Tsai Yu-Lun, Yi Tin, Chiang Hsien-Hsien, Lan Hsiang-Yun, Chiang Hui-Hsun, Liaw Jen-Jiuan
National Defense Medical Center; Tri-Service General Hospital.
National Yang Ming Chiao Tung University.
Nurs Ethics. 2021 Nov-Dec;28(7-8):1389-1401. doi: 10.1177/09697330211003239. Epub 2021 Jul 9.
Healthcare professionals follow codes of ethics, making them responsible for providing holistic care to all disaster victims. However, this often results in ethical dilemmas due to the need to provide rapid critical care while simultaneously attending to a complex spectrum of patient needs. These dilemmas can cause negative emotions to accumulate over time and impact physiological and psychological health, which can also threaten nurse-patient relationships.
This study aimed to understand the experience of nurses who cared for burn victims of the color-dust explosion and the meaning of ethical relationships between nurse and patient.
A qualitative descriptive study using a phenomenological approach.
Clinical nurses who provided care to the patients of the Formosa color-dust explosion of 2015 were selected by purposive sampling (N = 12) from a medical center in Taiwan. Data were collected using individual in-depth semi-structured interviews. Audiotaped interviews were transcribed and analyzed using Colaizzi's method.
This study was approved by the institutional review board of the study hospital. All participants provided written informed consent.
Three main themes described the essence of the ethical dilemmas experienced by nurses who cared for the burn-injured patients: (1) the calling must be answered, (2) the calling provoked my feelings, and (3) the calling called out my strengths.
Healthcare providers should recognize that nurses believed they had an ethical responsibility to care for color-dust explosion burn victims. Understanding the feelings of nurses during the care of patients and encouraging them to differentiate between the self and the other by fostering patient-nurse relationships based on intersubjectivity could help nurses increase self-care and improve patient caregiving.
医护人员遵循道德准则，有责任为所有灾难受害者提供全面护理。然而，由于需要迅速提供重症护理，同时又要兼顾患者复杂多样的需求，这常常导致道德困境。随着时间的推移，这些困境会使负面情绪不断累积，影响生理和心理健康，还可能威胁护患关系。
本研究旨在了解护理彩色粉尘爆炸烧伤患者的护士的经历，以及护患之间道德关系的意义。
采用现象学方法的定性描述性研究。
通过目的抽样从台湾一家医疗中心选取了2015年为福尔摩沙彩色粉尘爆炸患者提供护理的临床护士（N = 12）。数据通过个体深入半结构式访谈收集。对访谈录音进行转录，并采用科莱齐方法进行分析。
本研究经研究医院的机构审查委员会批准。所有参与者均提供了书面知情同意书。
三个主要主题描述了护理烧伤患者的护士所经历的道德困境的本质：（1）使命必达，（2）使命激发我的情感，（3）使命彰显我的力量。
医疗服务提供者应认识到，护士认为他们有道德责任护理彩色粉尘爆炸烧伤患者。了解护士在护理患者过程中的感受，并通过建立基于主体间性的护患关系鼓励他们区分自我与他人，这有助于护士增强自我护理能力并改善患者护理工作。
