CE: An Evidence-Based Update on Contraception.
Am J Nurs. 2020 Feb;120(2):22-33
Authors: Britton LE, Alspaugh A, Greene MZ, McLemore MR
Contraception is widely used in the United States, and nurses in all settings may encounter patients who are using or want to use contraceptives. Nurses may be called on to anticipate how family planning intersects with other health care services and provide patients with information based on the most current evidence. This article describes key characteristics of nonpermanent contraceptive methods, including mechanism of action, correct use, failure rates with perfect and typical use, contraindications, benefits, side effects, discontinuation procedures, and innovations in the field. We also discuss how contraceptive care is related to nursing ethics and health inequities.
PMID: 31977414 [PubMed - in process]
Nurses' experiences of working under time pressure in care for older persons.
Nurs Ethics. 2020 Jan 24;:969733019895797
Authors: Dierckx de Casterlé B, Mertens E, Steenacker J, Denier Y
BACKGROUND: The international health workforce crisis had led to an increasing shortage of nurses, which has substantial implications for the quality of patient care. This shortage potentially results in nurse-perceived time pressure, which can be particularly challenging for nurses who provide care for older persons.
OBJECTIVE: This study aimed to show how geriatric nurses experience working under time pressure, perceive its impact on care and deal with time pressure in daily care.
RESEARCH DESIGN: A qualitative descriptive interview design was used.
PARTICIPANTS AND RESEARCH CONTEXT: Purposive sampling led to the inclusion of 11 nurses from three geriatric nursing wards in two general hospitals in Flanders (Belgium). Data were collected using semi-structured in-depth interviews and analysed using the QUAGOL (Qualitative Analysis Guide of Leuven).
ETHICAL CONSIDERATIONS: The study protocol was approved by the Ethics Committee of the University Hospitals Leuven (Ethics committee of the University Hospitals Leuven).
FINDINGS: In all interviews, time pressure was described as ubiquitous in the daily care of older persons. A sense of failure in providing care was the common thread in many interviews. Nurses felt compelled to 'reduce' good-quality care to basic care by focusing on the physical and visible aspects of care. Nevertheless, personal experiences with time pressure and strategies to cope with it differed among the interviewees. These variations were related to the working environment and the nurses themselves. They underscored the importance of nurses' perspectives for a good understanding of the phenomenon of time pressure.
DISCUSSION AND CONCLUSION: Working under time pressure in the care of older persons leads to various important challenges for nursing ethics. The findings show that providing care that promotes the human dignity of older persons in busy working environments in which care is rationed is an important ethical challenge. As such, our study offers a baseline for further research and discussion on how to support nurses working under time pressure.
PMID: 31975637 [PubMed - as supplied by publisher]
Legal framework versus moral framework: military physicians and nurses coping with practical and ethical dilemmas.
J R Army Med Corps. 2019 Aug;165(4):279-281
Authors: Hooft FB
Within military operations, military physicians and nurses experience a dual loyalty to their professional identities. The moral frameworks of the medical and military professions are not similar, and require different kinds of choices and action from its members. But above all, the legal framework in which the healthcare personnel has to operate while deployed is different from the medical moral standards. Military necessity is prioritised over medical necessity. In debates on dual loyalty, legal frameworks should be considered as a more decisive factor in ethical decision-making processes. Legal frameworks, both general and mission-specific, support this prioritisation of military necessity, complicating the work of military physicians and nurses. During the post-Cold War era, in which neutrality and moral supremacy have served as legitimising factors for military peacekeeping or humanitarian missions, this misalignment between the moral and the legal framework is problematic. What is legally correct or justifiable may not be morally acceptable to either the medical professional standards or to the general public. The legal framework should be given more prominence within the debates on dual loyalty and military medical ethics. This paper argues that the misalignment between the legal and moral framework in which deployed healthcare personnel has had to operate complicated ethical decision-making processes, impeded their agency, and created problems ranging from military operational issues to personal trauma and moral injury for the people involved, and ultimately decreasing the legitimacy of the armed forces within society.
PMID: 30904832 [PubMed - indexed for MEDLINE]