Ethical conflicts among nurses in critical care units in a southern Chile hospital

Abstract

Introduction: Ethical conflicts arise when nurses cannot perform based on their values and beliefs because someone or something prevents them from doing so.
Objective: To determine the level of ethical conflict among nurses in critical care units in a southern Chile hospital.
Methods: This is a transversal and association study with 38 nurses of critical care units. The Questionnaire on Ethical Conflict (CuCEE) which has a Cronbach alfa of 0.82 was used. An item on social and work-related issues was added. Descriptive statistics including Pearson Chi square (95% CI) were calculated according to criteria of ethical rigor.
Results: 68.4% were women. The average age was 33.6 years old (SD ± 8.2). 60.5% work in adult Critical Patient Unit. The working experience average was 8.7 years. The working experience average within units of critical care was 6.9 years (SD ± 4.6). High levels in frequency and severity of ethical conflicts were observed. Moral indignation was the main type of ethical conflict though with a moderate exposition index (IEce). The most conflictive situations were: ‘Acknowledging that the analgesic and sedative treatment given to the patients was not effective enough resulting in their suffering’ and ‘Working with medical staff who was considered professionally incompetent’. No significant associations were found among the social and work-related and academic variables and IEce.
Conclusions: The situations with greater conflict are related to the suffering of the patients and the working dynamics. There are barriers which prevent the provision of a care based on the values. Moreover, observing those who do not proceed ethically further supports the necessity to promote preventive conducts of these behaviors.