Nurse Moral Distress and Ethical Work Environment

Corley, Mary C.; Minick, Ptlene; Elswick, R. K.; Jacobs, Mary Ann

doi:10.1191/0969733005ne809oa

Cited by 469 publications

(643 citation statements)

References 35 publications

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“…The results of this study showed that ethical climate with average score of 3.48 with a standard deviation of 0.61 was moderate, in Corley et al (2005), this average was 3.33 out of 5 (6), in Ulrich et al Equal was 2.6 (7) that is less than the average of this study. Perhaps the reason for this difference in working conditions and organizational culture in Iran hospitals with other countries.…”

Section: Discussionmentioning

confidence: 39%

The relationship between ethical climate of hospital and moral courage of nursing staff

et al. 2019

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Introduction:Courage is the ethical virtues that has special place in the nursing profession, whose role in patient support is highlighted. Courage virtues seems to grow with environmental reinforcement and social support. Hospital as a dynamic social institution has different forms of ethical climates. The purpose of this study was to determine the correlation between the ethical climate of the hospital and the moral courage of the nurses in one of the medical universities of Iran medical science's selected hospitals. Method: This study is a descriptive-correlational study. The sample included 156 nurses who were selected by available method. A translated questionnaire of Olson's ethical climate and Sekerka's et al moral courage was used to collect data, in addition to demographic questions. The data were analyzed by SPSS software version 21 using descriptive and inferential statistics. Findings: Nurses' perception of the ethical climates of the hospital was average (mean= 3.79, SD = 0.56) and their courage was moderate (mean 3.87, SD=0.86). There was a significant positive correlation between nurses' ethical climates and their moral courage (r = 0.90, p <0.001). Conclusion: According to the findings of this study, the moral courage virtue of nurses in ethical climates of support and care grows well. Therefore, to improve the role of protecting patients' rights and promote moral courage, attention should be paid to improving the ethical climates of the hospital. In addition, planners and nursing managers should consider arrangements for developing the ethical climates of the workplace.

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Section: Discussionmentioning

confidence: 39%

The relationship between ethical climate of hospital and moral courage of nursing staff

et al. 2019

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“…In other fields also, the frequency with which health-care workers and trainees experience ethical confrontations are unclear. 16,18 Medical and nursing training and practice are often difficult, residents or nurses may also participate in procedures or resuscitations about which they have major reservations in other domains of practice. For example, ethical confrontations may be experienced by residents and nurses in the setting of performing liver transplantation in alcoholic patients, bariatric surgery, aesthetic surgery, prolonged and aggressive therapy after multiple relapses in oncology patients, intensive resuscitation of elderly patients with poor functioning, etc.…”

Section: Resultsmentioning

confidence: 99%

Moral distress in the neonatal intensive care unit: caregiver's experience

et al. 2007

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Background: The Neonatal Intensive Care Unit (NICU) can be ethically charged, which can create challenges for health-care workers.Objective: To determine the frequency with which nurses and residents have experienced ethical confrontations and what factors are associated with increased frequency.Design/Methods: An anonymous questionnaire was distributed to nurses in a university center, a high-risk obstetric service, a maternity hospital NICU with 85% in-born patients and an outborn NICU, most of whose preterm admissions are those with surgical complications. Obstetric and pediatric residents in the four universities of the province also received the questionnaire, which included demographics, opinions regarding the gestational age threshold at which resuscitation of a premature infant with bradycardia was appropriate, knowledge of cerebral palsy (CP) outcomes (as an indicator of knowledge about long-term sequelae of prematurity) and questions about ethical confrontation in the NICU.Results: Two hundred and seventy-nine caregivers participated (115 full time nurses and 164 residents). All the distributed questionnaires were completed. Frequent ethical confrontation was reported by 35% of the nurses and 19% of the residents. Among the nurses, moral distress differed significantly between work environments. Nurses working in an out-born NICU and obstetric nurses were more likely to overestimate CP prevalence (P<0.05). Nurses who overestimated CP rates had higher thresholds for resuscitation and were more likely to experience ethical confrontations. Of the residents, 60% were pediatric and 40% obstetric. All groups of residents frequently overestimated the prevalence of CP, and knowledge differed significantly by residency program (P<0.05). The residents who overestimated CP rates had higher thresholds for resuscitation, had more incorrect answers regarding prematurity outcomes and were less likely to have ethical confrontations.Conclusions: A large proportion of nurses and residents report frequent ethical confrontations. Many residents and nurses have limited knowledge of outcomes and high threshold for resuscitation. Ethical confrontation is more common among nurses with poor knowledge about outcomes, and less common in residents with poor knowledge about outcomes.

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“…Clinical setting/population Gutierrez (2005), Meltzer and Huckabay (2004), Sundin-Huard and Fahy (1999) Critical care Aiken et al (2002), Corley et al (2005), Rice et al (2008) Medical/surgical care…”

Section: Author(s)mentioning

confidence: 99%