ETHICAL-LEGAL CHALLENGES IN PATIENT CARE IN THE EMERGENCY DEPARTMENT: NURSES’ PERSPECTIVE

Abstract

Objective: To describe, analyze and discuss the ethical-legal challenges regarding patient care in an emergency department from the nurses’ perspective in a public hospital in Chiclayo, Peru. Material and Method: Qualitative, descriptive research; 12 nurses working in an emergency department participated. The sample was non-probabilistic, determined by the saturation and redundancy technique. Data were collected using a semi-structured interview validated by expert judgment, recorded and then processed for content analysis, after approval by a Research Ethics Committee and prior informed consent. Results: Four categories emerged: a) Ethical conflicts in interpersonal relationships: lack of respect to colleagues and patients, b) Infrastructure that promotes confrontations, lack of human and material resources and privacy protection, c) Facing health and end-of-life problems with possible legal accusations, and d) Need for protocols and ethical-legal support due to work-related consequences. Conclusion: Nurses who work in the emergency department face various problems: infrastructure generates confrontations between colleagues, work team and relatives; there are problems in communication and interpersonal relationships between colleagues and with patients’ relatives, who may insult, physically attack and present accusations. When dealing with critical situations nurses act according to emergency legislation, but they cannot adequately handle protocols and care guidelines and are not fully aware of health-related laws or nursing code of ethics. It is necessary to have better skills for emotional control in the face of work-related stress and encourage authorities to make improvements in infrastructure, resources and personnel.