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Ethically difficult situations in hemodialysis care - Nurses' narratives
Catarina E C Fischer Grönlund1, Anna I S Söderberg2, Karin M Zingmark3
1Umeå University, Sweden Catarina.fischer.gronlund@umu.se.
Nursing Ethics
|August 10, 2014
Summary
Registered nurses in end-stage renal disease care experienced ethical dilemmas, often feeling alone and acting against their conscience due to a lack of dialogue with physicians. This highlights the need for open communication to protect professional integrity.
Area of Science:
- Nursing Ethics
- Renal Nursing
- Bioethics
Background:
- End-stage renal disease (ESRD) care involves complex existential issues, leading to ethical problems and team conflicts.
- Physicians in previous studies reported feeling irresolute and unconfirmed when facing ethical dilemmas.
Purpose of the Study:
- To explore registered nurses' experiences of ethically difficult situations causing a troubled conscience in dialysis care.
- To understand the lived experiences of nurses navigating moral distress in ESRD patient care.
Main Methods:
- Phenomenological hermeneutic approach.
- Narrative interviews with 10 registered nurses in dialysis care.
- Study approved by the Ethics Committee of the Faculty of Medicine, Umeå University.
Main Results:
- A central theme identified was 'Calling for a deliberative dialogue'.
- Sub-themes included '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'.
Conclusions:
- Nurses attempted but failed to engage physicians in dialogue about ethical concerns and uncertainty, leading to feelings of isolation and acting against their conscience.
- Ethical dilemmas jeopardize personal and professional integrity; continuous deliberation in a trusting atmosphere is crucial for professionals and patients.
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