Coping with moral distress – The experiences of intensive care nurses: An interpretive descriptive study

Forozeiya, Dana; Vanderspank‐Wright, Brandi; Bourbonnais, Frances Fothergill; Moreau, Denise; Wright, David

doi:10.1016/j.iccn.2019.03.002

Cited by 39 publications

(69 citation statements)

References 31 publications

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“…20 These nurses began to question how much suffering their patients were enduring in the quest to keep them alive at all costs. 18,19,21,22 Nurses began to question whether considerations had been made for the value of life, 17 the humanity of the patient, 20 or the “benefits and burdens imposed by treatment.” 20 This was especially evident when “resuscitating an extremely premature infant” 22 or when doing a futile resuscitation for an adult patient. 17 At this point, nurses felt they were “inflicting more harm than good,” 22 especially when partaking in painful procedures or procedures intended to prolong life in a patient who would ultimately die.…”

Section: Resultsmentioning

confidence: 99%

Moral distress in emergency and critical care nurses: A metaethnography

Arnold

2020

Nurs Ethics

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Background: Moral distress has detrimental effects on nurses which impacts the entire healthcare cycle. Described as a crescendo effect, resolved situations of moral distress leave residue on the nurse with three potential outcomes: moral numbing, conscious objection to the situation, and burnout. Objective: This metaethnography strives to achieve a fuller understanding of moral distress by interpreting the body of qualitative work of moral distress in emergency and critical care nurses. Method: This study used the Noblit and Hare’s approach of interpretative synthesis. Ten studies met the criteria and were used in this synthesis. Ethical considerations: Ethical issues were minimal since no human subjects were involved. Ethical requirements were respected in all study phases. Results: The synthesis of qualitative research on moral distress resulted in one central theme, “the battle within,” and five subthemes. Conclusions: The unique nature of this nursing specialty resulted in a lasting inner conflict for nurses that is consistent with the previously described crescendo effect. The effects are complex and long lasting and may potentially affect the nurses’ future patient care.

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Section: Resultsmentioning

confidence: 99%

Moral distress in emergency and critical care nurses: A metaethnography

Arnold

2020

Nurs Ethics

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“…Despite the availability of advanced treatment modalities and an abundance of technological interventions, intensive care unit (ICU) patients regularly succumb to their illness; and ICU mortality rates vary between 10 and 30% globally ( Coombs, Addlington-Hall, & Long-Sutehall, 2012 ; Sprung, Cohen, Sjokvist et al, 2003). Further, given that end-of-life care in the ICU often coincides with deliberate and informed decisions around the withdrawal of life sustaining measures ( Downar, Delaney, Hawryluck, & Kenny 2016 ), the critical care environment is one that regularly encounters complex moral and ethical dialogue and debate ( Forozeiya, Vanderspank-Wright, Fothergill-Bourbonnais, Moreau, & Wright, 2019 ). As a result, critical care nurses regularly encounter complexity and uncertainty in their practice.…”

Section: Introductionmentioning

confidence: 99%

The effect of COVID-19 pandemic on the mental health of Canadian critical care nurses providing patient care during the early phase pandemic: A mixed method study

Crowe

Howard

Vanderspank‐Wright

et al. 2021

Intensive and Critical Care Nursing

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185

219

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“…Most nurses perceive this emotional commitment as a requirement of their profession, and the patients' experiences, their problems and suffering contribute to the development of compassion in nurses (Boyle, 2011;McQueen, 2004). It implies that nurses inherently accept to be exposed to large emotional demands, carrying the risk of "burnout" (Benner & Wrubel, 1989;Delgado, Upton, Ranse, Furness, & Foster, 2017;Forozeiya, Vanderspank-Wright, Bourbonnais, Moreau, & Wright, 2019;Garrosa, Moreno-jime, Liang, & Gonza, 2008;Havaei, MacPhee, & Susan Dahinten, 2016;Javadi-Pashaki & Darvishpour, 2019;McQueen, 2004;Zito, Cortese, & Colombo, 2016). Emotional exhaustion has been defined as the principal dimension of "burnout" in nurses (Schooley, Hikmet, Tarcan, & Yorgancioglu, 2016).…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…What they, as nurses, do or do not, and what they think they should do (or should have done) causes moral distress in them (Bridges et al, 2013;Forozeiya et al, 2019;Koll & Egan, 2004).…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…What they, as nurses, do or do not, and what they think they should do (or should have done) causes moral distress in them (Bridges et al, 2013; Forozeiya et al, 2019; Koll & Egan, 2004). Other causes of distress are the inability to express opinions in front of other professionals (Choe, Kang, & Park, 2015), the inability to provide a dignified death, prolonged hospitalization of patients and/or the lack of respect of family members by other professionals (Wiegand & Funk, 2012).…”

Section: Introductionmentioning

confidence: 99%

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Nurses’ emotions on care relationship: A qualitative study

et al. 2020

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Aims: To describe nurses' experiences regarding the care relationship built with medical-surgical patients in acute hospitalization units and the association with their clinical practice. Background: Nurses' commitment to care and their relationships as well are the core of quality of care. Nurses consider that the emotional commitment is essential to the profession, thus accepting to be exposed to emotional distress. Methods: In-depth interviews were conducted to explore the experience of 23 nurses from seven Spanish hospitals. Taped interviews were transcribed verbatim and analysed according to inductive content analysis. Results: Six subcategories emerged from the data analysis: Fulfilling experiences, Feeling the pain of others, Emotional distress, Stepping back, Seeking professional support, and Evolution of emotions, which were combined in two main categories: Nurses' emotions and Nurses' coping strategies. Patient's suffering, work environment and interprofessional relations influence the care relationship. Conclusions: Positive and negative emotions emerge spontaneously in professional relationships of experienced nurses. Lack of time and high workloads are factors that hinder the nurse-patient relationship. This care relationship is often the reason that fulfils them. Despite their level of expertise and having coping strategies, these are not always effective and, sometimes, nurses need professional help. Implications for Nursing Management: Nurses will continue performing their job with commitment; therefore, nursing managers should take care of their staff and pay attention to the emotional competence related to patients' relationships. Promoting self-care and a good working environment could improve their coping mechanisms.

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Coping with moral distress – The experiences of intensive care nurses: An interpretive descriptive study

Cited by 39 publications

References 31 publications

Moral distress in emergency and critical care nurses: A metaethnography

Moral distress in emergency and critical care nurses: A metaethnography

The effect of COVID-19 pandemic on the mental health of Canadian critical care nurses providing patient care during the early phase pandemic: A mixed method study

Nurses’ emotions on care relationship: A qualitative study

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