Experienced nurses' narratives of their being in ethically difficult care situations. The problem to act in accordance with one's ethical reasoning and feelings

Abstract

In previous interviews, experienced nurses have reported that their decisions in ethical matters depended "on the situation at hand." We interviewed 18 good, experienced cancer nurses to determine how they handled ethical decisions. They were asked to give an account of difficult situations that required ethical decisions to be made. The 60 narrated situations were interpreted step-by-step departing from the following two questions: What do nurses experience when being in ethically difficult care situations? What does the expression "it depends on the situation at hand how I act" mean? In complex situations, the nurses reported that the ethical situations that arose were regarded either as overwhelming or at the other end of the spectrum, as possible to grasp, and they expressed either loneliness or togetherness, respectively. When reporting overwhelming situations, the nurses mostly referred to themselves by using the word "one," i.e., "one would" and used "they" when referring to their coactors. When narrating situations possible to grasp, they used the terms "I" and "we." The most important situational factor that was revealed in these narratives was whether or not the nurses had a support group in which to share their thoughts. Without the support group, they reported difficulties acting in accordance with their ethical reasoning and feelings.