The Ethical Dilemma Experienced By Nurses In The Intensive Care Unit (NICU) Neonatology Room H. Adam Malik Medan General Hospital: Phenomenology Study
The Ethical Dilemma Experienced by Nurses in the Intensive Care Unit (NICU) Neonatology Room H. Adam Malik Medan General Hospital: A Phenomenology Study
Introduction
The Intensive Care Unit (NICU) neonatology space is a specialized treatment site for premature babies or babies with health conditions that require extra attention. In the midst of the hustle and bustle of medical equipment and the struggle to save the tiny life, nurses face complex ethics dilemmas. This dilemma emerges from the intersection between patient beliefs, doctor's philosophy, and hospital policy, which often makes nurses feel trapped and dilemmatic in carrying out their duties. The purpose of this study is to explore the ethical dilemma experienced by nurses in NICU H. Adam Malik Central General Hospital Medan.
Methodology
This study used a qualitative phenomenological approach to explore the ethical dilemma experienced by nurses in NICU. Ten nurses with a minimum of one year experience in NICU and the status of Civil Servants (PNS) became participants in this research. Data was collected through in-depth interviews for 60 minutes for each participant, then analyzed using the manual content analysis method based on the Colaiizi Framework (1978).
Results
The results showed seven main themes describing the ethical dilemma faced by nurses in NICU:
1. Running the Doctor's Instructions vs. Guided by Morals
Nurses are faced with a dilemma when they have to carry out doctor's instructions that may conflict with their moral values. For example, nurses may be asked to provide certain treatment, but are doubtful for fear of side effects for babies. This dilemma arises when nurses have to balance between following doctor's orders and their own moral principles. The conflict between medical orders and personal values can lead to feelings of guilt and anxiety among nurses.
2. Maintaining the Ventilator for Babies MBO vs. Move the Ventilator to Babies Who Are Struggling to Live
This dilemma appears when resources are limited, especially ventilator. Nurses must decide whether to maintain a ventilator for babies with multiple birth orders (MBO), who may have lower life expectancy, or move them to babies who are struggling to live. The decision to allocate limited resources can be a difficult and emotional task for nurses.
3. Balancing Family Trust and Baby's Welfare
Nurses must balance between respecting the trust and desires of the family by considering what is best for the comfort and welfare of the baby. This dilemma arises when families are in an unstable emotional condition and require time to understand the situation. The nurse's role is to provide emotional support and guidance to families while also ensuring the baby's safety and well-being.
4. Respecting Family Human Rights and Ensuring Baby's Safety
Nurses must respect family human rights, but are also responsible for ensuring baby's safety. This dilemma arises when families have different opinions on the best course of treatment for their baby. The nurse's role is to navigate these complex family dynamics while also ensuring the baby's safety and well-being.
5. Prioritizing Treatment and Resource Allocation
Nurses must prioritize treatment and resource allocation in a way that is fair and just. This dilemma arises when resources are limited, and nurses must decide who receives treatment and who does not. The decision to allocate limited resources can be a difficult and emotional task for nurses.
6. Managing Conflicting Opinions and Emotions
Nurses must manage conflicting opinions and emotions among family members, doctors, and other healthcare professionals. This dilemma arises when there are disagreements on the best course of treatment for the baby. The nurse's role is to facilitate communication and find a solution that is in the best interest of the baby.
7. Maintaining Professional Boundaries and Emotional Distance
Nurses must maintain professional boundaries and emotional distance from families and patients. This dilemma arises when nurses become emotionally invested in the care of their patients. The nurse's role is to provide emotional support and guidance while also maintaining a professional distance.
Conclusion
This study emphasizes the importance of nurses in NICU to always be guided by ethical principles and carry out the role of advocacy for babies so that they get comfortable care and in accordance with their needs. The results of this study provide valuable information for health practitioners, especially nurses in NICU, to better understand and overcome the ethics dilemma they face in carrying out their duties. Increasing awareness and understanding of ethical dilemmas will improve the quality of health services for infants and families in NICU.
Recommendations
Further research can use other methods, such as grounded theory and action research, to dig deeper into the ethical dilemma faced by nurses in NICU. The results of this study can be used to develop educational programs and training for nurses in NICU to improve their skills in managing ethical dilemmas. Additionally, healthcare institutions can use the findings of this study to develop policies and procedures that address the ethical dilemmas faced by nurses in NICU.
Frequently Asked Questions (FAQs) About the Ethical Dilemma Experienced by Nurses in the Intensive Care Unit (NICU) Neonatology Room H. Adam Malik Medan General Hospital
Q: What is the main theme of this study?
A: The main theme of this study is to explore the ethical dilemma experienced by nurses in NICU H. Adam Malik Central General Hospital Medan.
Q: What is the qualitative phenomenological approach used in this study?
A: The qualitative phenomenological approach is a research methodology that aims to understand the meaning and experience of a phenomenon from the perspective of the individuals involved.
Q: How many nurses participated in this study?
A: Ten nurses with a minimum of one year experience in NICU and the status of Civil Servants (PNS) participated in this study.
Q: What is the Colaiizi Framework used in this study?
A: The Colaiizi Framework is a method of analyzing qualitative data that involves identifying and coding themes and patterns in the data.
Q: What are the seven main themes describing the ethical dilemma faced by nurses in NICU?
A: The seven main themes are:
- Running the doctor's instructions vs. guided by morals
- Maintaining the ventilator for babies MBO vs. move the ventilator to babies who are struggling to live
- Balancing family trust and baby's welfare
- Respecting family human rights and ensuring baby's safety
- Prioritizing treatment and resource allocation
- Managing conflicting opinions and emotions
- Maintaining professional boundaries and emotional distance
Q: What is the importance of this study?
A: This study emphasizes the importance of nurses in NICU to always be guided by ethical principles and carry out the role of advocacy for babies so that they get comfortable care and in accordance with their needs.
Q: What are the implications of this study?
A: The results of this study provide valuable information for health practitioners, especially nurses in NICU, to better understand and overcome the ethics dilemma they face in carrying out their duties. Increasing awareness and understanding of ethical dilemmas will improve the quality of health services for infants and families in NICU.
Q: What are the recommendations for further research?
A: Further research can use other methods, such as grounded theory and action research, to dig deeper into the ethical dilemma faced by nurses in NICU. The results of this study can be used to develop educational programs and training for nurses in NICU to improve their skills in managing ethical dilemmas.
Q: What are the implications for healthcare institutions?
A: Healthcare institutions can use the findings of this study to develop policies and procedures that address the ethical dilemmas faced by nurses in NICU.
Q: What are the limitations of this study?
A: The limitations of this study include the small sample size and the use of a single research methodology.
Q: What are the future directions for research?
A: Future research can explore the experiences of nurses in other healthcare settings and the impact of policy changes on the ethical dilemmas faced by nurses in NICU.
Q: What are the implications for nursing education and practice?
A: The results of this study can be used to develop educational programs and training for nurses in NICU to improve their skills in managing ethical dilemmas. Nursing education and practice should prioritize the development of nurses' skills in managing ethical dilemmas and advocating for patients' rights.