Long-term care nurses' moral convictions

Area of Science:

• Nursing Ethics
• Bioethics
• Qualitative Research

Background:

• Moral certainty and uncertainty significantly influence nurses' ethical decisions.
• Nurses in long-term care frequently encounter ethical challenges related to artificial nutrition and hydration.
• Understanding nurses' convictions is crucial for ethical practice.

Purpose of the Study:

• To explore and describe the convictions of long-term care nurses regarding withholding or withdrawing artificial nutrition and hydration from elders.
• To identify categories of moral conviction and uncertainty experienced by nurses.

Main Methods:

• Qualitative study utilizing Colaizzi's (1978) methodology.
• Interviews with a convenience sample of 25 BSN and MSN-prepared long-term care nurses.
• Analysis of nurses' experiences and convictions on artificial nutrition and hydration.

Main Results:

• Five categories of conviction emerged: absolute, strong, moderate moral conviction, moral uncertainty with conviction, and moral uncertainty.
• 84% of nurses believed artificial nutrition and hydration (tube feeding) were not always in the resident's best interest.
• 16% of nurses were uncertain but prioritized preventing resident suffering.

Conclusions:

• A pattern suggests that greater nurse experience with nontreatment decisions correlates with agreement.
• Findings highlight the spectrum of moral conviction and uncertainty in end-of-life care decisions.
• Implications for nursing practice and education regarding ethical decision-making are discussed.