An investigation of ethical dilemmas faced by nurses in emergency units at the University of Maiduguri Teaching Hospital
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Background of the Study
Nurses, as key healthcare professionals, play a critical role in patient care, particularly in emergency units, where they must act quickly and make decisions that can be life-altering. The University of Maiduguri Teaching Hospital (UMTH) is one of the largest healthcare institutions in Nigeria, and its emergency unit is often the first point of contact for individuals in critical conditions. Nurses working in emergency units frequently face complex ethical dilemmas due to the high pressure and urgency of care, limited resources, and the need to prioritize patient needs (Smith, 2023; Akintoye et al., 2024). These dilemmas can range from questions about patient autonomy, resource allocation, and end-of-life decisions to the balance between clinical protocols and compassionate care.
The nature of these ethical dilemmas often stems from the challenges of making decisions when confronted with conflicting values, scarce medical resources, and a high-stakes environment. Nurses may also struggle with balancing the demands of the healthcare system and the well-being of the patient, sometimes resulting in moral distress or burnout (Williams et al., 2023). Studies have shown that nurses in emergency settings are often exposed to situations where they must navigate ethical conflicts while maintaining their professional and moral integrity (Jones et al., 2024). In Nigeria, the situation is exacerbated by infrastructural limitations, understaffing, and socio-cultural factors, which make the ethical decision-making process even more complex (Khan & Ali, 2023).
The literature on ethical dilemmas in Nigerian emergency units remains underdeveloped, and there is a need to explore these issues to provide a better understanding of the specific challenges nurses face in the context of the UMTH. This research will contribute to the existing body of knowledge and inform policies on nurse training, ethical guidelines, and institutional support to help nurses navigate the ethical challenges they encounter. It will also have implications for improving the quality of care provided in emergency units and ensuring that nurses can fulfill their professional duties while maintaining ethical standards.
Statement of the Problem
Nurses working in emergency units are often tasked with making quick decisions in life-or-death situations, where there is little room for error. However, the ethical dilemmas they encounter can significantly affect their professional judgment, leading to moral distress, burnout, and a diminished quality of care. At UMTH, nurses face numerous challenges, including limited resources, heavy workloads, and difficult patient outcomes, which can further complicate ethical decision-making. While there is general awareness of the ethical issues facing healthcare providers in emergency settings, there is a paucity of research specific to the Nigerian context, particularly at UMTH. Without a deep understanding of the ethical dilemmas faced by nurses in this setting, it is difficult to implement effective strategies to support their decision-making process and improve patient care outcomes. Therefore, there is a critical need to investigate the specific ethical challenges faced by nurses in the emergency unit at UMTH.
Objectives of the Study
1. To identify the key ethical dilemmas faced by nurses in the emergency unit at the University of Maiduguri Teaching Hospital.
2. To assess the impact of ethical dilemmas on the decision-making process and the quality of care provided by nurses in the emergency unit.
3. To evaluate the institutional support and resources available to nurses for addressing ethical dilemmas in the emergency unit.
Research Questions
1. What are the primary ethical dilemmas faced by nurses in the emergency unit at UMTH?
2. How do ethical dilemmas affect the decision-making process and quality of care in the emergency unit?
3. What types of institutional support and resources are available to assist nurses in addressing ethical dilemmas in the emergency unit?
Research Hypotheses
1. Nurses in the emergency unit at UMTH encounter significant ethical dilemmas related to patient autonomy, resource allocation, and life-saving interventions.
2. Ethical dilemmas negatively affect the decision-making process and quality of care provided by nurses in the emergency unit at UMTH.
3. Adequate institutional support and resources mitigate the negative impact of ethical dilemmas on nurses' decision-making and patient care in the emergency unit.
Scope and Limitations of the Study
The scope of this study is limited to nurses working in the emergency unit of the University of Maiduguri Teaching Hospital, which may not be representative of other hospitals in Nigeria or the broader African context. The study will focus on identifying ethical dilemmas, assessing their impact on care delivery, and evaluating institutional support mechanisms. The limitations of the study include possible biases in self-reported data, challenges in accessing a diverse sample of nurses, and potential cultural factors that may influence the nurses' perception of ethical dilemmas.
Definitions of Terms
• Ethical dilemmas: Situations in which nurses are faced with conflicting moral principles that complicate decision-making in patient care.
• Emergency unit: A hospital department that provides immediate treatment to patients with urgent and critical health conditions.
• Moral distress: A feeling of discomfort or anguish experienced when one is unable to act according to their ethical beliefs due to external constraints.
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