Ethical challenges in nursing emergency practice

Aim. The aim of this study is to illuminate nurses’ experiences of being in ethically difficult situations in an emergency ward. Background. Nurses working in emergency practice are frequently faced with ethical issues and challenges in their work. Many studies have been conducted concerning ethical challenges, but no empirical studies related to ethics in emergency wards in Norway have been carried out. Design. A qualitative interview study was conducted. Method. Five registered nurses were interviewed about their experiences in an emergency ward in a hospital in Norway. The concept of ethically difficult situations was not defined that the question was left open for the respondents themselves to define what they experienced as ethically difficult. A phenomenological hermeneutical method was used. Results. The most salient point revealed by the study is the enormous difficulty associated with the prioritisation of tasks and the attendant sense of responsibility which this entailed, particularly in the case of nurses in charge. The narratives reveal the vulnerability of the nurses in ethically challenging situations. Conclusions. Despite the pressure of responsibility for their patients, the nurses enjoy a sense of satisfaction in their work. Those recognising the ethical dimension in their own professional practice are unable to hide behind others and thus evade their share of the responsibility. Relevance to clinical practice. Nurses with similar experiences may find the results credible recognising the descriptions or interpretations and seeing them in relation to similar situations. Nurses working on medical and surgical wards, in nursing homes and community care may also feel a great responsibility, difficulties in prioritising and a lack of time for the patients.