RESUMO
OBJECTIVE: To reflect about the do-not-resuscitation order at COVID-19 in Brazil, under bioethical focus and medical and nursing professional ethics. METHOD: Reflection study based on the principlist bioethics of Beauchamps and Childress and in professional ethics, problematizing actions, and decisions of non-resuscitation in the pandemic. RESULTS: It is important to consider the patient's clinic, appropriation of treatment goals for people with comorbidities, elderly people, with less chance of surviving to resuscitation, or less quality of life, with the palliative care team, to avoid dysthanasia, use of scarce resources and greater exposure of professionals to contamination. CONCLUSION: COVID-19 increased the vulnerabilities of professionals and patients, impacting professional decisions and conduct more widely than important values ââsuch as the restriction of freedom. It propelled the population in general to rethink ethical and bioethical values ââregarding life and death, interfering in decisions about them, supported by human dignity.
Assuntos
Temas Bioéticos , COVID-19/terapia , Reanimação Cardiopulmonar , Enfermagem de Cuidados Críticos/ética , Atenção à Saúde/ética , Cuidados Paliativos/ética , Ordens quanto à Conduta (Ética Médica)/ética , Adulto , Cuidados Críticos , Tomada de Decisões/ética , Ética Profissional , Feminino , Alocação de Recursos para a Atenção à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Qualidade de Vida , SARS-CoV-2RESUMO
OBJECTIVES: To determine the relationship between ethical climate and burnout in nurses working in Intensive Care Units (ICUs). METHODS: This cross-sectional and multi-center study was conducted among 212 nurses working in adult ICUs of six hospitals affiliated to Shiraz University of Medical Sciences, Iran in 2019. The participants were selected using systematic random sampling technique. Data was collected using valid instruments of Olson's Hospital Ethical Climate Survey (HECS) and Maslach Burnout Inventory (MBI). RESULTS: Ethical climate was favorable (3.5±0.6). The intensity (32.2±12.4) and frequency (25.5±12.4) of burnout were high. Ethical climate had significant and inverse relationships with frequency of burnout (r =-0.23, p=0.001) and with intensity of burnout (r=-0.186, p=0.007). Ethical climate explained 5.9% of burnout. Statistically significant relationships were also found between these factors: age with ethical climate (p=0.001), work shifts with burnout (p=0.02), and gender and with intensity frequency of burnout in ICU nurses (p=0.038). The results of Spearman correlation coefficient showed significant and inverse relationships between ethical climate and job burnout (r=-0.243, p < 0.001). CONCLUSIONS: Nurses in ICUs perceived that ethical climate was favorable however, burnout was high. Therefore, burnout can be affected by many factors and it is necessary to support ICU nurses since they undertake difficult and complicated task. It is recommended to assess factors that increase burnout and adopt specific measures and approaches to relieve nursing burnout.
Assuntos
Esgotamento Profissional/etiologia , Esgotamento Profissional/psicologia , Enfermagem de Cuidados Críticos/ética , Unidades de Terapia Intensiva/ética , Enfermeiras e Enfermeiros/psicologia , Cultura Organizacional , Percepção Social , Adulto , Esgotamento Profissional/diagnóstico , Esgotamento Profissional/epidemiologia , Enfermagem de Cuidados Críticos/organização & administração , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Unidades de Terapia Intensiva/organização & administração , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/organização & administração , Testes Psicológicos , Análise de Regressão , Fatores de RiscoRESUMO
Antecedentes: Colombia es culturalmente diversa y vive procesos de desplazamiento forzado por la violencia siendo uno de los países con mayor desplazamiento interno del mundo. Colombia tiene alta morbilidad y mortalidad por las enfermedades crónicas. Las enfermeras en los hospitales deben cuidar de esas poblaciones de diversos orígenes pero se desconoce si tienen competencia cultural para hacerlo. Objetivo: Describir la competencia cultural expresada por Enfermeras hospitalares, cuando cuidan a pacientes con Enfermedad Crónica. Metodología: Estudio etnográfico interpretativo. Hicieron parte del estudio diez PE con más de un año de trabajo en el Hospital San Antonio con personas adultas con enfermedad crónica en el hospital. Los datos fueron recogidos de la observación participante, grupo focal, seis entrevistas etnográficas y diez narrativas después de 14 meses de trabajo en campo. El análisis de los datos siguieron las fases propuestas por Leininger en un proceso inductivo deductivo. La confirmabilidad, transferibilidad, auditabilidad y credibilidad hicieron parte del rigor metodológico. Todos los aspectos éticos fueron considerados. Resultados: Los hallazgos muestran un tema cultural: Intento por responder al asunto cultural de los pacientes desde mi ética profesional como algo implícito en la práctica de las EH. Así intentan respetar, aprender, ser sensibles y responder a los pacientes de diversos orígenes buscando dignificarlos, este no es un proceso sistemático. Finalmente se concluye que hay un aprendizaje práctico de la experiencia haciendo que no se tenga el conocimiento, ni la habilidad pero si la conciencia de sí, la parte ética las mueve y es ahí donde responden. (AU)
Background: Colombia is culturally diverse and live processes of forced displacement by violence remains one of the countries with the largest internal displacement in the world. Colombia has high morbidity and mortality from chronic diseases. Nurses in hospitals must care for these populations but whether they have the cultural competence. Objective: To describe cultural competence expressed by nurses hospitals when caring for patients with Chronic Disease. Methodology: Interpretive Ethnographic study. They were part of the study ten nurses more than a year of work in the San Antonio Hospital with adults with chronic disease nurses in the hospital. Data were collected from participant observation, focus groups, and ethnographic interviews with six nurses and ten plots after 14 months of field work. The data analysis followed the steps proposed in an inductive process Leininger - deductive. Confirmability, transferability, auditability and credibility are considered as part of the methodological rigor. All ethical issues were considered. Results: The findings show a cultural issue: I try to respond to the cultural issue of patients from my professional ethics as something implicit in the practice of nurses. So nurses try to respect, learn, be sensitive and respond to patients from diverse backgrounds seeking dignify this is not a systematic process. Finally it is concluded that there is a practical learning experience making knowledge is known, but not the ability of self-consciousness, the ethical part the moves and that is where they respond. (AU)