Suffering from moral distress

[edimo]

In a research study conducted by the University of British Columbia in Canada, half of the ICU nurses and 27% of Doctors surveyed (1,400 participants) considered quitting their jobs over moral distress.

Full article can be found here:

Doctors and nurses working with critically ill patients suffer moral distress, research finds

Working with acutely ill patients is emotionally, mentally, physically and ethically taxing on most days. I have been in situations where there is a disconnect between the family and medical team or even the family and the patient over plan of care, and we as nurses are left between a rock and a hard place. But we can also help to facilitate these conversations. Conversations that should be happening with patients well in advance (if possible) and if not, making sure POA's are actually acting in the best interest of the patient.

Have you been in situation that has caused you moral distress?

[HouTx, BSN, MSN, EdD]

This is a fascinating and very valuable area of research. I have found that although there is an increasing awareness of ethical issues & prioritization of moral dilemmas related to treatment decisions, futile care, etc..... there is still insufficient attention to the cumulative effects (of dealing with morally distressing events) upon the nursing staff. Prime example: it is still not uncommon in community hospitals for terminally ill (no code) patients to be maintained in the ICU because of physician &/or family preferences. No one considers the emotional well-being of dedicated critical care nurses forced to simply watch as the patient gradually diminshes... vital signs ebbing.... heart rate/rhythm deterioriating. For these nurses, who have built their entire careers on preserving life ... this can be an excruciating experience. BTDT.

NICU staff bear witness to ethically ambiguous issues on a continuous basis. They see families dissolve due to the burden (emotional, financial, physical, etc) of dealing with these tiny, fragile creatures... expending precious resources on care that may be very unlikely to make a difference in the outcome.

Med Surg nurses whose workload forces them to budget their time to such an extreme that they have no time to provide emotional support to a newly diagnosed Ca patient or 'stop the line' when they realize that a patient is being discharged without adequate understanding of her wound care.

Moral distress is everywhere - a catalyst to burnout.