When referring to situations in the interviews that had been discussed in the reflection groups, we reminded the participants to remove person-identifying information.
These examples concern mostly patient autonomy, a common repetitive problem.> Another main group of ethical challenges discussed in the reflection groups focus on family participation.
In addition, the collegial support they have developed in the reflection groups is a good contribution to strengthening the relationship between staff members.
First of all, it is obvious that some of the ethically challenging situations that have been discussed in the reflection groups will probably not always, and perhaps especially not by ethicists, be perceived as ethical problems, but more as problem of professional, technical, organisational, and collegial character.
Furthermore, we took field notes during observation (e.g. as co-facilitators), training sessions, supervision, project meetings, and other experiences we as researchers have gained through working with the larger project, and with the facilitators and the reflection groups in particular.
Initially, we wanted the reflection groups to be multidisciplinary, something that we only partially succeeded in.
In the ethics reflection group we discover that the resident has fixed procedures as part of an effort to develop ADL skills, and this is part of her routine; no coffee before morning grooming and tooth brushing is complete.
The most frequent discussions in the ethics reflection groups have been ethically challenging patient cases from the participant's workday.
The interviews uncovered differences between the various departments when it comes to organisation and the staff's attendance in the ethics reflection groups.
It was tailored to the needs of a nursing programme (in Norway) as former studies showed that many students had superficial level of reflection in their reflective journals, few students applied knowledge to their reflections and some met unprepared in the guided reflection groups.
