Identifying Moral Distress : Ethical Concerns Of Intensive Care Unit Nurses

Humans often struggle to find the right answers in life. Knowing the difference between right and wrong is not always easy and one can be overwhelmed with the problems and ethical issues surrounding them. As a future healthcare professional, it is imperative to understand the role that ethics plays in nursing and how ethical dilemmas impact individuals. There are countless complex ethical issues that confront nurses during their careers and it is crucial they understand where their own values and beliefs lie. Euthanasia, DNR’s, end of life care, privacy, stem cell research and restraints are all great examples of some common ethical issues. “While there are many challenges facing nurses in the work environment (nursing short-age, mandated

Nursing is not an easy job and those who chose it as their profession are truly special people. Nurses are confronted with ethical decisions that need to be made on a daily basis. Often they know the right thing to do but because of circumstances like institutional structure and conflicts with others, obstacles are created and distress ensues (Jenner, 2001). It is during times like these that nurses must rely on the training that they have received as well as the code of ethics that has been set down for their profession in order to do the right thing.

Jameton defines moral distress as, occurring when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action. Oncology nurses find themselves struggling with moral distress in an oncology unit, which is where cancer patients are cared for and educated by the nurse. An oncology nurse suffers moral distress when they know the right course of action, but feel powerless to act out the choice because of the institution or its policies, lack of resources, lack of support, or legal limits. Oncology nurses provide care over an extended period of time and often administer aggressive treatments. Oncology nurses witness the implications of life-prolonging interventions that may contradict with the delivery of care. By witnessing the adverse effects of this treatment, especially affects the nurse when the goals of care are to provide compassion rather than curative. Moral distress affects the oncology nurse, their emotions, their relationship with patients, other health providers, or family members.

Moral distress is experienced by nurses every day in today’s health care system. Moral distress has been found to be manifested as anger, frustration, guilt, loss of self-worth, depression, powerlessness and helplessness (Zuzelo, 2007, p. 346). Failure to recognize and manage moral distress is causing nurses to be “burned out” have high turnover rate, and even leaving nursing profession all together.

Nurses apply their moral and ethical training in difficult scenarios within the workplace where leadership and guidance are necessary in the nursing profession.

The role of ethics in organizational behavior is the underlying factor to the success and longevity of any organization. A set of rules and guidelines focusing on promoting safety, trust, and responsible practice within the workplace must be established internally. Organizations develop code of ethics that center upon the promotion of good. Ethics are vital in developing trusting relationships between employees and administration within.

Nurses are faced with ethical dilemmas or ethical distress every day, each situation being unique and requiring nurses to set aside their own values and beliefs in order to provide proper care for their patients (Ramos, Brehmer, Vargas, Trombetta, Silveira, & Drago, 2015). Ethical dilemmas allow nurses to learn more about themselves and help shape their morals and values (Potter & Perry, 2014). An ethical dilemma arises in a situation in which no solution seems completely satisfactory (Drumwright, 2012).

Why do nurses feel frustrated when they confront with ethical dilemma in ICU? (How they resolve)?

Have you ever sat and thought about how nurses can give good ethical quality of care when they seem to always be understaffed and overcrowded? In this Research paper, I will look at what the effects of understaffing is on nurses and patients. Per the CUPE website their research show that one in ten patients in Canada acquire a nosocomial infection during their visits to the hospital. This seems to be a very alarming rate. Their research has also come to show that thirty percent of these infections are preventable, and that understaffing is one of the major attributors to this growing problem.

From a particular self-administered survey taken by over 1000 nurses in four different states and in four different census regions in the United States, over half appeared to “feel uncomfortable in addressing the ethical issues they encountered in patient care”. (Ulrich et al. 1). However, from analysis of over 422 questionnaires, the top five most frequently occurring and

According to the article “Understanding and Addressing Moral Distress” the last 23 years have not changed. “Moral distress occurs when nurses know the ethically correct action to take but feels powerless to take that action” (Epstein & Delgado, 2010). Moral distress often encompasses nurse’s feelings of dissatisfaction, aggravation, anger, and are conflicting with the requirements of care, and the fundamental views of the work environment. Moral distress also can cause nurses to be overwhelmed, often leading them to believe that leaving the work setting, and the profession is the only answer, due to the negative impact of ethical challenges, emotional sufferings, and the intuition only worrying about the cost of nursing care. (Corley,

From a particular self-administered survey taken by over 1000 nurses in four different states and in four different census regions in the United States, over half appeared to “feel uncomfortable in addressing the ethical issues they encountered in patient care”. (Ulrich et al. 1). Also, from analysis of over 422 questionnaires, the top five most frequently occurring and trying ethical patient care issues were “protecting patients’ rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making”. (Ulrich et al. 1). Although,

The ethical dilemma is a situation by which it’s difficult to determine whether a situation is can be handled without disappointing both sides. Therefore, an ethical dilemma exists when the right thing to do is clear or when members of the healthcare team cannot agree on the right thing to do. Ethical dilemmas require negotiation of different points of view (potter, Perry, Stockert, & Hall 2011pg 78).

A moral distress involves two components. It is when a person has emotional and physical stress when one knows the right action to take but are unable to do the action. A moral distress also occur when a person acts in a way regardless of their values and moral beliefs “which undermines your integrity” (American Association of Critical Care Nurses [AACCN], 2004)..

between two sets of human values, both of which are judged to be “good” but neither of