Palliative sedation and moral distress: A qualitative study of nurses.
Appl Nurs Res
; 40: 157-161, 2018 04.
Article
en En
| MEDLINE
| ID: mdl-29579492
ABSTRACT
BACKGROUND:
Clinical nursing practice may involve moral distress, which has been reported to occur frequently when nurses care for dying patients. Palliative sedation is a practice that is used to alleviate unbearable and refractory suffering in the last phase of life and has been linked to distress in nurses.AIM:
The aim of this study was to explore nurses' reports on the practice of palliative sedation focusing on their experiences with pressure, dilemmas and morally distressing situations.METHODS:
In-depth interviews with 36 nurses working in hospital, nursing home or primary care.RESULTS:
Several nurses described situations in which they felt that administration of palliative sedation was in the patient's best interest, but where they were constrained from taking action. Nurses also reported on situations where they experienced pressure to be actively involved in the provision of palliative sedation, while they felt this was not in the patient's best interest. The latter situation related to (1) starting palliative sedation when the nurse felt not all options to relieve suffering had been explored yet; (2) family requesting an increase of the sedation level where the nurse felt that this may involve unjustified hastening of death; (3) a decision by the physician to start palliative sedation where the patient had previously expressed an explicit wish for euthanasia.CONCLUSIONS:
Nurses experienced moral distress in situations where they were not able to act in what they believed is the patient's best interest. Situations involving moral distress require nurses to be well informed and able to adequately communicate with suffering patients, distressed family and physicians.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dolor
/
Enfermería de Cuidados Paliativos al Final de la Vida
/
Hipnóticos y Sedantes
/
Principios Morales
/
Personal de Enfermería en Hospital
Tipo de estudio:
Prognostic_studies
/
Qualitative_research
Límite:
Adult
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Appl Nurs Res
Asunto de la revista:
ENFERMAGEM
Año:
2018
Tipo del documento:
Article