Ethical Dilemmas as a Source of Stress among Doctors and Nurses in the Intensive Care Unit

Abstract

Background: The intensive care unit (ICU) is the busiest part of a hospital, with a high workload and stress experienced by both doctors and nurses. The distress experienced by health professionals includes both anxiety and decline in morale, and may even lead to wrong decisions critical for patients’ lives. Aim: Investigation of ethical dilemmas as a source of stress for doctors and nurses, and their relationship with the work stress situations experienced in the ICU. Method: The study population consisted of 119 health professionals, doctors and nurses, working in the ICUs of 5 hospitals in Greece. A questionnaire specially designed by the researchers was used, based on the international literature, and specifically based on a study of Corley and co-workers. Data analysis was performed with the Statistical Package for Social Sciences (SPSS) v. 17.0. Results: Of the 119 health professionals who completed the questionnaire, 61.3% were women. The average age of the respondants was 37±7.8 years, and their average duration of work in the ICU was 4±4.4 years. Nurses comprised 61.3% of the sample, and of the physicians 50% were junior doctors. A statistically significant difference was found between doctors and nurses in the stress experienced and making decisions regarding end-stage patients, with doctors experiencing more stress than nurses (mean 4.022±1.3) (p<0.001). Conclusions: Both physicians and nurses in the ICU face daily ethical and legal dilemmas and must sometimes make decisions that might be contrary to their personal beliefs or the views of the patient’s family.