Community nurses’ experiences of ethical dilemmas in palliative care: a Swedish study

Karlsson, Matts; Roxberg, Åsa; Silva, António Barbosa da; Berggren, Ingela

doi:10.12968/ijpn.2010.16.5.48143

Cited by 25 publications

(47 citation statements)

References 27 publications

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“…Nurses who provide end‐of‐life care in the patient's own home often felt ill at ease and powerless in their work when dealing with conflicts in the family .This is in line with Karlsson et al. , who found that community nurses experienced powerlessness, frustration and concern in relation to ethical dilemmas in end‐of‐life care in the patient's own home. The nurses felt powerless when they did everything possible, but the patient's relatives placed still higher demands on them that they were unable to fulfil.…”

Section: Introductionsupporting

confidence: 70%

Community nurses' experiences of ethical problems in end‐of‐life care in the patient's own home

Karlsson

Karlsson²,

Silva

et al. 2012

Scandinavian Caring Sciences

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The nurses exhibited commitment and a desire to do good when caring for patients in the end-of-life phase, even if they sometimes experienced feelings of lack of control. This implies that, when confronted with care-related issues, they have the power to both act and react. This study aimed to increase understanding of ethical problems that arise in end-of-life care in the patient's own home and revealed the need to take the patients', relatives' and nurses' perspectives on health and suffering into consideration to ensure good end-of-life home care.

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Section: Introductionsupporting

confidence: 70%

Community nurses' experiences of ethical problems in end‐of‐life care in the patient's own home

Karlsson

Karlsson²,

Silva

et al. 2012

Scandinavian Caring Sciences

Self Cite

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“…1,2,5,[8][9][10][11][12] Leuter and colleagues 11 found that most nurses experienced recurrent ethical problems and did not feel effectively supported by the health care system. These include futile or nonbeneficial care, pain management, patient autonomy (lack of decisional capacity, patient confidentiality or privacy), advance care planning (disregard of patients' wishes), communication difficulties, conflicts between patients/families and health providers, and conflicts between nurses and colleagues.…”

Section: Discussionmentioning

confidence: 99%

Ethical Issues Experienced by Hospice and Palliative Nurses

Cheon

Coyle

Wiegand

et al. 2015

Journal of Hospice & Palliative Nursing

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Nurses encounter ethical dilemmas in their clinical practice especially those associated with palliative and end-of-life care. The Hospice and Palliative Nurses Association (HPNA) members were asked to participate in an ethics survey. The survey aimed to identify ethical issues experienced by hospice and palliative nurses, identify resources available to them and barriers if any to their use, and to identify how HPNA can be of support to hospice and palliative nurses. One hundred twenty-nine (n = 129) HPNA members completed the online survey. The information from each of the surveys was carefully reviewed, and responses were collapsed into 6 themes. The ethical dilemmas included inadequate communication, provision of nonbeneficial care, patient autonomy usurped/threatened, issues with symptom management and the use of opioids, issues related to decision making, and issues related to discontinuing life-prolonging therapies. Approximately two-thirds of the nurses used resources in an attempt to resolve the ethical issues, including a formal ethics consultation, involvement of the palliative/hospice team, consulting with other professionals, and use of educational resources. One-third of the nurses said there were institutional or personal barriers that prevented the ethical dilemma from being resolved. Participants suggested ways that HPNA could help them to effectively manage ethical dilemmas.

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“…An earlier study confirms that the meeting with the dying patient forces the nurse to deal with existential questions about the meaning of life. [38] The interviewed nurses stressed the value of developing one's communication skills in relation to the patient and relatives. According to Karlsson and Sandén, [39] good palliative caring demands successful communication and a good relationship with the patient and relatives.…”

Section: Discussionmentioning

confidence: 99%

Nurses’ experience of caring for palliative-stage patients in a hospital setting in Sweden

Pennbrant

Tomaszewska

Penttilä

2015

Clinical Nursing Studies

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Objective: The aim of this study was to describe nurses' experiences of caring for palliative-stage patients in a hospital setting.Methods: A qualitative study based on six interviews with strategically selected nurses in an oncology department in western Sweden. The interviews were analyzed using a phenomenological-hermeneutic approach.Results: The results identified three themes: 1) Developing professional self-confidence; 2) Developing communication skills; and 3) Having time for reflection. Each theme has at least two subthemes.Conclusions: Caring for palliative-stage patients requires a combination of knowledge, experience and professional and personal self-confidence. Nurses need regular coaching by staff and professionals with more experience dealing with and processing suffering, death and related existential issues. Nurses need to separate work from private life and have satisfying and relaxing leisure activities.

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Community nurses’ experiences of ethical dilemmas in palliative care: a Swedish study

Abstract: The study confirms the need for knowledge about how community nurses experience dilemmas in ethical decision-making. They have the freedom to act and the willingness to make decisions, but they lack competence and knowledge about how their colleagues' experience and deal with such issues.

Cited by 25 publications

References 27 publications

Community nurses' experiences of ethical problems in end‐of‐life care in the patient's own home

Community nurses' experiences of ethical problems in end‐of‐life care in the patient's own home

Ethical Issues Experienced by Hospice and Palliative Nurses

Nurses’ experience of caring for palliative-stage patients in a hospital setting in Sweden

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