当支持生命的干预措施导致道德困扰时。

IF 1 Q4 CRITICAL CARE MEDICINE Critical Care Nursing Quarterly Pub Date : 2024-07-01 Epub Date: 2024-06-07 DOI:10.1097/CNQ.0000000000000509
Kerstin Hudgins
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引用次数: 0

摘要

精神痛苦会对护士和护理团队产生重大影响。作为一个奉行关爱和同情原则的职业,护士经常要面对病人接受无用的治疗。随着延长生命的极端措施的增多,撤消这些医疗方式的困难也随之而来。如果预后不佳,治疗被认为是治疗性的而不是姑息性的,那么医疗服务提供者往往会因为他们的干预而感到矛盾和痛苦。美国护理学院协会对与无效护理有关的不适当生命支持治疗的使用增加表示日益关注。一名 69 岁的无家可归者被严重殴打,心脏骤停,在停机时间不明的情况下进行了抢救,这一令人信服的案例为本报告提供了背景框架。伦理冲突可能变得非常具有挑战性,这不可避免地增加了病人及其护理人员的痛苦。研究结果表明,医疗机构可以从制定流程中获益,使伦理考虑成为日常临床实践中早期和常规的一部分。积极主动地处理伦理冲突可以改善患者的治疗效果,减少精神痛苦。
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When Life-Supporting Interventions Lead to Moral Distress.

Moral distress can impact nurses and the care team significantly. A profession dedicated to the principles of caring and compassion is often subjected to patients receiving futile treatment. With the proliferation of extreme life-prolonging measures come the difficulties in the withdrawal of those medical modalities. If a prognosis is poor and care is perceived as curative rather than palliative, providers may often feel conflicted and distressed by their interventions. The American Association of Colleges of Nursing has expressed growing concern about an increase in the use of inappropriate life-support treatments related to futile care. The compelling case of a severely beaten 69-year-old homeless man who had cardiac-arrested and was resuscitated after an unknown amount of down-time, provides the contextual framework for this report. Ethical conflicts can become very challenging, which inevitably increases the suffering of the patient and their caregivers. Research findings suggest that health care organizations can benefit from enacting processes that make ethical considerations an early and routine part of everyday clinical practice. A proactive approach to ethical conflicts may improve patient care outcomes and decrease moral distress.

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来源期刊
Critical Care Nursing Quarterly
Critical Care Nursing Quarterly CRITICAL CARE MEDICINE-
CiteScore
2.60
自引率
0.00%
发文量
76
期刊介绍: Critical Care Nursing Quarterly (CCNQ) is a peer-reviewed journal that provides current practice-oriented information for the continuing education and improved clinical practice of critical care professionals, including nurses, physicians, and allied health care professionals.
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