diplomsko delo
Povzetek
Uvod: Zdravstveni delavci morajo, zavoljo etičnega delovanja, upoštevati bolnikovo življenje v najširšem smislu. Ko govorimo o etiki v poklicu medicinske sestre ne moremo mimo etičnih načel. Poudarek je na holističnem pristopu do pacienta, pri čemer je treba zagotavljati procesno metodo dela v zdravstveni negi. Še posebej velikemu številu etičnih dilem je podvrženo področje pediatrije. Namen: Namen diplomskega dela je predstaviti najpogostejše etične dileme s katerimi se srečujejo medicinske sestre pri zdravstveni negi otrok. Metode dela: V diplomskem delu je bila uporabljena deskriptivna metoda dela s pregledom strokovne literature. Uporabljena je bila literatura v angleškem in slovenskem jeziku. Literatura v angleškem jeziku je bila iskana v podatkovnih bazah PubMed/Medline in Science direct. Področja iskanja literature so bila razdeljena na: etične dileme pri komunikaciji z otrokom, etične dileme pri zagotavljanju avtonomije otroka, etične dileme pri lajšanju bolečine in etične dileme v pediatrični paliativni oskrbi. Slovenska literatura je bila iskana v portalu Google učenjak in v spletnem arhivu Obzornik zdravstvene nege. Kriterij za vključevanje člankov v pregled literature je bila objava med leti 2010 in 2022. Tako je bilo v končni pregled literature vključenih 16 člankov. Rezultati: Mnoge etične dileme se začnejo s komunikacijo med medicinsko sestro in pacientom, v našem primeru otrokom in družino ter ostalim zdravstvenim timom. Glavne značilnosti, ki jih mora vsebovati komunikacija z otrokom, so: potrpežljivost, jasno podajanje navodil, zagotavljanje časa, dodatna pojasnila in uporaba tišine. Otroku je potrebno zagotoviti dovolj časa, da izrazi svoja čustva. Ena izmed pomembnih dilem, do katerih prihaja tudi v slovenskih bolnišnicah, je pomanjkanje prostora za zaupen pogovor s otrokom in bližnjimi. Posebna vrsta etičnih dilem je podajanje informacij v primeru deljenega skrbništva ali v primeru, ko eden izmed staršev ne želi, da drugi prejema informacije. Pri zagotavljanju avtonomije otroka se pojavlja vprašanje, ali se v primeru, da poseg otrok nujno potrebuje, le-ta izvede tudi, če sam v to ne privoli. Fizično omejevanje otrok je pogosto omenjena etična dilema, pri kateri dolžnost, do opravljanja določenega postopka, razumemo kot nasprotovanje, otrokovim željam. Na področju lajšanja bolečine je ključnega pomena pravilna ocena bolečine pri otroku. Etično in moralno je sporno, da medicinska sestra, ki ima na voljo znanje in orodja za lajšanje bolečine, le-tega pri pacientu ne izvede primerno. Najpogosteje prihaja do etičnih dilem pri pediatrični paliativni zdravstveni negi. Dilema nastane, ko medicinska sestra zaradi psihične obremenitve, ne zmore kakovostno opraviti svojega dela. Sprejemanje smrti je vedno težko, še zahtevnejše pa je, ko gre za otroka. Pri paliativni pediatrični oskrbi pogosto prihaja do etične dileme, ko starši želijo, da se zdravljenje nadaljuje, zdravniški tim pa oceni, da je bolj primerna paliativna nega. Za zdravniški tim je zato eden izmed največjih izzivov, da s svojimi ugotovitvami primerno seznanijo družino in dosežejo, da se z dejstvi tudi soočijo. Razprava in zaključek: Ko govorimo o kakovostni zdravstveni negi, ne moremo mimo spoštovanja etičnih načel. Področje zdravstvene nege otroka je še posebej občutljivo področje, česar pa se je potrebno zavedati že tekom izobraževanja medicinskih sester. Izobraževalni proces mora zagotavljati tematike področja pediatrična paliativne oskrbe, razvoja otroka in razvoja njegovih kognitivnih sposobnosti. Pri delu v klinični praksi je ključnega pomena v družino usmerjena zdravstvena nega ter primerna komunikacija, tako znotraj zdravstvenega tima kot tudi z otrokovo družino in otrokom samim.
Ključne besede
diplomska dela;zdravstvena nega;avtonomija;etične dileme;komunikacija;lajšanje bolečine;pediatrična paliativna oskrba;zdravstvena nega otroka;
Podatki
Jezik: |
Slovenski jezik |
Leto izida: |
2023 |
Tipologija: |
2.11 - Diplomsko delo |
Organizacija: |
UL ZF - Zdravstvena fakulteta |
Založnik: |
[L. Kolenc] |
UDK: |
616-083 |
COBISS: |
164464387
|
Št. ogledov: |
7 |
Št. prenosov: |
2 |
Ocena: |
0 (0 glasov) |
Metapodatki: |
|
Ostali podatki
Sekundarni jezik: |
Angleški jezik |
Sekundarni naslov: |
Ethical dilemmas in pediatric nursing |
Sekundarni povzetek: |
Introduction: Ethics in nursing is expressed as a holistic approach to preservation and respect of dignity and integrity of the patient. To act ethically, healthcare professionals must consider the patient's life in the broadest sense. A large number of ethical dilemmas are encountered in the field of pediatrics. Some of these are problems with the child's consent, the child's ability to make decisions about his own treatment, pain management problems, respect for the family and the child, and breaking bad news. Purpose: The aim of the thesis is to present the most common ethical dilemmas that nurses encounter in the care of children. Methods: A descriptive method of work was used in the thesis, with a review of professional literature. Literature was searched in English and Slovenian. Foreign literature in the English language was searched in the databases PubMed/Medline and Science Direct. The areas of the literature search were divided into: communication with the child, child autonomy, pain relief and pediatric palliative care. Slovene literature was searched in the Google Scholar portal and in the online archive of Obzornik zdravstvene nege. The criterion for including articles in the literature review was published between 2010 and 2022, 16 articles were included in the final literature review. Results: All ethical dilemmas begin with communication between the nurse and the patient, in our case the child, family and parents, and the rest of the healthcare team. The main characteristics that must be included in communication with the child are: patience, clear instructions, provision of time, additional explanations, and use of silence. It is necessary to provide the child with enough time to express his feelings. One of the important dilemmas that often arise in Slovenian hospitals is the lack of space for a confidential conversation with the child and relatives. A special type of ethical dilemma that was highlighted by nurses is the provision of information in the case of shared custody or in the case where one of the parents did not want the other to receive the information. The main dilemma that arises when ensuring a child's autonomy is whether we carry out the procedure that the child needs, but does not agree to. Physical restraint of children has often appeared as one of the most controversial topics, as it can be understood as a dilemma in which our duty to carry out a certain procedure conflicts with the child's wishes. In the field of pain relief, the correct assessment of the child's pain is of utmost importance. It is ethically and morally questionable when a nurse, if she has the knowledge and tools to relieve pain, does not perform it properly. Pediatric palliative care is where ethical dilemmas arise most often. There is a dilemma of how can health care workers do their jobs with quality, when they are mentally incapable of doing so. Accepting death is even more challenging when it comes to a child. A dilemma arose again: If the parents want the treatment to continue, but the medical team considers that palliative care is more appropriate, how to bring this closer to the family. Discussion and conclusion: When we talk about quality nursing care, it also includes respect for ethical principles. The field of child health care brings a huge number of ethical dilemmas that can be solved or prevented. Considering this results, it would be necessary to introduce topics such as pediatric palliative care, the development of the child, and its cognitive abilities into the very process of nurse education. In clinical practice, the most important thing is family-oriented nursing, appropriate communication within the medical team, with the child's family and the child himself. |
Sekundarne ključne besede: |
diploma theses;nursing care;autonomy;ethical dilemmas;communication;pain relief;pediatric palliative care;child nursing; |
Vrsta dela (COBISS): |
Diplomsko delo/naloga |
Študijski program: |
0 |
Komentar na gradivo: |
Univ. v Ljubljani, Zdravstvena fak., Oddelek za zdravstveno nego |
Strani: |
35 str. |
ID: |
19933526 |