Caring for victims of child maltreatment: Pediatric nurses’ moral distress and burnout

Abstract

Background: Moral distress is a significant concern for nurses as it can lead to burnout and intentions to leave the profession. Pediatric nurses encounter stressful and ethically challenging situations when they care for suspected victims of child maltreatment. Data on pediatric nurses’ moral distress are limited, as most research in this field has been done in adult inpatient and intensive care units. Aim: The purpose of this study was to describe pediatric nurses’ moral distress and evaluate the impact of caring for suspected victims of child maltreatment on nurses’ moral distress, burnout, and intention to leave. Design and method: This descriptive cross-sectional correlational study was conducted in a mid-Atlantic, urban area Magnet pediatric level I trauma center that cares for over 1800 cases of suspected child maltreatment annually. An anonymous electronic survey was sent to all the nurses working at the hospital. Ethical considerations: Institutional Review Board approval was received from the first author’s university and the hospital where the study was conducted. Findings: Overall, nurses ( N = 146) reported low levels of moral distress with a mean score of 59.54 (SD = 49.22) and a range of 0–300 on the Moral Distress Scale Neonatal–Pediatric version. Although the frequency of caring for suspected child maltreatment victims did not affect nurses’ moral distress, caring for victims with fatal maltreatment contributed to nurses’ intention to leave, χ2 (1) = 5.35, p = 0.02. Conclusion: The results of this study add to the understanding of moral distress in pediatric nursing. Caring for victims with fatal maltreatment impacts pediatric nurses’ intention to leave.

Moral Distress and Moral Injury in Military Healthcare Clinicians: A Scoping Review

“…MD literature extensively explored short- and long-term sequelae leading to compassion fatigue, 7 , 24 , 25 , 41 , 42 , 61 , 68 , 69 , 70 , 71 , 72 , 73 , 74 burnout, 28 , 44 , 47 , 49 , 55 , 65 , 71 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 and post-traumatic stress disorder (PTSD). 45 , 47 , 79 , 87 Interpersonal stressors, 24 , 27 , 41 , 80 , 88 depersonalization, 37 , 76 , 89 and a crescendo or cumulative effect 15 , 37 , 41 showed implications for the person and healthcare team.…”

“… 45 , 47 , 79 , 87 Interpersonal stressors, 24 , 27 , 41 , 80 , 88 depersonalization, 37 , 76 , 89 and a crescendo or cumulative effect 15 , 37 , 41 showed implications for the person and healthcare team. Organizational impact of MD included perceived compromised care, 40 , 41 , 59 perceived overwhelming workloads, 32 , 90 poor retention, 36 , 49 , 54 , 59 , 76 , 77 , 78 , 79 , 91 , 92 poor quality of care provided, 43 , 59 , 77 , 85 , 89 and reduced ethical climate. 26 , 39 , 40 , 58 , 67 , 76 , 78 , 81 , 93 , 94 , 95 , 96 Outcomes of MI in healthcare clinician literature were limited and primarily reported through its association with other mental health conditions such as depression, alcohol use, anxiety, anger, self‐harm, social problems, burnout, and PTSD.…”

Moral Distress and Intention to Leave During COVID

“…Research has focused mainly on nurses' moral distress, the practice environment, and intentions to leave before or at the pandemic's peak, showing that nurses' moral distress and/or their practice environment are related to their intentions to leave. [11][12][13][14][15][16] The current workplace climate, which includes nurses who prevailed throughout the pandemic, has not been adequately assessed. The effects of caring for COVID-19 patients and the practice environment have had a unique impact on nurses who have endured after the pandemic's peak.…”

“…This may promote nurses' work enthusiasm, reduce moral distress, and increase retention rates. Research has focused mainly on nurses' moral distress, the practice environment, and intentions to leave before or at the pandemic's peak, showing that nurses' moral distress and/or their practice environment are related to their intentions to leave 11-16 . The current workplace climate, which includes nurses who prevailed throughout the pandemic, has not been adequately assessed.…”

An Interprofessional Approach to Family-Centered Child Protective Services Referral: A Case Report

“…It is critical that trauma nurses are aware of the safety protocols in place at their institutions and how to manage the psychological and social impact on their professional work role (Avander et al, 2016). Although caring for suspected victims of child maltreatment has not shown to affect nurses' levels of moral distress, caring for victims with fatal maltreatment contributed to nurses' intention to leave their job (Karakachian et al, 2021).…”