title: Solving ethically difficult care situations in nursing homes.
abstract: Patients in nursing homes sometimes give accounts of episodes in which they feel their autonomy and/or self-respect are violated as a result of the care they receive from nursing staff. In these ethically difficult care situations nurses use strategies such as negotiation, explanation and, in some cases, restraint. This study investigates how nurses apply these strategies to resolve ethical dilemmas in such a way that patients experience respect rather than violation. Critical issues that will be discussed include the definition of ethically difficult care situations in nursing homes and the identification of strategies for resolving such situations. Examples of the use of three strategies are presented. The use of negotiation, restraint and explanation are discussed in order to ensure respect for patients' autonomy and thus to optimize health care outcomes.
authors.affiliation: Oslo University College, Faculty of Nursing, Box 4, St Olavs plass, N-0130 Oslo, Norway. Aashild.Slettebo@su.hio.no
authors.forename: Ashild
authors.initials: A
authors.lastname: Slettebø
authors.forename: Eli Haugen
authors.initials: EH
authors.lastname: Bunch
mesh_terms: D000739:Anecdotes as Topic; D004993:Ethics, Nursing; D006707:Homes for the Aged / Q000941:ethics* / Q000458:organization & administration; D006801:Humans; D009664:Norway; D024802:Nurse's Role; D009723:Nurse-Patient Relations / Q000941:ethics*; D009735:Nursing Homes / Q000941:ethics* / Q000458:organization & administration; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000941:ethics* / Q000458:organization & administration / Q000523:psychology; D026684:Personal Autonomy; D012149:Restraint, Physical / Q000941:ethics; D017751:Safety Management / Q000941:ethics; D011795:Surveys and Questionnaires; D013997:Time Factors