Etični konflikti med medicinskimi sestrami v intenzivni enoti

Avtorji

  • Katja Naraločnik Univerzitetni klinični center Ljubljana, Urgentni kirurški blok, Zaloška cesta 7, 1000 Ljubljana, Slovenija
  • Barbara Donik Univerza v Mariboru, Fakulteta za zdravstvene vede, Žitna ulica 15, 2000 Maribor, Slovenija
  • Sergej Kmetec Univerza v Mariboru, Fakulteta za zdravstvene vede, Žitna ulica 15, 2000 Maribor, Slovenija https://orcid.org/0000-0002-5601-0940
  • Zvonka Fekonja Univerza v Mariboru, Fakulteta za zdravstvene vede, Žitna ulica 15, 2000 Maribor, Slovenija https://orcid.org/0000-0002-4224-8843

DOI:

https://doi.org/10.14528/snr.2020.54.4.3021

Ključne besede:

delovne obremenitve, moralni distres, nezadovoljstvo, izgorelost, moralna stiska

Povzetek

Uvod: Etični konflikt predstavlja resen poklicni problem. Medicinske sestre so na svojem delovnem mestu čedalje bolj obremenjene, še posebej v intenzivnih enotah, kjer je delo z življenjsko ogroženimi pacienti posebej težavno in je pojavnost etičnih konfliktov toliko večja. Namen je bil ugotoviti stopnjo izpostavljenosti etičnim konfliktom med medicinskimi sestrami v intenzivni enoti.
Metode: Izvedena je bila kvantitativna presečna opazovalna raziskava. Vanjo je bilo vključenih 97 medicinskih sester, zaposlenih v intenzivnih enotah ene bolnišnice. Podatki so bili zbrani s pomočjo vprašalnika in statistično obdelani z uporabo univariatne statistike.
Rezultati: Raziskava je pokazala, da so medicinske sestre v intenzivnih enotah zmerno izpostavljene etičnim konfliktom (x = 138,85, s = 89,08). Najpogosteje doživljajo etični konflikt ob situacijah, ko primanjkuje virov,ki zdravstvenemu timu omogočajo upoštevanje etičnih smernic za delovanje (x = 14,11, s = 9,13). Najmanj so izpostavljene etičnim konfliktom, ko je treba v okviru kliničnega preizkušanja dajati zdravila in pri tem ne prejmejo vseh potrebnih informacij, ki so po njihovem mnenju potrebne za izvajanje te naloge (x = 2,25, s = 3,70).
Diskusija in zaključek: Pri pojavnosti stopnje etičnega konflikta pri medicinskih sestrah je bilo ugotovljeno, da se srečujejo s konflikti, ki so rahlo problematični in precej problematični. Največji etični konflikt se pojavi pri pomanjkanju časa za upoštevanje etičnih smernic za delovanje, kar kaže, da je medicinskih sester premalo za kakovostno oskrbo pacientov.

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Literatura

Azoulay, É., Timsit, J.-F., Sprung, C.L., Soares, M., Rusinová, K., Lafabrie, A., et al., 2009. Prevalence and factors of intensive care unit conflicts. American Journal of Respiratory and Critical Care Medicine, 180(9), pp. 853–860.

Bond, L., Kearns, A., Mason, P., Tannahill, C., Egan, M. & Whitely, E., 2012. Exploring the relationships between housing, neighbourhoods and mental wellbeing for residents of deprived areas. BMC Public Health, 12(1), p. 48. https://doi.org/10.1186/1471-2458-12-48 PMid:22257729; PMCid:PMC3293078

Browning, A.M., 2013. CNE article: moral distress and psychological empowerment in critical care nurses caring for adults at end of life. American Journal of Critical Care, 22(2), pp. 143–151. https://doi.org/10.4037/ajcc2013437 PMid:23455864

Canzona, M.R., Love, D., Barrett, R., Henley, J., Bridges, S., Koontz, A., et al., 2018. "Operating in the dark": nurses' attempts to help patients and families manage the transition from oncology to comfort care. Journal of Clinical Nursing, 27, pp. 4158–4167. https://doi.org/10.1111/jocn.14603 PMid: 29968315

Corley, M.C., Minick, P., Elswick, R.K., & Jacobs, M., 2005. Nurse moral distress and ethical work environment. Nursing Ethics, 12(4), pp. 381–390. https://doi.org/10.1191/0969733005ne809oa PMid:16045246

de Veer, A.J., Francke, A.L., Struijs, A., & Willems, D.L., 2013. Determinants of moral distress in daily nursing practice: a cross sectional correlational questionnaire survey. International Journal of Nursing Studies, 50(1), pp. 100–108. https://doi.org/10.1016/j.ijnurstu.2012.08.017 PMid:22989404

Dyo, M., Kalowes, P. & Devries, J. 2016. Moral distress and intention to leave: a comparison of adult and paediatric nurses by hospital setting. Intensive & Critical Care Nursing, 36, pp. 42–48. https://doi.org/10.1016/j.iccn.2016.04.003 PMid:27209561

Ebrahimi, H., Kazemi, A., Asghari Jafarabadi, M., & Azarm, A., 2013. Moral distress in nurses working in educational hospitals of Northwest Medical Universities of Iran. Iranian Journal of Medical Ethics and History of Medicine, 6(4), pp. 80–88.

Edwards, M., Throndson, K. & Girardin, J., 2012. Survey of Canadian critical care nurses' experiences of conflict in intensive care units. Dynamics, 23(3), pp. 15–19.

Epstein, E.G. & Hamric, A.B., 2009. Moral distress, moral residue, and the crescendo effect. Jounal of Clinical Ethics, 20(4), pp. 330–342.

Falcó-Pegueroles, A., Lluch-Canut, T. & Guàrdia-Olmos, J., 2013. Development process and initial validation of the Ethical Conflict in Nursing Questionnaire-Critical Care Version. BMC Medical Ethics, 14(1), p. 22. https://doi.org/10.1186/1472-6939-14-22 PMid:23725477; PMCid:PMC3711987

Falcó-Pegueroles, A., Lluch-Canut, M.T., Martínez-Estalella, G., Zabalegui-Yarnoz, A., Delgado-Hito, P., Via-Clavero, G., et al., 2016. Levels of exposure to ethical conflict in the ICU: correlation between sociodemographic variables and the clinical environment. Intensive & Critical Care Nursing, 33(2), pp. 12–20. https://doi.org/10.1016/j.iccn.2015.10.004 PMid:26796289

Falco-Pegueroles, A., Lluch-Canut, T., Roldan-Merino, J., Goberna-Tricas, J., & Guardia-Olmos, J., 2015. Ethical conflict in critical care nursing: correlation between exposure and types. Nursing Ethics, 22(5), pp. 594–607. https://doi.org/10.1177/0969733014549883 PMid:25335920

Gaudine, A. & Thorne, L., 2012. Nurses' ethical conflict with hospitals: a longitudinal study of outcomes. Nursing Ethics, 19(6), pp. 727–737. https://doi.org/10.1177/0969733011421626 PMid:22619238

Gutierrez, K.M., 2005. Critical care nurses' perceptions of and responses to moral distress. Dimensions of Critical Care Nursing, 24(5), pp. 229–241. https://doi.org/10.1097/00003465-200509000-00011 PMid:16258357

Hamric, A.B. & Blackhall, L.J., 2007. Nurse-physician perspectives on the care of dying patients in intensive care units: collaboration, moral distress, and ethical climate. Critical Care Medicine, 35(2), pp. 422–429. https://doi.org/10.1097/01.CCM.0000254722.50608.2D PMid:17205001

Kälvemark, S., Höglund, A.T., Hansson, M.G., Westerholm, P., & Arnetz, B., 2004. Living with conflicts-ethical dilemmas and moral distress in the health care system. Social Science & Medicine, 58(6), pp. 1075–1084. https://doi.org/10.1016/S0277-9536(03)00279-X

Kodeks etike v zdravstveni negi in oskrbi Slovenije in Kodeks etike za babice Slovenije, 2014. Ljubljana: Zbornica zdravstvene in babiške nege Slovenije – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije.

Laurs, L., Blaževičienė, A., Capezuti, E. & Milonas, D., 2020. Moral distress and intention to leave the profession: Lithuanian nurses in municipal hospitals. Journal of Nursing Scholarship, 52(2), pp. 201–209. https://doi.org/10.1111/jnu.12536 PMid:31837105

Pishgooie, A.H., Barkhordari-Sharifabad, M., Atashzadeh- Shoorideh, F., & Falcó-Pegueroles, A., 2018. Ethical conflict among nurses working in the intensive care units. Nursing Ethics, 26(7/8), pp. 2225–2238. https://doi.org/10.1177/0969733018796686 PMid:30336767

Polit, D.F. & Beck, C.T., 2017. Essentials of nursing research: appraising evidence for nursing practice. Philadelphia: Wolters Kluwer / Lippincott Williams & Wilkins.

Raines, M.L., 2000. Ethical decision making in nurses. Relationships among moral reasoning, coping style, and ethics stress. JONA’S Healthcare Law, Ethics and Regulation, 2(1), pp. 29–41. https://doi.org/10.1097/00128488-200002010-00006

Saberi, Z., Shahriari, M. & Yazdannik, A.R., 2019. The relationship between ethical conflict and nurses' personal and organisational characteristics. Nursing Ethics, 26(7/8), pp. 2427–2437. https://doi.org/10.1177/0969733018791350 PMid:30134760

Schwenzer, K.J. & Wang, L., 2006. Assessing moral distress in respiratory care practitioners. Critical Care Medicine, 34(12), pp. 2967–2973. https://doi.org/10.1097/01.CCM.0000248879.19054.73 PMid:17075370

Tavakol, N. & Molazem, Z., 2015. Exploring moral distress in the intensive care unit nurses of Shiraz Heart Center in 2013. Journal of Education & Ethic in Nursing, 4(2), pp. 49–56.

Vahedian-Azimi, A., Hajiesmaeili, M., Kangasniemi, M., Fornés-Vives, J., Hunsucker, R.L., Rahimibashar, F., et al., 2019. Effects of stress on critical care nurses: a national cross sectional study. Journal of Intensive Care Medicine, 34(4), pp. 311–322. https://doi.org/10.1177/0885066617696853 PMid:29277137

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Objavljeno

2020-12-14

Kako citirati

Naraločnik, K., Donik, B., Kmetec, S., & Fekonja, Z. (2020). Etični konflikti med medicinskimi sestrami v intenzivni enoti. Obzornik Zdravstvene Nege, 54(4), 289–296. https://doi.org/10.14528/snr.2020.54.4.3021

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