Ethical dilemmas in prehospital emergency care – from the perspective of specialist ambulance nurse students

Abstract

The aim of this study was to describe specialist ambulance nurse students' experiences of ethical conflicts and dilemmas in prehospital emergency care. In the autumn of 2015, after participating in a mandatory lecture on ethics, 24 specialist ambulance nurse (SAN) students reported experiences and interpretations concerning conflicts and ethical dilemmas from prehospital emergency care. The text consisted of 24 written critical incidents which were interpreted using hermeneutic text interpretation. The text revealed three themes: Not safeguarding a patient's body and identity; Not agreeing on the care actions; and Not treating the patient with dignity. The SANs experiences ethical dilemmas and conflict of values when they witness how others violate a patient's dignity. Discussion and reflection is based on ethical conflicts and dilemmas experienced when students see how caregivers do not safeguard the patient's body or identity. When caregivers have a conflicting will, it results in patients not being treated in an ethical manner. Also, seeing how caregivers put themselves in a power position over patients is described as an ethical dilemma that students experience when they choose not to intervene.

Family Presence and Audience Effects on Cardiopulmonary Resuscitation: Perceptions of Pre-hospital Emergency Caregivers in Turkey

“…Pre-hospital emergency care is mostly different from hospital-based care. Because the proceeding here is generally acute and the decision-making process in this practice is generally both critical and has a complex nature[6]. CPR is one of the most combined processes in this field, as it includes medical, social, cultural and ethical issues.…”

“…Education is an important key for the attitude change. When CPR providers are presented with FPDR education, their opinion-based beliefs may be modified to lower their guard against the issue, and to improve overall support of FPDR[6,76]. Therefore, education and professional experience can be defined as factors that could change the PECs’ attitudes toward FPDR in this regard.…”

Adopting a ‘System of Caring' as a leadership strategy toward professionalisation within South African emergency medical services: A grounded theory

“…What is less clear is the connection between trust, expectations and the experience of ‘being cared for’ as an antecedent for professionalization from the point of view of the EMS workforce member. Considering available literature, the realisation that the South African EMS workforce seek out and desire an experience of caring in the work system is not unique to the findings of this research, with various international studies demonstrating that an ethos of caring is fundamental to effective EMS systems [2 , 14 , 37] . What has been lacking in the research is a means to actually operationalise an ethos of caring into an EMS work system, which the authors have attempted to address through the ‘System of Caring’.…”

Family Presence and the Press Effects on Prehospital Cardiopulmonary Resuscitation: Attitudes of a Group of Emergency Caregivers

“…Of course, education is surely an important key to attitude change. When CPR providers are presented with FPDR education, their opinion-based beliefs may be modified to lower their guard against the issue and to improve overall support of FPDR (Abelsson and Lindwall 2018;Feagan and Fisher 2011). Therefore, education and professional experience can be defined as the factors that could change the PECs' attitudes toward FPDR in this regard.…”

“…Prehospital emergency caregivers (PECs) are confronted with a number of ethical considerations when they are on their way to treat a person who suffers an out-of-hospital cardiac arrest with CPR (Ågård et al 2012;Brenner et al 2018). One of the conflicts in the prehospital setting is family-witnessed CPR called family presence during CPR (FPDR) (Abelsson and Lindwall 2018;Erbay 2014;Karlsson, Karlsson, and Hilli 2019;Torabi et al 2019).…”