Nurses’ Experiences with Ethical Dilemmas in Critical Care Settings: A Mixed-Method Study at Saidu Teaching Hospital
Shah Hussain, Atta Ullah, Arif Ullah
Abstract
Background: Critical care nurses (CCNs) routinely experience multiple ethical dilemmas that force them to test their ability to make decisions while respecting their professional duties. Nurses working in critical care need to resolve difficulties stemming from contradictory issues in end-of-life patient care, self-determination, resource distribution, and professional ethical standards. Aim: This study explores the ethical challenges faced by CCNs at Saidu Teaching Hospital while examining their professional tactics for addressing these issues. Methodology: This study employed a mixed-method approach, integrating quantitative and qualitative data collection. A structured questionnaire was used to survey 50 CCNs regarding their ethical challenges. The study conducted ten in-depth interviews with nurses who shared their procedures for dealing with problems, along with their techniques for making ethical decisions. Quantitative data were analyzed using SPSS, while thematic analysis was applied to qualitative data. Results: The study showed that staff members frequently encounter ethical conflicts, which mainly include end-of-life decisions, together with the withholding of life-prolonging care and family-related disputes. Stress levels among nurses reached extremely high points according to their self-reported observations, and 16% were registered in this category. Most nurses face these ethical situations through peer collaboration (80%) while using their own moral guidelines (60%). However, participants expressed dissatisfaction with institutional ethics committees and training, citing inadequate support. Conclusion: CCNs at Saidu Teaching Hospital frequently encounter ethical dilemmas. Nurses need support from institutions, together with practical ethical training and well-defined guidelines, to properly address their professional situations.