Value conflicts in perioperative practice

2018 ◽  
Vol 26 (7-8) ◽  
pp. 2213-2224 ◽  
Author(s):  
Ann-Catrin Blomberg ◽  
Birgitta Bisholt ◽  
Lillemor Lindwall
Keyword(s):  
Patient Care ◽  
Ethics Committee ◽  
Operating Theatre ◽  
Nursing Process ◽  
Surgical Team ◽  
Value Conflicts ◽  
Text Interpretation ◽  
Perioperative Nursing ◽  
Ethical Conflicts ◽  
The Will

Background: The foundation of all nursing practice is respect for human rights, ethical value and human dignity. In perioperative practice, challenging situations appear quickly and operating theatre nurses must be able to make different ethical judgements. Sometimes they must choose against their own professional principles, and this creates ethical conflicts in themselves. Objectives: This study describes operating theatre nurses’ experiences of ethical value conflicts in perioperative practice. Research design: Qualitative design, narratives from 15 operating theatre nurses and hermeneutic text interpretation. Ethical consideration: The study followed ethical principles in accordance with the Helsinki Declaration and approval was granted by the local university ethics committee. Findings: The result showed that value conflicts arose in perioperative practice when operating theatre nurses were prevented from being present in the perioperative nursing process, because of current habits in perioperative practice. The patient’s care became uncaring when health professionals did not see and listen to each other and when collaboration in the surgical team was not available for the patient’s best. This occurred when operating theatre nurses’ competence was not taken seriously and was ignored in patient care. Conclusion: Value conflicts arose when operating theatre nurses experienced that continuity of patient care was lacking. They experienced compassion with the patient but still had the will and ability to be there and take responsibility for the patient. This led to feelings of despair, powerlessness and of having a bad conscience which could lead to dissatisfaction, and even resignations.

Fire in operating theatres: DaSH-ing to the rescue

2018 ◽  
Vol 28 (7-8) ◽  
pp. 188-193
Author(s):  
Liam Wilson ◽  
Omer Farooq
Keyword(s):  
Patient Care ◽  
Fire Safety ◽  
Training Session ◽  
Operating Theatre ◽  
In Situ Simulation ◽  
Safe Patient Care ◽  
Team Interactions ◽  
Operating Theatres ◽  
Theatre Staff ◽  
Safety Officer

Operating theatres are dynamic environments that require multi professional team interactions. Effective team working is essential for efficient delivery of safe patient care. A fire in the operating theatre is a rare but potentially life threatening event for both patients and staff. A rapid and cohesive response from theatre and allied staff including porters, fire safety officer etc is paramount. We delivered a training session that utilised in situ simulation (simulation in workplace). After conducting needs analysis, learning objectives were agreed. After thorough planning, the date and location of the training session were identified. Contingency plans were put in place to ensure that patient care was not compromised at any point. To ensure success, checklists for faculty were devised and adhered to. A medium fidelity manikin with live monitoring was used. The first part of the scenario involved management of a surgical emergency by theatre staff. The second part involved management of a fire in the operating theatre while an emergency procedure was being undertaken. To achieve maximum learning potential, debriefing was provided immediately after each part of the scenario. A fire safety officer was present as a content expert. Latent errors (hidden errors in the workplace, staff knowledge etc) were identified. Malfunctioning of theatre floor windows and staff unawareness about the location of an evacuation site were some of the identified latent errors. Thorough feedback to address these issues was provided to the participants on the day. A detailed report of the training session was given to the relevant departments. This resulted in the equipment faults being rectified. The training session was a very positive experience and helped not only in improving participants’ knowledge, behaviour and confidence but also it made system and environment better equipped.

scholarly journals Results of the Nursing Outcomes Classification/NOC for patients with obsessive-compulsive disorder

2020 ◽  
Vol 73 (1) ◽  
Author(s):  
Ananda Ughini Bertoldo Pires ◽  
Amália de Fátima Lucena ◽  
Andressa Behenck ◽  
Elizeth Heldt
Keyword(s):  
Mental Health ◽  
Obsessive Compulsive Disorder ◽  
Behavioral Therapy ◽  
Ethics Committee ◽  
Nursing Process ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Nursing Outcomes ◽  
Nursing Outcomes Classification

ABSTRACT Objective: To analyze the application of nursing outcomes and indicators selected from the Nursing Outcomes Classification (NOC) to evaluate patients with obsessive-compulsive disorder (OCD) in outpatient follow-up. Method: Outcome-based research. First, a consensus was achieved between nurses specialized in mental health (MH) and in the nursing process to select NOC-related outcomes and indicators, followed by the elaboration of their conceptual and operational definitions. Then, an instrument was created with these, which was tested in a pilot group of six patients treated at a MH outpatient clinic. The instrument was applied to patients with OCD undergoing Group Cognitive Behavioral Therapy (GCBT). The study was approved by the Research Ethics Committee of the institution. Results: Four NOC outcomes and 17 indicators were selected. There was a significant change in the scores of nine indicators after CBGT. Conclusion: The study showed feasibility for evaluating symptoms of patients with OCD through NOC outcomes and indicators in an outpatient situation.

Preoperative Assessment and Intraoperative Care Planning

2006 ◽  
Vol 16 (4) ◽  
pp. 187-194 ◽  
Author(s):  
Ciarán Hurley ◽  
Janet McAleavy
Keyword(s):  
Patient Care ◽  
Preoperative Assessment ◽  
Surgical Patients ◽  
Care Planning ◽  
Nursing Process ◽  
Nursing Assessment ◽  
Intraoperative Care ◽  
Assessment Strategy ◽  
Research Interviews

We interviewed ten theatre nurses about their contribution to patient care. Their assessment strategy usually involved meeting patients on arrival in the department and did not include accessing the Trust's preoperative assessment document. In this paper we discuss the nursing assessment of surgical patients in the context of the nursing process as it was described in our research interviews.

scholarly journals Operating theatre nurses’ self‐reported clinical competence in perioperative nursing: A mixed method study

Nursing Open ◽  
2019 ◽  
Vol 6 (4) ◽  
pp. 1510-1518 ◽  
Author(s):  
Ann‐Catrin Blomberg ◽  
Lillemor Lindwall ◽  
Birgitta Bisholt
Keyword(s):  
Mixed Method ◽  
Clinical Competence ◽  
Operating Theatre ◽  
Mixed Method Study ◽  
Perioperative Nursing

Assessing Human Factors in the Operating Theatre: Differences in Perceptions within the Surgical Team

2019 ◽  
Vol 229 (4) ◽  
pp. S235-S236
Author(s):  
Anne Sophie van Dalen ◽  
Mitchell Goldenberg ◽  
Teodor P. Grantcharov ◽  
Marlies P. Schijven
Keyword(s):  
Human Factors ◽  
Operating Theatre ◽  
Surgical Team

The Advantages of Moral Diversity

1992 ◽  
Vol 9 (2) ◽  
pp. 38-62 ◽  
Author(s):  
Amélie Oksenberg Rorty
Keyword(s):  
Private Life ◽  
Public And Private ◽  
Political Consequences ◽  
Moral Diversity ◽  
Conflict And Cooperation ◽  
Ethical Orientations ◽  
Ethical Conflicts ◽  
The Will ◽  
State Of Affairs ◽  
Political Principles

We are well served, both practically and morally, by ethical diversity, by living in a community whose members have values and priorities that are, at a habit-forming, action-guiding level, often different from our own. Of course, unchecked ethical diversity can lead to disaster, to chaos and conflict. We attempt to avoid or mitigate such conflict by articulating general moral and political principles, and developing the virtues of acting on those principles. But as far as leading a good life — the life that best suits what is best in us — goes, it is not essential that we agree on the interpretations of those common principles, or that we are committed to them, by some general act of the will. What matters is that they form our habits and institutions, so that we succeed in cooperating practically, to promote the state of affairs that realizes what we each prize. People of different ethical orientations can — and need to — cooperate fruitfully in practical life while having different interpretations and justifications of general moral or procedural principles. Indeed, at least some principles are best left ambiguous, and some crucial moral and ethical conflicts are best understood, and best arbitrated, as failures of practical cooperation rather than as disagreements about the truth of certain general propositions or theories.This way of construing ethical conflict and cooperation carries political consequences. It appears to make the task of resolving ethical conflicts more modest and, perhaps, easier to accomplish. But it raises formidable problems about how to design the range of educative institutions that bridge public and private life.

scholarly journals Perioperative nursing: maintaining momentum and staying safe

2018 ◽  
Vol 23 (8) ◽  
pp. 727-739 ◽  
Author(s):  
Jon R McGarry ◽  
Catherine Pope ◽  
Sue M Green
Keyword(s):  
Clinical Practice ◽  
Thematic Analysis ◽  
Healthcare Services ◽  
Operating Theatre ◽  
Core Component ◽  
Perioperative Nurses ◽  
Perioperative Nursing ◽  
Ethnographic Observation

Background: Perioperative practice underpins one of the key activities of many healthcare services, but the work of perioperative nurses is little known. A better understanding of their work is important to enable articulation of their contribution to clinical practice. Aim: This study observed the practice of perioperative nurses and explored how they described their role. Methods: Using ethnographic observation and interview, 85 hours’ observation of 11 nurses were undertaken, and 8 nurses were interviewed. Results: Thematic analysis was undertaken enabling themes to emerge with two being identified. The first, ‘maintaining momentum’, described the need to keep people and equipment moving. The second, ‘accounting for safety’, referred to the need to keep the patient safe during this dangerous period. Tension between these two phenomena was apparent. Conclusions: Perioperative nurses describe one of their key roles as maintaining the momentum of the patient’s journey through the operating theatre, but having to balance this with the need to ensure the patient’s safety. A core component of the perioperative nurse’s work is thus management of the tension between these two elements. This study illuminated how these nurses understand their practice.

Attempting to Rationalise the Perioperative Nursing Role

2001 ◽  
Vol 2 (3-4) ◽  
pp. 9-13
Author(s):  
Cina Behar-Spicer
Keyword(s):  
Patient Care ◽  
Nursing Role ◽  
Perioperative Nursing ◽  
Operating Theatres

Nursing and the role of the nurse have always been difficult to define (Nightingale 1986). This is especially true in operating theatres where task focused care often takes precedence over holistic patient care (Conway 1995). There is no shortage of literature suggesting that theatre nurses are preoccupied in preparation of instrumentation (Conway 1995, Holmes 1994) and if a non-nurse were to observe staff in some operating theatres it may be difficult to see where the nursing exists.

scholarly journals Physicians’ and nurses’ expectations and objections toward a clinical ethics committee

2013 ◽  
Vol 20 (7) ◽  
pp. 771-783 ◽  
Author(s):  
Maximiliane Jansky ◽  
Gabriella Marx ◽  
Friedemann Nauck ◽  
Bernd Alt-Epping
Keyword(s):  
Clinical Ethics ◽  
Ethical Issues ◽  
Ethics Consultation ◽  
Ethics Committees ◽  
Ethics Committee ◽  
University Hospital ◽  
Sufficient Information ◽  
Interprofessional Communication ◽  
Clinical Ethics Committee ◽  
Ethical Conflicts

The study aimed to explore the subjective need of healthcare professionals for ethics consultation, their experience with ethical conflicts, and expectations and objections toward a Clinical Ethics Committee. Staff at a university hospital took part in a survey (January to June 2010) using a questionnaire with open and closed questions. Descriptive data for physicians and nurses (response rate = 13.5%, n = 101) are presented. Physicians and nurses reported similar high frequencies of ethical conflicts but rated the relevance of ethical issues differently. Nurses stated ethical issues as less important to physicians than to themselves. Ethical conflicts were mostly discussed with staff from one’s own profession. Respondents predominantly expected the Clinical Ethics Committee to provide competent support. Mostly, nurses feared it might have no influence on clinical practice. Findings suggest that experiences of ethical conflicts might reflect interprofessional communication patterns. Expectations and objections against Clinical Ethics Committees were multifaceted, and should be overcome by providing sufficient information. The Clinical Ethics Committee needs to take different perspectives of professions into account.

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