Heroism as moral dilemma in nowadays nursing.pdf
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1、 School of Health Science Blekinge Institute of Technology 371 79 Karlskrona Sweden Heroism as moral dilemma in nowadays nursing A two part study: Part 1: Literature review (study I) Part 2: Empirical study (study II) Master Thesis, 30ECTS Caring Science No: HAL 2006:14 Author: Dalia Pukinskien, R.N
2、. Supervisor: Britt Ebbeskog, PhD, RNT senior lecturer. Examiner: Sirkka-Liisa Ekman, PhD, Professor. 2 ABSTRACT Heroism is a moral concept with various dimensions. Heroes are determined according to ones individual taste and thats why they are very subjective. The title “hero” is the determination
3、of the “High price” or value that is given to a person by people as an attempt to show their thankfulness and admiration for their great generosity. The thesis was designed as a two-part study. The overall aim of the thesis was to illuminate the phenomenon of heroism as moral dilemma in our-day nurs
4、ing. Study I aim was to describe aspects which are connected to heroism in literature. Results from study I elucidate from main themes: altruism and sacrifice as primary values in nursing practice; motivation to moral actions; moral character; acting up in the patients bets interest. The main idea o
5、f the first identified theme is that sacrifice like altruism is one of important elements in the patient-carer relationship. Nurses want to be altruistic and they wish to receive positive feedback from patients when giving help. The positive feedback is essential to nurses in order for them to provi
6、de altruistic care. Following theme show that that nurses demand very high standards of themselves in their interactions with their patients, being in ethically difficult care situations. Once nurses are aware of the values that motivate them, they are more capable of accepting patients attitudes an
7、d behaviours, and their ability to solve problems and make decisions will become enhanced. In the third theme we can find that a spirit of compassion not only prevents people from doing harm, but may make us sacrifice our lives to protect the other human being. Moral character consists of a set of s
8、table virtues that affect a persons judgment and action. From the last theme we can see that nurses act on instinct, quick thinking and desire to help others. Caring as an ethical way of being is a rather more broadly understood morale requirement. The research shows that nursing as caring professio
9、n embodies many humanistic values as altruism, sacrifice, heroism. Heroism is framed in many different ways: it means doing the ordinary under extraordinary circumstances; it is the call of duty in everyday nursing. Heroes are determined according to ones individual taste and thats why they are very
10、 subjective. The title “hero” is the determination of the “High price” or value that is given to a person by people as an attempt to show their thankfulness and admiration for their great generosity. Heroism as moral dilemma appears in everyday nursing practice. Acting up heroically depends on nurse
11、s moral values and no moral reasons. Dilemma is an outcome of conflicting moral principles and rules. Nurses devote their lives to helping others and dont see themselves as heroes. Aim of study II was out of a semi-structured interview to investigate 3 nurses opinion about heroism in our-day nursing
12、. Data was collected by semi-structured interviews with 15 nurses, working and living in Lithuania. Data was analysed by qualitative content analysis method. Results from study II are: overall seven themes were identified: nursing as a loving care; devotion to duty; satisfaction doing the job; self-
13、sacrifice; ready to be hero; nurse-heroine in her daily practice; moral disorientation in nursing. The findings are explained and discussed. In conclusion of study II, most of nurses havent lost the most important values in health care profession. Conclusion of the whole study is that in Lithuania l
14、ove for the suffering patient is the highest value, and this value guides nurses to do heroic actions. Key words: heroism, nursing, sacrifice, values, moral character. 4 CONTENT GENERAL INTRODUCTION.6 BACKGROUND.8 The concept heroism analysis9 Every-day nursing12 Heroism as a moral concept 15 Herois
15、m in the Bible.18 Nursing as a moral practice.19 Rational for the study.21 RESEARCH QUESTIONS .21 AIMS22 PART 1: LITERATURE STUDY (STUDY I) 23 METHOD23 Results29 Altruism and sacrifice as priory values in nursing practice29 Motivation to moral actions 30 Moral character.31 Acting up in the patients
16、best interest.33 DISCUSSION 34 Methodological considerations34 Reflections on the results.35 CONCLUSSIONS. 42 PART 2: EMPIRICAL STUDY (STUDY II)43 METHOD43 DESIGN.44 DATA COLLECTION.44 Participants and procedure.45 Ethical considerations46 Data analysis46 FINDINGS.48 DISCUSSION54 Methodological cons
17、iderations54 REFLECTIONS ON RESULTS.54 5 CONCLUSSIONS.58 REFERENCES.61 Appendix 1: Matrix empirical articles Appendix 2: Matrix theoretical articles Appendix 3: Interview guide Appendix 4: Nurses descriptions of heroism and hero 6 GENERAL INTRODUCTION The choice of the topic for this study is the re
18、sult of a deep thought about heroism in our days nursing as moral dilemma in all human activities, for the better understanding of caring for peoples health with the spirit of heroism not only in the rare occasions, but in everyday nursing. One of the major changes which seem to have taken place in
19、our society during the past century is a shift from general public agreement about moral values to a much greater variety of expressed moral opinion and tolerance of diversity. Of course, not everyone 100 years ago agreed about what was morally right and wrong, nor today is society without consensus
20、 on some moral issues. But the variety of viewpoints that it is acceptable to express and possible to justify in public does seem to have become greater. This global situation of moral pluralism may well be one reason why we are particularly aware today of moral conflicts and dilemmas. How we view t
21、his situation will depend on our moral presupposition: some of us will see it as symptomatic of moral liberation, others of moral decay. The truth is probably, as usual, more complex and because we are living through it, largely hidden from us. On the basis of what has happened to societies in the p
22、ast, one way of interpreting what is happening now may be by comparing it with the transition from childhood to adolescence. An obvious aspect of this comparison is the way in which many people today look back nostalgically to the lost moral certainties of the past. In our time the growth of travel,
23、 international communications, the mass media and public education. These changes have made more people than ever before aware of the variety of moral viewpoints that it is possible to hold and consequently of the difficulty, in the face of this, of maintaining that any one traditional moral viewpoi
24、nt is right or the best. Emphasis on the individual which favours such values as self-sacrifice, tolerance rather than conformity and flexibility, rather than strict obedience to moral rules. Changes of this kind seem to be reflected today in changing attitudes within nursing, traditionally a female
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