Penticuff J H
High-Risk Perinatal Nursing, School of Nursing, University of Texas, Austin.
Nurs Clin North Am. 1989 Dec;24(4):987-97.
This discussion of nurse advocacy and infant suffering in neonatal intensive care was based on content analysis of interviews of 20 neonatal nurses in three NICUs over a period of 6 years. Throughout that span of time, nurses experienced significant emotional distress when they believed that therapies resulted in infant suffering without proportional benefit. In all of the nurses interviewed, infant suffering triggered a variety of acts of advocacy, ranging from changes in nursing care to decrease infant distress to formal requests that the medical plan of care be reviewed. Characteristics of infants, nurses, and the NICU organization were described as possibly influential to nurse advocacy. Finally, some thoughts about an ethic of the good were presented. Gajardo-Velasquez noted, "Nothing really great and important can be obtained without a certain amount of sacrifice; therefore, suffering is present in every human action that tends to transform and create new conditions for life." Our technology in the NICU has saved many lives and prevented much suffering and avoidable disability. It has also, for some, been a source of profound suffering. It is hoped that nurses in neonatal intensive care will use the ideas presented here as a starting point for their individual and collective examination of what constitutes an ethic of the good. Perhaps such an ethic can minimize the cost in suffering of the powerful technology of neonatal intensive care.
本关于新生儿重症监护中护士的维权倡导及婴儿痛苦的讨论，是基于对6年间三个新生儿重症监护病房的20名新生儿护士访谈内容的分析。在那段时间里，当护士们认为治疗措施导致婴儿承受痛苦却未带来相应益处时，他们会经历巨大的情感困扰。在所有接受访谈的护士中，婴儿的痛苦引发了各种维权倡导行为，从改变护理方式以减轻婴儿痛苦，到正式要求审查医疗护理计划。婴儿、护士及新生儿重症监护病房组织的特征被描述为可能对护士的维权倡导有影响。最后，提出了一些关于善的伦理的思考。加亚尔多 - 贝拉斯克斯指出：“没有一定程度的牺牲，就无法真正获得伟大而重要的东西；因此，在每一个旨在改变并为生活创造新条件的人类行动中，痛苦都存在。”我们新生儿重症监护病房的技术挽救了许多生命，预防了许多痛苦和可避免的残疾。但对一些人来说，它也是巨大痛苦的根源。希望新生儿重症监护病房的护士们能以此处提出的观点为起点，对构成善的伦理的内容进行个人和集体审视。或许这样一种伦理可以将新生儿重症监护强大技术所带来的痛苦代价降至最低。
