Abstract
BackgroundWorking as an ambulance nurse involves facing ethically problematic situations with multi-dimensional suffering, requiring the ability to create a trustful relationship. This entails a need to be clinically trained in order to identify ethical conflicts.AimTo describe ethical conflicts in patient relationships as experienced by ambulance nursing students during clinical studies.Research designAn exploratory and interpretative design was used to inductively analyse textual data from examinations in clinical placement courses.ParticipantsThe 69 participants attended a 1-year educational programme for ambulance nurses at a Swedish university.Ethical considerationsThe research was conducted in accordance with the Declaration of Helsinki. Participants gave voluntary informed consent for this study.FindingsThe students encountered ethical conflicts in patient relationships when they had inadequate access to the patient’s narrative. Doubts regarding patient autonomy were due to uncertainty regarding the patient’s decision-making ability, which forced students to handle patient autonomy. Conflicting assessments of the patient’s best interest added to the conflicts and also meant a disruption in patient focus. The absence of trustful relationships reinforced the ethical conflicts, together with an inadequacy in meeting different needs, which limited the possibility of providing proper care.DiscussionContextual circumstances add complexity to ethical conflicts regarding patient autonomy, dependency and the patient’s best interest. Students felt they were fluctuating between paternalism and letting the patient choose, and were challenged by considerations regarding the patient’s communication and decision-making ability, the views of third parties, and the need for prioritisation.ConclusionThe essence of the patient relationship is a struggle to preserve autonomy while focusing on the patient’s best interest. Hence, there is a need for education and training that promotes ethical knowledge and ethical reflection focusing on the core nursing and caring values of trust and autonomy, particularly in situations that affect the patient’s decision-making ability.
Highlights
Different concepts are used to describe ethically problematic situations, the core meaning of this concept entails a situation in which values, norms or principles are threatened or in conflict, and a decision has to be made on how to act.[1]
The experiences of ambulance nursing students regarding ethical conflicts in patient relationships emerged as six main themes comprising 19 sub-themes (Table 2)
The patient’s condition could range from being unconscious to wanting, but being unable, to communicate properly. This means that there is no basis for shared decision-making, resulting in ethical conflicts related to the patient’s inability to give their consent
Summary
Different concepts are used to describe ethically problematic situations, the core meaning of this concept entails a situation in which values, norms or principles are threatened or in conflict, and a decision has to be made on how to act.[1]. Working in the ambulance service involves dealing with multiple ethical problems Students in this setting must be clinically trained to handle ethically problematic situations with multi-dimensional suffering, requiring the ability to provide medical care while creating a trustful relationship. Working as an ambulance nurse involves facing ethically problematic situations with multi-dimensional suffering, requiring the ability to create a trustful relationship This entails a need to be clinically trained in order to identify ethical conflicts. Discussion: Contextual circumstances add complexity to ethical conflicts regarding patient autonomy, dependency and the patient’s best interest Students felt they were fluctuating between paternalism and letting the patient choose, and were challenged by considerations regarding the patient’s communication and decision-making ability, the views of third parties, and the need for prioritisation. There is a need for education and training that promotes ethical knowledge and ethical reflection focusing on the core nursing and caring values of trust and autonomy, in situations that affect the patient’s decision-making ability
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
