A National Survey on Moral Obligations in Critical Care

Pavlish, Carol; Brown-Saltzman, Katherine; Raho, Joseph A.; Chen, Belinda

doi:10.4037/ajcc2019512

Cited by 12 publications

(7 citation statements)

References 42 publications

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“…12 An important target for research and practice is the inclusion of nurse leaders in proactive ethics rounds with the interprofessional team. 12,36,43,44 Nurses in our study frequently described not feeling heard by their physician colleagues, and some nurses described how they coped by accepting their lack of control in situations of ethical conflict. Indeed, a negative relationship between moral distress frequency and psychological empowerment was found in another study.…”

Section: Discussionmentioning

confidence: 79%

“…[15][16][17] Improving nurse-physician collaboration is a vital area for intervention development to mitigate moral distress in critical care nursing practice. 32,36,44 Nurses in this study described the value of discussing their ethical perspectives and experiences with providers and being engaged in ethics consultations. Healthcare teams routinely support families, making challenging decisions about life-sustaining treatments in intensive care.…”

Section: Discussionmentioning

confidence: 99%

“…12 An important target for research and practice is the inclusion of nurse leaders in proactive ethics rounds with the interprofessional team. 12,36,43,44…”

Section: Discussionmentioning

confidence: 99%

“…15 –17 Improving nurse–physician collaboration is a vital area for intervention development to mitigate moral distress in critical care nursing practice. 32,36,44…”

Section: Discussionmentioning

confidence: 99%

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Giving nurses a voice during ethical conflict in the Intensive Care Unit

McAndrew

Hardin

2020

Nurs Ethics

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Background: Ethical conflict and subsequent nurse moral distress and burnout are common in the intensive care unit. There is a gap in our understanding of nurses’ perceptions of how organizational resources support them in addressing ethical conflict in the intensive care unit. Research question/objectives/methods: The aim of this qualitative, descriptive study was to explore how nurses experience ethical conflict and use organizational resources to support them as they address ethical conflict in their practice. Participants and research context: Responses to two open-ended questions were collected from critical care nurses working in five intensive care units at a large, academic medical center in the Midwestern region of the United States. Ethical considerations: This study was approved by the Institutional Review Board at the organization where the study took place. Findings: Three main interwoven themes emerged: nurses perceive (1) intensive care unit culture, practices, and organizational priorities contribute to patient suffering; (2) nurses are marginalized during ethical conflict in the intensive care unit; and (3) organizational resources have the potential to reduce nurse moral distress. Nurses identified ethics education, interprofessional dialogue, and greater involvement of nurses as important strategies to improve the management of ethical conflict. Discussion: Ethical conflict related to healthcare system challenges is intrinsic in the daily practice of critical care nurses. Nurses want to be engaged in discussions about their perspectives on ethical conflict and play an active role in addressing ethical conflict in their practice. Organizational resources that support nurses are vital to the resolution of ethical conflict. Conclusion: These findings can inform the development of interventions that aim to proactively and comprehensively address ethical conflict in the intensive care unit to reduce nurse moral distress and improve the delivery of patient and family care.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

“…12 An important target for research and practice is the inclusion of nurse leaders in proactive ethics rounds with the interprofessional team. 12,36,43,44…”

Section: Discussionmentioning

confidence: 99%

“…15 –17 Improving nurse–physician collaboration is a vital area for intervention development to mitigate moral distress in critical care nursing practice. 32,36,44…”

Section: Discussionmentioning

confidence: 99%

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Giving nurses a voice during ethical conflict in the Intensive Care Unit

McAndrew

Hardin

2020

Nurs Ethics

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“…The Intensive Care Unit (ICU) is a complex organization of trained healthcare professionals and advanced technical equipment used in the treatment of critically ill patients. Intensive care physicians routinely encounter ethically complex situations, as they have to decide how to treat or prolong the lives of their patients, incorporating the attitudes and expectations of the patient or their relatives, together with medical and ethical values [1]. According to the literature, the main ethical issues arising in ICUs involve patient admission and discharge decisions, which treatments are in the patient's best interests [2], conflicts over treatment modality or futile treatment, and decision-making at the end of life [3].…”

Section: Introductionmentioning

confidence: 99%

Intensive Care Residents’ Views Regarding Ethical Issues and Practices

Sevimli

Tekeli

2022

Med Sci Monit

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Background:This study sought to understand the ethical issues encountered by medical residents during their residencies, evaluate the solutions proffered by them, and present their suggestions. Material/Methods:A survey consisting of 32 questions, including demographic information, was developed and distributed to Intensive Care Unit (ICU) residents from December 2020 to January 2021. A total of 53 completed questionnaires were submitted to the researchers. The data were analyzed using SPSS software version 26.0. Results:Of the participating residents who returned completed forms, 50.9% were male and 49.1% were female, with an overall mean age of 30.5±4.4 years. Most residents' views on ethical issues concerned themselves, the clinic, and patients/patient relatives. Responses showed a number of commonalities with the views of ICU physicians in other countries. Suggestions for resolving ethical issues solutions included instruction in medical ethics for all staff, increasing and strengthening pathways of communication both inside and outside of the clinics, regular inventory of medical supplies and assessment of equipment to prevent a shortage of resources, and the establishment of a hospital ethics committee. Conclusions:As numerous and varied ethical issues were encountered in the participating ICUs, we propose the following: preparation of an ICU-specific guide for resolving ethical problems, clarification of rules based on legal regulations, determining a hierarchy of responsibilities, and ethics courses for all ICU staff. In addition, hospital managers should support ICU services from both a legal and ethical standpoint.

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How Ethics Can Support Clinicians Caring for Critically Ill Patients

Milliken

Sadovnikoff

2020

Compelling Ethical Challenges in Critical Care and Emergency Medicine

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A National Survey on Moral Obligations in Critical Care

Cited by 12 publications

References 42 publications

Giving nurses a voice during ethical conflict in the Intensive Care Unit

Giving nurses a voice during ethical conflict in the Intensive Care Unit

Intensive Care Residents’ Views Regarding Ethical Issues and Practices

How Ethics Can Support Clinicians Caring for Critically Ill Patients

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