THE STORIES OF PHYSICIANS, REGISTERED NURSES AND ENROLLED NURSES ABOUT ETHICALLY DIFFICULT CARE EPISODES IN SURGICAL CARE

Twenty physicians, 19 registered nurses (RN), and 20 enrolled nurses ( EN) working in surgical care in Sweden narrated their experences of be ing in ethically difficult care situations. All three professional gro ups disclosed a strong wish to help patients. The narrations of the ph ysicians and the ENs indicated that they were very much involved in th eir patients, while most of the RNs' stories were narrated from a dist anced onlooker's perspective and disclosed a lot of moral outrage, mai nly directed towards physicians. The physicians were the only group th at emphasized the importance of acting in accordance with science and proven experience. Like RNs they emphasized the importance and difficu lty of telling the truth to the patients and their families and being open to one's own and others' harsh experiences. RNs and ENs emphasize d the patient's right to a death with dignity and the difficulties con nected with being with dying patients, and they also described feeling s of powerlessness and neglect of patients related to a heavy work loa d. ENs narrated difficulties related to providing patients with indivi dualized but fair care.