BACKGROUND::Neglect and abuse of elders in care institutions is a recurring issue in the media. Elders in care institutions are vulnerable due to their physical, cognitive, and verbal limitations. Such vulnerabilities may make them more susceptible to mistreatment by caregivers on whom they are heavily dependent. OBJECTIVES::The goal was to understand caregivers' concerns about ensuring correct and proper treatment, as well as their experiences with neglect and abuse of older patients. This article examines resources and challenges of professional ethics within the care setting. RESEARCH DESIGN::A study was conducted to explore the quality of care provided to older patients in nursing homes, geriatrics institutions, and ambulant care in the northwest region of Switzerland. PARTICIPANTS AND RESEARCH CONTEXT::A total of 23 semi-structured interviews were conducted with nursing staff of varying experience levels. ETHICAL CONSIDERATIONS::Ethical approval was granted by the competent regional ethics commission, Ethikkomission Nordwest-und Zentralschweiz EKNZ [Ethics Commission Northwest and Central Switzerland] (2014-015). FINDINGS::Three themes emerged from our data analysis: professional identity, professional context, and professional relationships. Our findings indicate mutual vulnerabilities within these three themes, characterizing the interactions between nursing staff and older patients. Study participants believe that incidences of error, neglect, and abuse are consequences of their own vulnerability since they are not able to meet the demands of an overstraining work situation. DISCUSSION::Different aspects of this mutual vulnerability are described and critically discussed as challenges for professional ethics. CONCLUSION::Early education, continuous training as well as better management and response from the institution are necessary to maintain professionalism while handling mutual vulnerabilities.

译文

背景:在护理机构中忽视和虐待长者是媒体中经常发生的问题。照料机构中的老年人由于身体,认知和言语上的限制而容易受到伤害。这种漏洞可能使他们更容易受到严重依赖的看护人的虐待。
目的::目的是了解护理人员对确保正确和适当治疗的关注,以及他们对老年人的忽视和虐待的经历。本文探讨了护理环境中职业道德的资源和挑战。
研究设计::进行了一项研究,以探索在瑞士西北地区为养老院,老年病院和急救服务的老年患者提供的护理质量。
参与者和研究背景::总共23次半结构化访谈是针对不同经验水平的护理人员进行的。
道德方面的考虑::道德上的批准由主管的地区道德委员会Ethikkomission Nordwest-Zentralschweiz EKNZ [西北和中部道德委员会](2014-015)批准。
结果::我们的数据分析提出了三个主题:专业身份,专业背景和专业关系。我们的发现表明这三个主题之间存在共同的脆弱性,这是护理人员与老年患者之间相互作用的特征。研究参与者认为,错误,忽视和虐待的发生是他们自身脆弱性的后果,因为他们无法满足过度紧张的工作环境的要求。
讨论::这种相互脆弱性的不同方面都作为职业道德的挑战进行了描述和严格讨论。
结论:早期教育,持续培训以及机构的更好管理和回应对于保持专业水平同时处理相互脆弱性是必要的。

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