Ethical Dilemmas Experienced by Nurses Working in Critical Care Units in Kenyatta National Hospital

Abstract

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 experienced by nurses working in Critical Care Units of the Kenyatta National Hospital in their everyday practice. It also aimed to explore what actions the nurses take to deal with the issues and what factors influence the decisions. 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 123 nurses working in the critical care areas. The participants were selected using stratified random sampling method. The qualitative content analysis identified the following 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). In resolving the dilemmas most of the participants indicated that they would report the issues to the physician. The socio- demographic factors that significantly affected the experience of ethical dilemmas included: age, professional qualification and level of knowledge of ethical issues.

The findings can be utilized as literature for further research on ethical issues.