Ethical problems experienced by nurses in mobile pre-hospital care
DOI:
https://doi.org/10.35699/2316-9389.2025.41921Keywords:
Nurses, Bioethics, Ethics, Nursing Ethics, Emergency Care, Emergency Nursing, Emergency Medical ServicesAbstract
Objective: to describe the ethical problems experienced by nurses in mobile prehospital care. Method: descriptive research with a qualitative approach, carried out with 19 nurses working in mobile emergency services in the five regions of Brazil. Data collection took place in November and December 2021, through an online collection form using the Google Forms tool. To analyze the data obtained, Bardin's thematic content analysis was used. Results: the emerging ethical problems were grouped into three thematic categories: ethical conflicts between professionals, users, and families; ethical conflicts between teams in the emergency care network; and ethical conflicts arising from the organizational structure. Conclusion: it was identified that nurses experience ethical problems when working in the street setting. Aware that moral uncertainties impact the quality of care, this study supports the need to expand discussions on the ethical issues that emerge in emergency services.
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1. Oliveira SS, Lima AB, Santa-Rosa DO, Freitas GF, Ferraz MOA. Experiences of the moral deliberation of nurses in mobile pre-hospital care. Rev Baiana Enferm [Internet]. 2020[citado em 2022 out. 20];35:1-9. Disponível em: https://doi.org/10.18471/rbe.v35.38733
2. Andrade TF, Silva MMJ. Características dos enfermeiros no atendimento pré-hospitalar: concepções sobre a formação e exercício professional. Enferm Foco [Internet]. 2019[citado em 2022 out. 18];10(1):81-6. Disponível em: https://doi.org/10.21675/2357-707X.2019.v10.n1.1444
3. Pizzolato AC, Sarquis LMM, Silva MJP, Mantovani MF. Empirical indicators of human needs affected in mobile prehospital care: a methodological research. Online Braz J Nurs [Internet]. 2018[citado em 2022 out. 19];17(1):18-27. Disponível em: https://doi.org/10.17665/1676-4285.20185640
4. Carvalho AEL, Frazão IS, Silva DMR, Andrade MS, Vasconcelos SC, Aquino JM. Stress of nursing professionals working in pre-hospital care. Rev Bras Enferm [Internet]. 2020[citado em 2022 out. 19];73(2):e20180660. Disponível em: http://dx.doi.org/10.1590/0034-7167-2018-0660
5. Gracia D. La alianza deliberativa. Bioética Complutense [Internet]. 2011 [citado em 2022 out. 18];9:4-6. Disponível em: https://www.ucm.es/data/cont/docs/137-2016-02-18-Bolet%C3%ADn%209.pdf
6. Torabi M, Borhani F, Abbaszadeh A, Atashzadeh-Shoorideh F. Experiences of pre-hospital emergency medical personnel in ethical decision-making: a qualitative study. BMC Med Ethics [Internet]. 2018[citado em 2022 out. 20];19:95. Disponível em: https://doi.org/10.1186/s12910-018-0334-x
7. Bremer A, Holmberg M. Ethical conflicts in patient relationships: Experiences of ambulance nursing students. Nurs Ethics [Internet]. 2020[citado em 2022 out. 19];27(4):946-59. Disponível em: https://doi.org/10.1177/0969733020911077
8. Silva JG, Chavaglia SRR, Ruiz MT, Cunha MCB, Nascimento KG, Amaral SEM. Obstetric occurrences treated by the mobile emergency care service. Rev Enferm UFPE [Internet]. 2018[citado em 2022 out. 20];12(12):3158-64. Disponível em: https://doi.org/10.5205/1981-8963-v12i12a237918p3158-3164-2018
9. Pereira LC, Rosa PH, Zamberlan C, Machado KFC, Ilha S. Nurse’s activities in the pre-hospital care services: potentialities, fragilities and perspectives. RSD Res Soc Dev [Internet]. 2020[citado em 2022 out. 21];9(4):e119942926. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/2926
10. Araújo FDP, Brito OD, Lima MMS, Galindo Neto NM, Caetano JA, Barros LM. Assessment of the quality of life of prehospital care nursing professionals. Rev Bras Med Trab [Internet]. 2018[citado em 2022 out. 18];16(3):312-7. Disponível em: https://doi.org/10.5327/Z1679443520180293
11. Fontanella BJB, Ricas J, Turato ER. Amostragem por saturação em pesquisas qualitativas em saúde: contribuições teóricas. Cad Saúde Pública [Internet]. 2008[citado em 2022 out. 18];24(1):17-27. Disponível em: https://www.scielosp.org/article/csp/2008.v24n1/17-27/.
12. Bardin L. Análise de conteúdo. São Paulo: Edições 70; 2016.
13. Ministério da Saúde (BR). Resolução nº 466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União [Internet], Brasília, 13 jun. 2013[citado em 2022 out. 22]. Disponível em: https://conselho.saude.gov.br/resolucoes/2012/Reso466.pdf
14. Ministério da Saúde (BR). Ofício Circular nº 2/2021/CONEP/SECNS/MS. 2021[citado em 2022 out. 18]. Disponível em: http://conselho.saude.gov.br/images/Oficio_Circular_2_24fev2021.pdf
15. Godoi AMM, Garrafa V. Bioethics reading of the principle of non-discrimination and non-stigmatization. Saúde Soc [Internet]. 2014[citado em 2022 out. 13];23(1):157-66. Disponível em: https://doi.org/10.1590/S0104-12902014000100012
16. International Council of Nurses. Código de Ética do CIE para Enfermeiras(Os)¹. Revisado em 2012. Geneva: International Council of Nurses; 2012[citado em 2022 out. 13]. Tradução para o português realizada por Telma Ribeiro Garcia (PPGENF-UFPB ICN Accredited ICNP® Centre), com revisão de Maria Amélia de Campos Oliveira (EEUSP). Reproduzido com autorização do Conselho Internacional de Enfermeiras(os) – CIE. Disponível em: http://sobende.org.br/pdf/Codigo%20de%20Etica%20do%20CIE%20-%20revisado%20em%202012.pdf
17. Zoboli E. Tomada de decisão em bioética clínica: casuística e deliberação moral. Rev Bioét [Internet]. 2013[citado em 2022 out. 10];21(3):389-96. Disponível em: https://doi.org/10.1590/S1983-80422013000300002
18. Mata KSS, Ribeiro ÍAP, Pereira PSL, Nascimento MVF, Carvalho GCN, Macedo JB, et al. Obstacles in SAMU pre-hospital care: nurses' perception. Rev Enferm UFPE On Line [Internet]. 2018[citado em 2022 out. 20];12(8):2137-45. Disponível em: https://doi.org/10.5205/1981-8963-v12i8a236537p2137-2145-2018
19. Sanches MA, Cunha TR, Siqueira SS, Siqueira JE. Bioethical perspectives on decision-making in times of pandemic. Rev Bioét [Internet]. 2020[citado em 2022 out. 23];28(3):410-7. Disponível em: http://dx.doi.org/10.1590/1983-80422020283401
20. Ribeiro SCC, Ferreira GI, Sallas J, Novaes MRCG, Guilhem DB. Ethical-professional decision – making in exceptional situations given the Covid-19 pandemic: a scoping review. Online Braz J Nurs (Online) [Internet]. 2022 [citado em 2022 out. 20];21(Suppl.2):e20226557. Disponível em: https://doi.org/10.17665/1676-4285.20226557
21. Nogueira JWS, Rodrigues MCS. Effective communication in teamwork in health: a challenge for patient safety*. Cogitare Enferm [Internet]. 2015[citado em 2022 out. 20];20(3):630-4. Disponível em: http://dx.doi.org/10.5380/ce.v20i3.40016
22. Oliveira SS, Pitzer CMT, Ferraz MOA, Lírio LKS, Santa Rosa DOS, Freitas KS, Souza EO. Ethical problems in the clinical practice of mobile pre-hospital care nurses: a scoping review. Online Braz J Nurs [Internet]. 2023. [citado em 2023 ago. 23];21:e20226644. Disponível em: https://doi.org/10.17665/1676-4285.20236650
23. Taveira RPC, Silva JLL, Souza RD, Rego VTSM, Lima VF, Soares RS. Nurse's role in emergency pre-hospital care. Glob Acad Nurs J [Internet]. 2021[citado em 2022 out. 18];2(3):e156. Disponível em: https://dx.doi.org/10.5935/2675-5602.20200156
24. Miorin JD, Dal Pai D, Ciconet RM, Lima MADS, Gerhardt LM, Indruczaki NS. Transfer of pre-hospital care and its potential risks for patient safety. Texto & Contexto Enferm [Internet]. 2020[citado em 2022 out. 20];29:e20190073. Disponível em: https://doi.org/10.1590/1980-265X-TCE-2019-0073
25. Ministério da Saúde (BR). HumanizaSUS: Documento base para gestores e trabalhadores do SUS. Brasília: Ministério da Saúde; 2010[citado em 2022 out. 13]. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/humanizasus_documento_gestores_trabalhadores_sus.pdf
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