Ethical problems experienced by oncology nurses

Abstract

Objective: to know the ethical problems experienced by oncology nurses. Method: descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Results: two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. Conclusion: for the effective confrontation of the ethical problems experienced by oncology nurses to occur, it is important to invest in the training of these professionals, preparing them in an ethical and human way to act as lawyers of the patient with cancer, in a context of dilemmas related mainly to the possibility of finitude.

The first nationwide study on facing and solving ethical dilemmas among healthcare professionals in Slovenia

“…which reported that not only physicians but also nurses and other HCPs may encounter different ethical dilemmas [42,[44][45][46]47]. The demographic characteristics of our HCPs showed that the majority of our participants were female (79.5%).…”

“…Nurses and other HCPs, who have the primary responsibility of caring for the patient, are somewhat more alert to the dilemmas associated with patients' well-being and dignity. Similarly, Norberg et al observed that nurses are more emotionally involved in ethical dilemmas concerning patient care compared to physicians [45][46][47][48][49][50].…”

Práticas integrativas e complementares para alívio ou controle da dor em oncologia

“…A importância do enfermeiro no seu papel educativo, através do diálogo com o paciente, orientando e elucidando as dúvidas acerca do diagnóstico e tratamento, bem como, ouvindo a manifestação da sua decisão, tornam-se fatores determinantes para a qualidade do cuidado ao paciente com câncer. Importante sinalizar os princípios da integralidade e da autonomia, ou seja, a capacidade do ser humano de decidir sobre algo, de acordo com seus valores, expectativas, necessidades, prioridades e crenças 21,22 .…”

Interfaces, lacunas e desafios entre bioética e oncologia

“…One of the studies describes the complex task of palliative sedation in cases of extreme suffering, which results in a shock of values between patient, family and health team 26 . Doctors and nurses are uncertain about the ideal time to discuss the end of life and the clinical balance between the physician's emotional involvement and the patient's wishes 32,37 . Opinions of physicians about requests of patients at the end of life, their willingness to comply with requests such as retention of intubation, application of increasing doses of drugs are related to experience in the area, with substantial change during residency 33 .…”

“…The formal medical school curriculum or continuing medical education can be a way of learning to improve the communication between doctor and patient, and to increase the bioethical knowledge of the health professional. However, this education can not be restricted to theoretical content, but also to practice and Interfaces, gaps and challenges between bioethics and oncology http://dx.doi.org/10.1590/1983-80422018263265 experience [14][15][16]25,27,30,32,34 . It is also worth mentioning the need for studies on training strategies, their influence on medical performance and the impact on the quality of ethical decisions 33 .…”