title: [Acute care nurses’ ethical reasoning: a thematic analysis].
abstract: BACKGROUND
  In the day-to-day course of nursing, ethical issues are being openly articulated to a growing extent. However, nurses only rarely systematically address these issues. This subject was explored in interviews with professionals who have a particular focus on ethics.
  
  
  OBJECTIVE
  Gain input for further developing the skills of nursing staff in ethical reasoning.
  
  
  METHODS
  In two focus groups and four individual interviews, we questioned 14 professionals, including nine nurses, who have a special interest in ethics.
  
  
  RESULTS
  Nurses find it ethically problematic when the wishes of patients are not respected or something is forced on them, creating the impression that the care being given is exacerbating rather than alleviating the patient’s suffering. These problematic aspects are often overlooked because the consequences of the action in question are not immediately apparent. Ethical issues in nursing are often addressed in informal, non-systematic discussions among nursing staff. Nurses actively and confidently engage in discussions on treatment goals, and the teamwork with doctors is usually experienced as being based on mutual respect and partnership. The inherent hierarchical role differences between nursing and medical staff nevertheless manifest in ethical issues.
  
  
  CONCLUSIONS
  Through the practical application of ethical reasoning in day-to-day nursing, structured discussions of the ethical aspects of cases and dedicated further education, nurses should learn to better recognise ethical issues in nursing and effectively analyse them and find solutions.
authors.affiliation: 1 Medizinische Querschnittsfunktionen, Operative Intensivbehandlung, Universitätsspital Basel, Schweiz.
authors.forename: Ursi
authors.initials: U
authors.lastname: Barandun Schäfer
authors.affiliation: 2 Bereich Medizin, Universitätsspital Basel, Schweiz.
authors.forename: Anja
authors.initials: A
authors.lastname: Ulrich
authors.affiliation: 3 Departement Anästhesie, Universitätsspital Basel, Schweiz.
authors.forename: Barbara
authors.initials: B
authors.lastname: Meyer-Zehnder
authors.affiliation: 4 Abteilung Praxisentwicklung Pflege/MTT, Universitätsspital Basel, Schweiz.|5 Institut für Pflegewissenschaft, Universität Basel, Schweiz.
authors.forename: Irena Anna
authors.initials: IA
authors.lastname: Frei
mesh_terms: D000208:Acute Disease / Q000451:nursing*; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D004993:Ethics, Nursing; D017144:Focus Groups; D006608:Hierarchy, Social; D006801:Humans; D033183:Interdisciplinary Communication; D024802:Nurse's Role; D009723:Nurse-Patient Relations / Q000941:ethics; D009732:Nursing Care / Q000941:ethics*; D019555:Physician-Nurse Relations; D013557:Switzerland
keywords: Ethische Reflexion; Pflege; Pflegeethik; clinical ethics; nursing care; nursing ethics; pflegerischer Verantwortungsbereich; qualitative Befragung; qualitative research