| Learning Objective #1: Identify the relationships among the professional self, being connected to patients, and caught in the middle of ethical dilemmas | |||
| Learning Objective #2: Identify four ways to enhance the ethical teaching of student and practicing nurses |
Four distinct but interconnected themes were derived. The primary theme “caught in the middle” represented a sense of being “trapped” between others in the caring relationship. It resulted from a violation of one or both of two other themes: the “sense of professional self” and the connection to the patient. The final theme addressed the consequences of this dilemma. The sense of feeling “caught in the middle” was provoked by an event in the trajectory of care for the patient. Although the specific situation differed, the event itself represented an ethical dilemma for the nurse when either the perceived connection to the patient/family or “sense of professional self” or both would be violated by acting. This violation of connection or of professional self resulted in feelings of powerlessness, anger, frustration, and fear of getting into trouble.
Many participants felt strongly about the situation, identifying significant personal and professional consequences. Most, however, indicated that the ethical dilemma contributed to their growth as individuals and nurses.
Few participants indicated they had any formal exposure to ethics in their basic nursing preparation and none who did believed the preparation was adequate. Participants indicated that they were unsure of what an ethical dilemma was. They undervalued their roles in the situation and expressed feelings of powerlessness, frustration and inadequacy as patient advocates. Results of this study have implications for nurse educators in pre-licensure and graduate programs as well as for clinical nurse specialists and others involved in continuing education for staff nurses.