McGrath Pam, Phillips Emma
Central Queensland University.
Monash Bioeth Rev. 2009 Jun;28(2):16-1-16.
The purpose of this article is to share with the reader the specific findings on the role of nurse as consumer advocate from a study on ethical decision-making in an emergency department (ED). Qualitative interviews were conducted with 11 health professionals (doctors and nurses) working in the ED of a hospital. The interviews were audio-recorded, transcribed verbatim and thematically analysed. In ED, where the decision-making is described as medico-centric, advocacy ipso facto necessitates a challenge to doctor decision-making. The findings indicate that ED nurses' experience with advocacy varied depending on the democratic qualities and communication skills of the particular doctor who had care of the consumer. It is noted that seeing the need for advocacy does not necessarily translate into effective action, as management support is essential for productive advocacy. A phenomenon of the desire not to rock the boat was reported. The findings indicate that the support of other nurses is essential for advocacy and affirm the importance of focusing on the ethical nature of the organisation as opposed to an exclusive focus on the individual.
本文旨在与读者分享一项关于急诊科伦理决策研究中护士作为消费者权益倡导者角色的具体发现。对一家医院急诊科的11名医护人员（医生和护士）进行了定性访谈。访谈进行了录音，逐字转录并进行了主题分析。在急诊科，决策被描述为以医生为中心，因此倡导本身就需要对医生的决策提出挑战。研究结果表明，急诊科护士的倡导经历因负责照顾消费者的特定医生的民主品质和沟通技巧而异。需要注意的是，意识到倡导的必要性并不一定能转化为有效的行动，因为管理层的支持对于有效的倡导至关重要。报告了一种不想惹事的现象。研究结果表明，其他护士的支持对于倡导至关重要，并肯定了关注组织的伦理性质而非仅仅关注个人的重要性。
