Exploring Factors Influencing Nurses' Ethical Decision Making for Post Operative Pain Management in the Upper East Regional Hospital, Bolgatanga

ABSTRACT

Postoperative pain (POP) remains a challenge for patients although they have the right to adequate pain management. It is unethical if pain is not managed adequately by nurses. However, there is inadequate literature on ethical decision making by nurses on pain management. Thus, this study aimed at exploring the factors influencing ethical decision making for POP management among nurses. The study employed qualitative exploratory descriptive design. Participants were recruited purposively from the surgical wards of the Regional Hospital, Bolgatanga. Semi-structured interview guide was used for data collection and data saturation was reached at the fourteenth participant through individual interviews. Five themes emerged from the data which was analysed using content analysis procedures. The themes were nurses’ knowledge of ethical principles, influence of unit leadership on ethical decision-making, influence of nurses’ relationship with other professionals, institutional factors influencing nurses’ ethical decision-making and intrinsic motivators of pain management. Findings showed that nurses had adequate knowledge of ethical principles and applied them in the management of POP. Personal commitment and empathy for patients were intrinsic factors for ethical decision-making for POP management. Protocols on pain management, disciplinary and ethics committees, and availability of analgesics were perceived to influence ethical decision-making for POP management. Nurses said institution of an ethics committee could help them know about ethical issues. Constructive feedback from unit leaders was also perceived to influence decision making for POP management positively. The study concluded that, there is the need to place premium on pain management while considering it as a right of patients and an ethical issue. Resources needed to provide ethically accepted management of pain should be provided to enhance pain management.