Newton Lorelei, Storch Janet L, Makaroff Kara Schick, Pauly Bernadette
University of Victoria / Camosun College Schools of Nursing Victoria, BC, Canada.
Nurs Leadersh (Tor Ont). 2012 Mar;25(1):90-104. doi: 10.12927/cjnl.2012.22828.
Nurses are frequently portrayed in the literature as being silent about ethical concerns that arise in their practice. This silence is often represented as a lack of voice. However, in our study, we found that nurses who responded to questions about moral distress were not so much silent as silenced. These nurses were enacting their moral agency by engaging in diverse, multiple and time-consuming actions in response to situations identified as morally distressing with families, colleagues, physicians, educators or managers. In many situations, they took action by contacting other healthcare team members, making referrals and coordinating care with other departments such as home care and hospice, as well as initiating contact with groups such as professional regulatory bodies or unions. Examining the relationship between ethical climate, moral distress and voice offers insights into both the meaning and impact of being silenced in the workplace.
在文献中，护士常常被描绘成在实践中对出现的伦理问题保持沉默。这种沉默通常被视为缺乏发言权。然而，在我们的研究中，我们发现，那些回答有关道德困扰问题的护士并非沉默，而是被噤声。这些护士通过针对与家属、同事、医生、教育工作者或管理人员相关的被认定为道德困扰的情况，采取多样、多重且耗时的行动来行使其道德能动性。在许多情况下，她们通过联系其他医疗团队成员、进行转诊以及与家庭护理和临终关怀等其他部门协调护理来采取行动，还会主动与专业监管机构或工会等团体取得联系。审视伦理氛围、道德困扰和发言权之间的关系，能让我们深入了解在工作场所被噤声的意义和影响。
