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无处可寻出路:护理专业学生在心理健康环境中遭遇道德困境的经历

No place to turn: nursing students' experiences of moral distress in mental health settings.

作者信息

Wojtowicz Bernadine, Hagen Brad, Van Daalen-Smith Cheryl

机构信息

Faculty of Health Sciences, The University of Lethbridge, Lethbridge, Alberta, Canada.

出版信息

Int J Ment Health Nurs. 2014 Jun;23(3):257-64. doi: 10.1111/inm.12043. Epub 2013 Aug 26.

Abstract

While researchers have documented the significant issue of moral distress among nurses, few have explored moral distress among mental health nurses. In addition, no research to date has explored nursing students' experiences of moral distress during mental health clinical rotations, despite nursing students typically reporting negative attitudes towards mental health nursing. This manuscript reports on a qualitative study involving seven Canadian baccalaureate nursing students, who reported on their experiences of moral distress during a 13-week clinical rotation on inpatient psychiatric units. Overall, nursing students reported significant moral distress related to the perceived lack of nurses talking meaningfully to patients on the unit, a hierarchical power structure for physicians, a lack of information given to patients about their psychiatric medications, and an inability of their nursing instructors to advocate for ethical change on the units. Several students made a specific connection between their moral distress and not wanting to pursue a career in mental health nursing.

摘要

虽然研究人员已经记录了护士中道德困扰这一重大问题,但很少有人探讨心理健康护士的道德困扰。此外,尽管护理专业学生通常对心理健康护理持消极态度,但迄今为止,尚无研究探讨护理专业学生在心理健康临床实习期间的道德困扰经历。本手稿报告了一项定性研究,该研究涉及七名加拿大护理学学士学生,他们讲述了自己在为期13周的住院精神科病房临床实习期间的道德困扰经历。总体而言,护理专业学生报告了严重的道德困扰,这些困扰涉及到感觉病房里护士与患者缺乏有意义的交流、医生的等级权力结构、未向患者提供有关其精神科药物的信息,以及他们的护理教师无法在病房倡导道德变革。几名学生将他们的道德困扰与不想从事心理健康护理职业建立了明确的联系。

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