Impact of ethical climate on moral distress revisited

Abstract

Recommendations were made for reducing the negative impact of ethical climate on moral distress. These include solving the nursing-shortage problem, increasing autonomy, and improving physical conditions.

Health care reform in Iran: Implications for nurses’ moral distress, patient rights, satisfaction and turnover intention

“…When workload increases, nurses are more likely to face moral tensions and to experience moral distress (Corley et al., ; Karanikola et al., ). In such situations the likelihood of a turnover intention in the profession (Atabay et al., ; Atashzadeh‐Shoorideh, Ashktorab, Yaghmaei, & Alavi Majd, ) and the likelihood of not respecting the rights of patients will increase (Yarney, Buabeng, Baidoo, & Bawole, ). This cycle of increasing workload, non‐observance of patient rights, increased moral tensions and a desire to leave the workforce will exacerbate the ever‐increasing shortage of nursing personnel.…”

“…When the workload increases, nurses are more likely to face moral tensions and to experience moral distress (Corley, Elswick, Gorman, & Clor, ). Also, in such a situation, the likelihood of an intention to leave the profession will increase (Atabay, Çangarli, & Penbek, ).…”

Educating for ethical leadership through web-based coaching

“…Storch et al 1 argue -consistent with the ICN code and the ENDA proto-code of ethicsthat nurse leaders can and should provide ethical leadership by 'building a moral community, that is, a workplace where values are made clear and are shared, where these values direct ethical action, and where individuals feel safe to be heard'. 1 The main focus within this perspective is not -like in the corporate literature -on the moral character and conduct of the leader, although this is a part of it, but instead on the leader's commitment to a strategic role in developing an ethical work climate, 10,33,34 incorporating ethical values of patient safety into decision-making at all levels 35 and supporting ethical nursing practice as part of excellence in patient care. 11 The empirical literature, as well as international codes of ethics, indicates a need for enhancing awareness of standards of ethics and educating for ethical leadership.…”

Moving from conceptual ambiguity to knowledgeable action: using a critical realist approach to studying moral distress

“…Overall, the critiques outlined above have led to a call for research on moral distress that will help to clarify the concept, as well as research that attends to the relationship between the individual agent and the structural contexts of health care (Pauly et al, 2009;Varcoe et al, 2012;Atabay et al, 2015). These critiques also reflect a challenge to developing a comprehensive understanding of moral distress that may originate in our ontological and epistemological perspectives.…”

“…Given the complexity of causality in moral distress, being able to better appreciate generative mechanisms is a significant methodological strength for research related to moral distress. For instance, although there is agreement regarding some of the contributing factors -such as the health care provider having an awareness of their moral obligation, yet being unable to enact their moral agency due to constraints -researchers continue to grapple with how individual and structural factors come together to create moral distress in some situations and not others (Austin, 2012;Varcoe et al, 2012;Atabay et al, 2015).…”