Difficulties of Nurses who are Involved in Family's Surrogate Decision-Making for an Emergency Patient and Their Reasons

This study aimed to identify difficulties of nurses who are involved in families performing surrogate decision-making for an emergency patient and their reasons. Semi-structured interviews were conducted involving 8 subjects. The obtained data were categorized based on Berelson, B content analysis, and an agreement rate of more than 70%, which was calculated based on the formula of Scott W.A., was used as criteria to ensure the reliability of the categories. As a result, 302 descriptions and expressions were extracted and classified into 13 categories, including [Nurses become suffer, being unable to accept decision-making by family members in a positive manner] and [Nurses become suffer because physicians often make decisions regarding treatment], and 698 were extracted regarding the reasons and grouped into 14 categories, such as [Due to their sense of ethics, views on nursing, and values, some nurses cannot positively accept decisions made by family members] and [Nurses have no means of evaluating their own approaches]. The agreement rate was 82.9% for difficulties and 93.2% for reasons, showing that the reliability was confirmed in both difficulties and reasons. The results suggest the need to conduct regular emergency case conferences among different professions to help nurses to reconfirm their individual responsibility and involvement with families, and provide an environment for nurses to review their practices to reduce their nursing ethical conflict.