Calculus formation: nurses' decision-making in abortion-related care

Area of Science:

• Nursing Ethics
• Clinical Decision-Making
• Reproductive Healthcare

Background:

• Nurses frequently encounter ethically challenging situations in patient care.
• Understanding nurses' decision-making processes in ethically complex contexts is crucial.
• Abortion care presents a unique ethical landscape for healthcare professionals.

Purpose of the Study:

• To explore the decision-making continuum of nurses regarding abortion care.
• To describe how nurses approach ethically challenging work in abortion contexts.
• To elucidate the cognitive, emotional, and behavioral factors influencing nurses' participation in abortion care.

Main Methods:

• Qualitative descriptive study utilizing thematic analysis.
• Interviews conducted with a purposive sample of 25 nurses.
• Participants represented diverse clinical settings including abortion clinics, EDs, ICUs, L&D, ORs, and PACUs.

Main Results:

• Nurses employed multifaceted, real-time decision-making processes ('calculi') for abortion care.
• Decision-making involved navigating between personal and professional roles, often holding simultaneous, contradictory positions.
• External opinions and the specific nurse-patient relationship dynamics significantly influenced care decisions, especially in elective abortion.

Conclusions:

• Findings advance the science of ethically challenging decision-making in nursing.
• The study expands understanding of factors shaping nurses' engagement with ethically challenging work.
• Nurse-patient relationship parameters are complex and context-specific in ethically challenging care scenarios.