Ethical Dilemmas of Nurses Working in Emergency Departments at Tertiary Hospitals
Keywords:
ethical dilemmas, nurses, emergency department, tertiary hospitalsAbstract
Ethical dilemmas (EtD) arise for nurses when there is a conflict or disassociation between their clients’ exact care needs and goals of the treatment team. This descriptive research aimed to examine the effects and frequency of EtD among nurses in four defined situations: when their patients and / or relatives, 1) refuse treatment, 2) have non-urgent illnesses/injuries, but want to receive emergency services, 3) need urgent surgery but have financial problems with medical bills, and 4) receive a Do Not Resuscitate (DNR) order. Participants were 136 nurses who had been working in emergency departments in five hospitals in southern Thailand for more than one year and were purposively recruited. The data collection instrument was comprised of two parts; the Demographic Data Questionnaire and the Ethical Dilemmas Questionnaire. Their content validities were examined by three experts (content validity index = .90) and the Ethical Dilemmas Questionnaire’s reliability was tested using Cronbach’s alpha coefficient (α = .91). The data were analyzed by using descriptive statistics. The research results found that the EtD in the fourth situation had the highest mean score for effect on the nurses (M = 7.68, SD = 1.55). The EtD in the first and second situations were the most frequently encountered and were rated as sometimes (44.9% and 39.7%, respectively) and the third and fourth situations were rated as seldom (40.4% and 39.0%, respectively). In conclusion, a DNR situation was rated as having the greatest effects on the nurses, it was also rated as the least (seldom) encountered EtD situation. Additionally, the most frequently faced EtD was rated as sometimes. The results of this research can be used to organize training workshops for emergency department nurses to improve skills related to analyzing ethical dilemmas and their competencies in nursing ethics.
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