title: Ethical challenges in neonatal intensive care nursing.
abstract: BACKGROUND
  Neonatal nurses report a great deal of ethical challenges in their everyday work. Seemingly trivial everyday choices nurses make are no more value-neutral than life-and-death choices. Everyday ethical challenges should also be recognized as ethical dilemmas in clinical practice.
  
  
  OBJECTIVE
  The purpose of this study is to investigate which types of ethical challenges neonatal nurses experience in their day-to-day care for critically ill newborns.
  
  
  METHODS
  Data were collected through semi-structured qualitative in-depth interviews. Phenomenological-hermeneutic analysis was applied to interpret the data.
  
  
  METHODS
  Six nurses from neonatal intensive care units at two Norwegian hospitals were interviewed on-site.
  
  
  METHODS
  The study is designed to comply with Ethical Guidelines for Nursing Research in the Nordic Countries and the Helsinki declaration.
  
  
  RESULTS
  Findings suggest that nurses experience a diverse range of everyday ethical challenges related to challenging interactions with parents and colleagues, emotional strain, protecting the vulnerable infant, finding the balance between sensitivity and authority, ensuring continuity of treatment, and miscommunication and professional disagreement.
  
  
  CONCLUSIONS
  A major finding in this study is how different agents involved in caring for the newborn experience their realities differently. When these realities collide, ethical challenges arise. Findings suggest that acting in the best interests of the child becomes more difficult in situations involving many agents with different perceptions of reality.
  
  
  CONCLUSIONS
  The study presents new aspects which increases knowledge and understanding of the reality of nursing in a neonatal intensive care unit, while also demanding increased research in this field of care.
authors.affiliation: University of Nordland, Norway maria.strandas@gmail.com.
authors.forename: Maria
authors.initials: M
authors.lastname: Strandås
authors.affiliation: University of Nordland, Norway.
authors.forename: Sven-Tore D
authors.initials: ST
authors.lastname: Fredriksen
mesh_terms: D000328:Adult; D064648:Critical Care Nursing / Q000941:ethics*; D004993:Ethics, Nursing; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000941:ethics*; D008875:Middle Aged; D009664:Norway; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D036301:Qualitative Research
keywords: Ethical issues; everyday ethics; neonatal intensive care unit; neonatal nursing; nursing care; phenomenological-hermeneutic