Pediatric Nurse's Moral Distress

The roles and responsibility of a nurse are that most nurses face moral problems similar to these faces by the physician as well as a moral problem uniquely related to their professional role thus nurse must sometimes choose between doing what they believe will promote patients well-being and the respecting the patient ’ self-determination. Lisa explained the role as a role, is a “norm-governed patterns of action that undertaken in accordance with the social expectations” (Lisa page 690). Thus, the ability to serve and work according to the

Myrtle Aydelotte once said, “Nursing encompasses an art, a humanistic orientation, a feeling for the value of the individual, and an intuitive sense of ethics, and the appropriateness of action taken.” In Pediatrics, nurses are faced with many ethical challenges that reflect back to their own personal beliefs and values, in congruent with being able to provide the best quality care both ethically and legally for children without autonomy. When providing care for these patients who do not have autonomy, the nurse’s priority is to advocate and support the child and the families’ needs on a daily basis. The purpose of this ethical paper is to project the dilemma and ethical issues that nurses often encounter involving children, including those who are unable to make decisions for themselves.

Such factors may affect the degree to which nurses are able to fulfill their moral obligations and/or the number and type of ethical dilemmas they may face.

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.

While the nursing profession is fulfilling, it is not without challenges. Nurses are faced with a multitude of ethical dilemmas in clinical practice on a daily basis. According to Fant (2012) no matter where nurses function in their diverse roles, they are faced with ethical decisions that can impact them and their patients. Some examples of moral issues that nurses encounter in contemporary nursing practice and research include but not limited to: refusal of treatment, scarcity of resources, disagreement with caregivers, treating patients with impaired decision-making, futile treatment decisions for cancer patients, end-of-life decisions, advanced treatment directives, and euthanasia (Leuter, Petrucci, Mattei, Tabassi, & Lancia, 2013).

Neonatal nurses spend their career working with babies, those that are healthy and those that are not. Working with newborns is guaranteed to have its challenges, especially for those particular nurses who choose to work in the neonatal intensive care unit. The neonatal intensive care unit, or NICU, is where the infants suffering from potentially fatal diseases/disorders are held. NICU nurses struggle with life and death situations each and everyday, which is sure to be accompanied by specific emotions such as moral distress. In the words of researcher Kain (2006), “moral distress is defined as uncomfortable, painful emotions that arise when institutional constraints prevent the nurse from performing nursing tasks that are deemed necessary

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)..

Moral distress is describe as the phenomenon in which a nurse understands and has clarity about a right action to take, but is constrained from taking it. It differs from an ethical dilemma in which there is recognition of a problem; in which at least two ethically justifiable but opposing solutions can be applied (American Nurses Association, 2014). Moral distress was first recognized among the nursing field; because of this, many of the studies have focused on the nursing population. However moral distress has also expanded to many other fields, making it now a multidisciplinary concern

Moral distress is yet one more causative factor of high occupational stress in emergency nursing. Fernandez-Parsons, Rodriguez, & Goyal, (2013) identified the top ten causes of moral distress in emergency nursing where work with incompetent healthcare provider was on top and provision of care that does not relief the suffering of the patient was on the bottom of the list. Moreover, the authors pointed out that moral or initial distress if not resolved effectively and timely, could lead to the reactive

Thank you for very interesting and eye-opening post. Reading your post, and as it is exemplified in posts from our colleagues as well, moral distress and the moral residue is an ongoing problem in many healthcare settings. Pauly, Varcoe, & Storch (2012) point out that many types of research have shown that moral distress is a widespread problem for many healthcare professionals in a wide range of acute and community healthcare settings. It seems that nurses often find themselves in the position of compromising their moral integrity. And, when moral integrity is threatened, for sure moral distress will occur. And, when moral distress stays unresolved, it can over time bring about moral residue. I do not think that we can eliminate moral distress, however, we can try to minimize it. Pauly et al. (2012) indicated that more research in the area of moral distress and the moral residue is needed. Also, joined ethics education of nurses, physicians, and other members of healthcare teams are the way how to minimize moral distress in healthcare settings.

Nurses are obligated to care for all patients; however, in certain situations the risks of harm might outweigh a nurse's moral obligation or duty to care for a given patient. There are limits to the personal risk of harm nurses can be expected to accept. Accepting personal risk exceeding the limits of duty is not a moral obligation; it is a moral option. (Medscape.com. n.d.)

Nurses are obligated to care for all patients; however, in certain situations the risks of harm might outweigh a nurse's moral obligation or duty to care for a given patient. There are limits to the personal risk of harm nurses can be expected to accept. Accepting personal risk exceeding the limits of duty is not a moral obligation; it is a moral option. (Medscape.com. n.d.)

Therefor they place themselves in a highly stress environment in order to provide the best care possible (Jensen,& Key,2009.p 32). However, at times there are many factors could interfere with one’s conscience and sometimes questioning. These factors cause the person to unable or failing to provide for the care that the patient require. For example, a nurse working in an emergency department might encounter a patient who is a Jehovah’s witness who is in need for blood transfusion, but due to their belief and teaching, the producer cannot be done. The nurses in this situation might feel conflicted with their conscience as they cannot do anything to help. In a prolong situation it can leads to the nurses felling useless, frustrated anger, burnout job dissatisfaction out, emotional detachment from patients which could lead to deteriorate the patient-caregiver relationship, as there is nothing that they can do but rather than to respect their choices and provide best care possible by (Genuis, & Lipp,

The title of my article is Exploring the moral distress of registered nurses. In today’s healthcare system nurses experience moral distress on a regular basis. This study is considered quantitative because the researcher used survey methods to identify types and frequencies of patient care situations that provokes moral distress. Data was collected over 4 months, surveys were returned to principle investigator and clinical managers. The data was collected by using an instrument called Moral Distress Scale (MDS). An instrument that has established reliability and validity. MDS measures two components of moral distress; intensity and frequency related to clinical practice. Open ended questions were asked to gain more detailed data. The researcher reduced data to numerical findings that are expressed in charts. I chose this article because nurses face moral distress on a daily basis. Unable to recognize and manage moral distress can lead to nurses being burned out, high turnover rate and finally leaving the nursing profession all together. This article was written because there is a gap of communication between organizations and staff members. Organizations need to provide basic training to staff members to recognize and manage moral distress. Another purpose of this article is to have nurses take responsibility for their education. Nurses need to be proactive and seek their manager’s help to build strong emotional

The following case presentation illustrates the moral distress a nurse may experience when her patient advocacy meets resistance, and her moral courage is challenged. It also describes ineffective management strategies to help nurses resolve the problem. If doctor or supervisors will hear Joanna and could recognize early that patient has ruptured abdominal aortic aneurysm, the surgery would save Mrs. Kelly life. Joanna 's conflicting values were feeling that something is not right with the patient. She was doing what was in her power to make others pay attention that