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Nurses' responses to ethical challenges in oncology practice: an ethnographic study
Carol Pavlish1, Katherine Brown-Saltzman, Patricia Jakel
1School of Nursing, University of California, Los Angeles, USA. cpavlish@sonnet.ucla.edu
Clinical Journal of Oncology Nursing
|November 27, 2012
Summary
Oncology nurses face complex ethical dilemmas, struggling with patient suffering, competing obligations, and communication challenges. Improving ethical practice requires supportive work environments and enhanced ethics skills for nurses.
Area of Science:
- Nursing
- Bioethics
- Qualitative Research
Background:
- Oncology nurses frequently encounter complex ethical challenges in their clinical practice.
- Understanding these challenges is crucial for improving patient care and nursing support.
Purpose of the Study:
- To explore oncology nurses' descriptions of ethical situations.
- To identify factors influencing ethically difficult situations from the perspective of nurses and key informants.
Main Methods:
- Ethnographic study involving 30 oncology nurses and 12 key informants.
- Data collection through descriptions of ethical situations and informant perspectives.
Main Results:
- Nurses described goals of preventing suffering, ensuring honesty, and contributing to patient improvement.
- Key challenges included witnessing suffering, balancing obligations, managing hope/honesty, time constraints, and hierarchical risks.
- Observed nurse actions ranged from addressing concerns to remaining silent.
Conclusions:
- Ethical challenges in oncology nursing are multifaceted, influenced by contextual factors.
- A contextual model of moral action suggests a need for practice environment improvements alongside ethics skills development.
- Supportive environments fostering interprofessional collaboration and open dialogue are essential for oncology nurses.
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