Sociodemographic Factors Influencing the Experience of Ethical Dilemmas Among Nurses in Critical Care Unit of Kenyatta National Hospital
American Journal of Nursing Science
Volume 6, Issue 2, April 2017, Pages: 113-124
Received: Nov. 22, 2016;
Accepted: Jan. 9, 2017;
Published: Feb. 24, 2017
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Jostine Ndunge Mutinda, School of Nursing, University of Embu, Embu Town, Kenya
Miriam Wagoro, School of Nursing, University of Nairobi, Nairobi City, Kenya
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Ethical issues have emerged in the recent years as a major component of health care for the critically ill patients, who are vulnerable and totally depend on nurse working in the critical care unit. The perception and magnitude of ethical dilemmas faced by nurses working in critical care unit of Kenyatta National Hospital (KNH) as well as the socio-demographic factors influencing this experience had not been determined. This exploratory survey was conducted on 123 nurses working in three critical care areas of the Kenyatta National Hospital. The research aimed to identify the ethical dilemmas by nurses working in Critical Care Units of the Kenyatta National Hospital in their everyday practice and the socio-demographic factors influencing the experience. Personnel records showed the nurses had varying socio-demographic characteristics which were found to influence the experience of dilemmas. Data were collected using questionnaires which were distributed to the123 nurses working in the critical care areas. The participants were selected using stratified random sampling method. Data was cleaned and analyzed using SPSS. Chi square test was used to assess the relationship between variables. The following were identified as the emerging ethical issues: end-of-life decisions (prolonging the dying process, withholding treatment, DNR orders and patients’ religious values), Patient care issues (unsafe nurse-patient ratios, allocation of scarce medical resources, breaches of patients’ privacy, ignoring patients’ autonomy, dealing with incompetent colleagues, discriminatory treatment of patients, patient/ relatives uninformed about the patient’s prognosis) and human rights issues (advance directives, informed consent, rights of pediatric patients and nursing of critically ill patients posing a risk to nurses). Various factors have been attributed to influencing the way one perceives ethical dilemmas. These include knowledge, age and gender among others. The study focused on the socio-demographic factors that significantly affected the experience of ethical dilemmas which included: age, professional qualification and level of knowledge of ethical issues. In conclusion this study shows that ethical dilemmas are an issue of concern among the nurses working in the critical care units of the KNH. The experience of ethical dilemmas is influenced by various socio-demographic factors.
Ethical Dilemmas, Critical Care Areas, Critical Care Nursing, Socio-demographic Factors
To cite this article
Jostine Ndunge Mutinda,
Sociodemographic Factors Influencing the Experience of Ethical Dilemmas Among Nurses in Critical Care Unit of Kenyatta National Hospital, American Journal of Nursing Science.
Vol. 6, No. 2,
2017, pp. 113-124.
Copyright © 2017 Authors retain the copyright of this article.
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Oerleman A. JM (2015). Ethical problems in intensive care unit admission and discharge decisions: a qualitative study among physicians and nurses in the Netherlands. doi: 10.1186/s12910-015-0001-4. PMCID: PMC4344998.
Whitlock EP et al. Behavioral Counseling Interventions: An Evidence-based Approach. Am J. Prev Med 2002; 22 (4): 267-84. 2014.
Sin Ho Jung (2014). Biom J. (2014). Stratified Fisher's Exact Test and its Sample Size Calculation. 10.1002/bimj.201300048.
Oerlemans et al. (2015). BMC Med Ethics. 2015; 16: 9. Case Development on Nurses' Ethical Dilemmas with Physicians' and Nurses' Decision Making. doi: 10.1186/s12910-015-0001-4.
Ethical decision making Net CE 2014. www.decisionlens.com.
Gerald P. K. and Patricia K. (2015). Ethical Risks, Making Decisions, and Taking Action.
Lin Jie (2015). International Journal of Nursing Sciences. The patient suicide attempt–An ethical dilemma case study. Volume 2, Issue 4, December 2015, Pages 408–413 http://dx.doi.org/10.1016/j.ijnss.2015.01.013.
John Santilli J. and Vogenberg R. (2015). Am Health Drug Benefits. Key Strategic Trends that Impact Healthcare Decision-Making and Stakeholder Roles in the New Marketplace 2015 Feb; 8 (1): 15–20.
Biddison LD et al. (2014). Ethical considerations: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement. doi: 10.1378/chest.14-0742.
Anderson A. (2014). Journal of caring sciences. Factors Affecting the Nurse-Patients’ Family Communication in Intensive Care Unit of Kerman: a Qualitative study. doi: 10.5681/jcs.2014.008.
Dong Won Park et al. (2015). Ethical Issues Recognized by Critical Care Nurses in the Intensive Care Units of a Tertiary Hospital. Journal of Korean Medical Science. Apr; 2014, 30 (4): 495–501. Published online 2015 Mar 19. doi 10.3346/jkms.2015. 30.4.495.
Julie Bird (2016). Fierce healthcare. 10 emerging health care standards in 2016.
Sue Stewart (2013). Should a Nursing Professional Report the Co-worker's Mistake?
Kimberly C. (2015). Ethical Dilemmas in the Intensive Care Unit Treating Pain and Symptoms in Noncommunicative Patients at End of Life. Journal of Hospice and Palliative Nursing.
Rose-Lima V et al. (2015). Conflicts between healthcare professionals and families of a multi-ethnic patient population during critical care: an ethnographic study. Crit Care. 2015; 19: 441. doi: 10.1186/s13054-015-1158-4.
Nursing Council of Kenya (2012). Kenya national workforce and training analysis data, Nairobi, Kenya.