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Gastroenterol Nurs. 2013 Jan-Feb;36(1):30-5. doi: 10.1097/SGA.0b013e31827da049.

At the ethical crossroads: how a gastroenterology procedure unit negotiated a solution for a reoccurring ethical dilemma.

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  • 1Gastroenterology Procedures Department, Department of Veterans Affairs, Minneapolis, MN 55417, USA.


The gastroenterology procedures environment has proven to be fertile ground for the realization of moral distress as it relates to the practice of nursing. Specifically, nurses are expected to fulfill their duty as advocates for their clients at all times and within all contexts; however, their ability to discharge this essential function has been complicated by such influential factors as sedating medications, competing ethical motivations, discordant conclusions of moral reasoning and action, as well as competing institutional factors. This article begins with a fictional case study to introduce readers to the contextual essence of the moral distress that a group of gastroenterology nurses was collectively experiencing. Subsequently, the aim of this article was to explicate how one department, with the aid of an ethics committee, negotiated a process similar to the case study to develop a pragmatic policy and identify an educational primer that encourages nurses to reexamine and value the tangible realities inherent and expected of an advocate in the dynamically complex environment that characterizes all gastroenterology procedure environments where gastroenterology nurses practice.

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