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The faceless encounter: ethical dilemmas in telephone nursing
Uppsala Science Park, Uppsala, Sweden. (Health Services Research)ORCID iD: 0000-0002-4302-5529
Uppsala Science Park, Uppsala, Sweden. (Centre for bioethics)
2007 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 10, p. 1865-1871Article in journal (Refereed) Published
Abstract [en]

Aim. This paper aims to present the findings of a study designed to describe ethical dilemmas, in the form of conflicting values, norms and interests, which telenurses experience in their work.

Background. Telephone nursing is an expanding part of health care. Telephone nurses in Sweden assess care needs, provide advice, support and information, and recommend and coordinate healthcare resources. Lately, ethical demands on healthcare professionals in general have increased. The reasons include new biomedical competence, an ageing population and constrained resources which have made priority setting a primary concern for doctors and nurses. When ethical problems arise, colleagues need open dialogue. Despite this, nurses lack such a dialogue.

Method. A purposeful sample of 12 female telenurses in Sweden was interviewed twice during 2004 and 2005. The transcribed interviews were analysed thematically.

Results. Five themes were found: talking through a third party; discussing personal and sensitive problems over the phone; insufficient resources and the organization of health care; balancing callers' information needs with professional responsibility; and differences in judging the caller's credibility.

Conclusion. The present study has identified five different themes in which Swedish telenurses experience ethical dilemmas in their work. This shows how ethical dilemmas in various forms are present in telenursing. Questions of autonomy, integrity and prioritizing are particularly highlighted by the participating nurses. Telenurses in Sweden also experience new ethical demands due to a multicultural society. Although several of the identified dilemmas also occur in other areas of nursing we argue that these situations are particularly challenging in telenursing.

Relevance to clinical practice. The work organization should provide opportunities for ethical competence-building, where ethical dilemmas in telenursing are highlighted and discussed. Such a strategy might lead to decreased moral uncertainty and distress among telenurses, with positive consequences for callers.

Place, publisher, year, edition, pages
2007. Vol. 16, no 10, p. 1865-1871
Keywords [en]
clinical decision making, nursing, nursing ethics, qualitative methods, telenursing, triage
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-21563DOI: 10.1111/j.1365-2702.2007.01839.xISI: 000249663400009PubMedID: 17880475Scopus ID: 2-s2.0-34548804379OAI: oai:DiVA.org:mdh-21563DiVA, id: diva2:649115
Available from: 2008-03-03 Created: 2013-09-17 Last updated: 2017-12-06Bibliographically approved

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Holmström, Inger

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