Nurses' Experiences of Discriminatory Care Towards Vulnerable Patients: A Qualitative Study From Iran.

چکیده اصلی

BACKGROUND: Discriminatory nursing care endangers patient rights, ethical standards and fair access to treatment-yet the lived experiences of nurses who engage in such practices remain understudied. This study seeks to explore Iranian nurses' personal experiences with their own discriminatory behaviours towards vulnerable patients in everyday clinical settings. METHODS: A qualitative conventional content analysis was conducted in 2024, using in-depth, unstructured interviews with 13 nurses from both public and private hospitals in Iran. Participants were purposefully sampled to ensure maximum variation, and data collection continued until saturation was reached. The interviews were analysed using the five-step framework developed by Graneheim and Lundman. RESULTS: A central theme, 'discrimination in service provision for vulnerable patients', emerged, highlighting two main categories: (1) Professional Shortfalls in the Care of Older Adults and (2) Shortfalls in Care for Persons at the End of Life. Nurses reported prioritizing younger patients, delaying or withholding essential care, reducing therapeutic communication and demonstrating inconsistent adherence to professional standards. CONCLUSION: Findings reveal subtle yet widespread discriminatory practices against older adults and end-of-life patients. Combating these disparities requires targeted education, supportive organizational policies and strategies to increase nurses' awareness of unconscious bias. IMPLICATIONS FOR PRACTICE: Reducing discriminatory behaviours promotes equitable, person-centred care. Enhancing empathy, prioritizing the needs of vulnerable patients and strengthening adherence to professional standards foster trust, dignity and a more inclusive clinical environment.

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