlqvist, Vera

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences; and Nursing

Articles in the publication: Nursing Ethics

By the university: Umeå University; Luleå University of Technology; Marie Cederschiöld högskola

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