Aström G, Jansson L, NorBerg A, Hallberg I R
Department of Advanced Nursing, University of Umeå, Sweden.
Cancer Nurs. 1993 Jun;16(3):179-87.
In previous interviews, experienced nurses have reported that their decisions in ethical matters depended "on the situation at hand." We interviewed 18 good, experienced cancer nurses to determine how they handled ethical decisions. They were asked to give an account of difficult situations that required ethical decisions to be made. The 60 narrated situations were interpreted step-by-step departing from the following two questions: What do nurses experience when being in ethically difficult care situations? What does the expression "it depends on the situation at hand how I act" mean? In complex situations, the nurses reported that the ethical situations that arose were regarded either as overwhelming or at the other end of the spectrum, as possible to grasp, and they expressed either loneliness or togetherness, respectively. When reporting overwhelming situations, the nurses mostly referred to themselves by using the word "one," i.e., "one would" and used "they" when referring to their coactors. When narrating situations possible to grasp, they used the terms "I" and "we." The most important situational factor that was revealed in these narratives was whether or not the nurses had a support group in which to share their thoughts. Without the support group, they reported difficulties acting in accordance with their ethical reasoning and feelings.
在之前的访谈中，经验丰富的护士报告称，她们在伦理问题上的决策“取决于手头的具体情况”。我们采访了18位优秀且经验丰富的癌症护理护士，以确定她们如何处理伦理决策。我们要求她们讲述需要做出伦理决策的困难情况。从以下两个问题出发，对这60个叙述的情况进行了逐步解读：护士在面临伦理困境的护理情况时会有怎样的体验？“我如何行动取决于手头的具体情况”这句话是什么意思？在复杂的情况下，护士们报告称，出现的伦理情况要么被视为难以应对，要么在另一个极端，即可以把握，她们分别表达了孤独感或团结感。在报告难以应对的情况时，护士们大多用“一个人”来指代自己，即“一个人会”，而在提及同事时用“他们”。在叙述可以把握的情况时，她们使用“我”和“我们”。这些叙述中揭示的最重要的情境因素是护士们是否有一个可以分享想法的支持小组。没有支持小组，她们报告说很难按照自己的伦理推理和感受行事。
