Qualitative study on nursing students' perspective on ethical conflicts at the end of life: "We are not prepared"

Abstract

Background: Nursing care for people at the end of life is a crucial aspect of health care that involves challenges and responsibilities. In this scenario, ethical conflicts often arise resulting in situations of great suffering and high-level emotional impact, for which nursing students do not feel sufficiently prepared. Objective: The aim of this study was to find out how nursing students perceive the ethical conflicts present at the end of life and their reflective and deliberative capacity in the face of these conflicts. Design: Descriptive qualitative study. Setting and participants: Between February and March 2023 with nursing students at the University of Huelva in Spain. Methods: Sixteen in-depth interviews were conducted. The data analysis was carried out using Giorgi’s method and Atlas.ti 22 software as a support. Results: The students reported that they had encountered ethical conflicts in the end-of-life phase during their internship care period. The main causes they mention are: the management of ethical conflicts, the position on euthanasia and conscientious objection, and the influence of values and beliefs about care. They highlight the lack of training in coping and emotion management in end-of-life care. Conclusion: Nursing students feel unprepared to deal with the suffering and ethical conflicts involved in end-oflife care, as well as the management of their own internal conflicts. There is therefore a need for the implementation of high-fidelity simulation-based training that generates the learning of the necessary competencies in bioethics and defensive palliative care through appropriate competencies.