Nursing and Ethics

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CHAPTER


DOI :10.26650/B/CH17CH24.2024.002.39   IUP :10.26650/B/CH17CH24.2024.002.39    Full Text (PDF)

Triage and Ethics in Disasters

Yasemin Gümüş Şekerci

Disasters are sudden and unexpected events that cause physical, psychological, spiritual, environmental, social, and economic problems and require national or international assistance. Turkey is one of the important disaster regions. Disaster nurses play a role in providing quality care, preventing complications, minimizing mortality, and increasing the incidence of survival in the disaster process. The roles of the disaster nurse include intervening in critical situations, detecting danger, reducing or eliminating injuries, managing events and medical equipment that may occur in the disaster area, mass care, emergency treatments, and triage. The use of triage systems by nurses is essential for successful disaster management. Triage systems are one of the most important measures taken in response to mass incidents caused by emergencies and disasters. Disaster triage can be defined as the process of rapidly categorizing and systematically classifying all patients/injured at the scene according to the severity of their condition and the availability of health services and transportation facilities to ensure that they receive the best treatment and care. During a disaster, nurses may face different ethical challenges due to triage. To improve the quality of care of the patient/injured, nurses need to find solutions to ethical problems in disaster triage. All ethical components of medical science, including utilitarianism, justice, equity, fairness, duty of care, transparency, consistency, proportionality, accountability, and resource management, should be used in disaster triage. However, in a major disaster, as a result of an acute and unpredictable imbalance between the capacity of medical resources and nurses and the needs of patients/injured, medical care resources may be insufficient, and timely and equitable distribution of health resources may be delayed, thus ethical dilemmas may occur. Disaster nurses should act in line with ethical principles without creating ethical dilemmas. Therefore, this chapter examines the importance of triage ethics in disasters, and suggestions are made to eliminate ethical dilemmas in triage practice.


Keywords: Disaster nurse, disaster management, disaster triage, ethical approach to disaster, triage ethics
DOI :10.26650/B/CH17CH24.2024.002.39   IUP :10.26650/B/CH17CH24.2024.002.39    Full Text (PDF)

Afetlerde Tri̇yaj ve Eti̇k

Yasemin Gümüş Şekerci

Afetler fiziksel, psikolojik, ruhsal, çevresel, sosyal ve ekonomik sorunlara neden olan, ulusal veya uluslararası düzeyde yardım talebi gerektiren ani gelişen beklenmedik olaylardır. Türkiye, önemli afet bölgelerinden biridir. Afet hemşiresi, afet sürecinde kaliteli bakımın sağlanması, komplikasyonların önlenmesi, mortalitenin en aza indirilmesi ve hayatta kalma insidansının arttırılmasında rol oynamaktadır. Afet hemşiresinin rolleri; kritik durumlara müdahale etmeyi, tehlikeyi tespit etmeyi, yaralanmaları azaltmayı veya ortadan kaldırmayı, afet bölgesinde yaşanabilecek olayları ve tıbbi ekipmanı yönetmeyi, toplu bakımı, acil tedavileri ve triyajı içermektedir. Afet yönetiminde başarılı olabilmesi için hemşireler tarafından triyaj sistemlerinin kullanılması esastır. Triyaj sistemlerinin kullanılması, acil durumlar ve afetlerin neden olduğu toplu olaylara yanıt olarak alınan en önemli önlemlerden biridir. Afet triyajı, olay yerindeki tüm hasta/yaralıların en iyi bakım ve tedavi alabilmesi amacıyla durumlarının ciddiyetine, sağlık hizmetlerinin ve ulaşım olanaklarının mevcudiyetine göre kategorize edilmesi, hızlı ve sistematik olarak sınıflandırılması süreci olarak tanımlanabilir. Bir afet sırasında, hemşireler triyaj nedeniyle farklı etik zorluklarla karşılaşabilirler. Hasta/yaralının bakım kalitesini artırmak amacıyla afet triyajında, hemşirelerin etik sorunlara çözüm bulması gerekir. Afet triyajında tıp biliminin yarar sağlama, adalet, eşitlik, adil olma, bakım yükümlülüğü, şeffaflık, tutarlılık, orantılılık, hesap verebilirlik, kaynak yönetimini içeren tüm etik bileşenleri kullanılmalıdır. Fakat büyük bir afette tıbbi kaynakların ve hemşirelerinin kapasitesi ile hasta/yaralıların gereskinimleri arasında akut ve öngörülemeyen bir dengesizlik sonucu tıbbi bakım kaynakları yetersiz kalır ve sağlık kaynaklarının zamanında ve adaletli dağılımı gecikebilir ve böylece etik ikilemler oluşabilir. Afet hemşireleri etik ikilemler oluşturmadan etik ilkeler doğrultusunda hareket etmelidir. Bu nedenle bu bölümde, afetlerde triyaj etiğinin önemi incelenmiş ve triyaj uygulamasında etik ikilemleri kaldırabilecek önerilerde bulunulmuştur. 


Keywords: Afet hemşiresi, afet yönetimi, afet triyajı, afete etik yaklaşım, triyaj etiği

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