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ETHICAL ISSUES FOR JAPANESE NURSES IN END-OF-LIFE CARE: FROM ANALYSIS OF THE ANGUISH OF NURSES IN AN ACUTE WARD
  1. M Kiyama1,
  2. N Morishita2 and
  3. H Tajima3
  1. 1Faculty of Health Promotion Sciences, Hamamatsu University
  2. 2Department of Integrated Human Sciences, Hamamatsu University School of Medicine
  3. 3Faculty of English and IT Management, Shumei University

Abstract

Background In Japan, many clinical nurses experience ethical dilemmas in daily nursing practice that cannot be resolved easily. Nurses feel strong regret in particular in cases in which the patient is at the end of life. Accordingly, based on one end-of-life case we elucidated the aspects of the patient's condition and the thoughts and disorientation of the nurses.

Aim To consider ethical issues for clinical nurses in end-of-life care.

Methods We surveyed seven nurses on the nursing team involved in this case, through group interviews. The interviews concerned topics including nursing policies and plans, the content of conferences, and the dilemmas nurses experienced.

Results Through data analysis, we identified 63 codes, 25 subcategories, and six core categories. While admitted, the patient constantly used the nurse-call for various reasons. She made particularly many calls during the postoperative acute stage and the postoperative recovery stage. In the postoperative acute stage, the nurses anticipated a danger when hearing the nurse-call, immediately answered the call, and went to her room to take appropriate action. However, during the postoperative recovery stage, the nurses were not aware of her sense of anxiety and were confused by the patient's frequent nurse-calls, even during recovery.

Discussion Gaps developed between the patient's thoughts and the ethical assumptions of nurses in end-of-life care. This gap was due to differences in each other's goals.

Conclusion This study will support promotion, from the nurse's point of view, of the provision of medical care that satisfies patients, which has not advanced smoothly in Japan.

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