Ethical Issues for Emergency Nurses during Resuscitation of Injured Patients

描述（由申请人提供）：在创伤中心急诊科艾德工作的护士作为创伤小组成员参与严重受伤患者的初步复苏。关于这些复苏的决定是在高压力的环境中做出的，并且由于高频率的伤害及其对社会的过高成本，不可避免地充斥着道德问题。这些决定是在快速评估生理状态的复杂过程中，在伦理原则、社会规范和期望以及法律的要求的覆盖下，在对患者的背景知识很少的情况下做出的。研究表明，护士在许多护理专业都面临着各种道德问题，导致的后果，如工作不满和道德困扰，这可能会降低护理质量。然而，具体的伦理问题艾德护士经验在严重受伤的病人，在这些情况下，以及如何护士参与这些决定的伦理决策的因素复苏过程中仍然在很大程度上未知。本研究旨在探讨艾德护理人员对严重创伤病患复苏过程中伦理议题的认知与决策。采用定性描述性设计，对参与严重损伤患者初始复苏的艾德护士进行半结构化面对面访谈，以回答以下四个研究问题：1.）在严重受伤病人的最初复苏过程中会出现什么伦理问题？，2.）的情况。艾德护士如何受到严重受伤病人最初复苏过程中出现的伦理问题的影响？，3.）第三章在严重受伤患者的初始复苏过程中，哪些因素影响了伦理决策？，和4.）在严重受伤的病人的复苏过程中，护士是如何参与决策的？这项研究将启动一个轨迹的经验生物伦理学研究，检查涉及创伤的道德和它们对医疗保健提供者的影响。这将最终导致改善医疗保健提供者关于创伤患者和情况的道德决策的方法，从而改善创伤患者接受的护理。道德问题的负面影响可能导致护理质量下降和患者预后不良。随着伤害发生率的升高，护理质量的下降和患者预后的不良可能对公共卫生产生破坏性影响。解决伦理问题所遇到的艾德护士可以导致战略和干预措施，以协助应对这些问题和决定。这不仅将改善公共卫生，而且还解决了NINR的使命声明和战略目标，改善护理工作环境，护理质量，并可能保留护士。

DESCRIPTION (provided by applicant): Nurses working in emergency departments ED of trauma centers participate as members of the trauma team in the initial resuscitation of severely injured patients. Decisions regarding these resuscitations are made in high stress environments and are inevitably rife with ethical issues due to the high frequency of injury and its exorbitant costs to society. These decisions are made with little background knowledge about the patients during a complex process of rapid assessment of physiological status overlaid by ethical principles, societal norms and expectations, and legal mandates. Research shows that nurses are confronted with various ethical issues throughout many nursing specialties, leading to consequences such as job dissatisfaction and moral distress which can decrease quality of care. However, the specific ethical issues ED nurses experience during the resuscitation of severely injured patients, the factors contributing to the ethical decisions made during the these situations, and how nurses are involved in these decisions remain largely unknown. The purpose of this study is to explicate ED nurses' perceptions of ethical issues and decisions during resuscitation of severely injured patients. A qualitative descriptive design using semi- structured face-to-face interviews of ED nurses participating in the initial resuscitation of severely injured patients will be used to answer the following four research questions: 1.) What ethical issues arise during the initial resuscitation of severely injured patients?, 2.) How are ED nurses affected by the ethical issues that arise during initial resuscitation of severely injured patients?, 3.) What factors contribute to the ethical decisions made during the initial resuscitation of severely injured patients?, and 4.) How are nurses involved in making decisions during resuscitation of severely injured patients? This study will initiate a trajectory of empirical bioethics research examining the ethics involved in trauma and the effects they have on health care providers. This will ultimately lead to methods of improving health care provider ethical decision making in regards to trauma patients and situations thereby improving the care trauma patients receive. The negative effects of ethical issues can lead to decreased quality of care and poor patient outcomes. With the high occurrence of injury, decreased quality of care and poor patient outcomes can have devastating effects on public health. Addressing the ethical issues encountered by the ED nurses can lead to strategies and interventions to assist in coping with these issues and decisions. This will not only improve public health, but also address NINR's mission statement and strategic goals improving the nursing work environment, quality of care, and possibly retention of nurses.