Understanding And Addressing Moral Distress

Nurses confront numerous dilemmas throughout their professional lives. The different types of dilemmas include, but are not limited to, ethical, moral, and legal dilemmas. These are the three most common dilemmas in nursing. A dilemma can be defined in many different ways. But all dilemmas are situations in which you have to make a difficult choice. Chiaranai (2011) states that an “ethical dilemma is a circumstance that arises from fundamental conflicts between ethical beliefs, duties, principles and theories” (p. 250). Therefore, an ethical dilemma forces the nurse to address thought on what is right and what the harm might be to the patient.

Engulfed in a cloud of grey uncertainty, there are many situations that are blemished in the profession of nursing. Ethical dilemmas are often the most challenging to handle as they are interlinked with our own personal values and morals, requiring knowledge and attention to many factors (Burkhardt, Nathaniel, & Walton, 2014). Ethical predicaments will cross our paths daily and we need to utilize ethical frameworks, codes and our personal decision making to come to a well-informed conclusion. When we are in the midst of an uncertain quandary our human nature is tested, and we thoroughly scrutinise who we are ethically and morally. I am going to work through an ethical decision making model and discuss my journey with an encounter I have

An ethical dilemma is defined as a mental state when the nurse has to make a choice between the options and choices that he or she has at her disposal. The choice is a crucial task as the opting of the step will subsequently determine the health status of the concerned patient, hence it requires a great deal of wisdom along with proper medical and health training before any such step is opted as it is a matter of life and death. Strong emphasis should therefore be on the acquisition of proper knowledge and skills so that nurses do posses the autonomy to interact with patients regarding ethical issues involved in health care affairs and address them efficiently. It is normally argued that nurses are not provided sufficient

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).

Effective nursing, in order to properly serve patients as well as the greater community, must necessarily be based on a strong, unshakeable foundation of ethical practice, which can be expressed through various theoretical nursing models. This paper will examine the theoretical basis for author’s own ethical nursing practice, and relate the theoretical discussion to the specific Phenomenon of Interest that was previously identified in earlier papers.

Engulfed by a cloud of grey, there are many situations that are not unblemished in the profession of nursing. Ethical dilemmas are often the most challenging to handle as they are interlinked with our own personal values and morals, requiring knowledge and attention to many factors (Burkhardt, Nathaniel, & Walton, 2014). Ethical predicaments will cross our paths daily and we need to utilize ethical frameworks, codes and our personal decision making to come to a well-informed conclusion. When we are in the vicinity of an uncertain quandary our human nature is tested, and we thoroughly scrutinise who we are ethically and morally. I am going to work through an ethical decision making model

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

In the article ¨Moral Distress And Avoidance Behavior In Nurses Working In Critical Care And Noncritical Care Units,” by Mary Jo De Villers, she states ¨it has been predicted that there will be a shortage of 500,000 nurses in the United States by 2025.¨ This counts for the United States alone. Many articles state that more and more research is being done on moral distress relating to nurses all around. This leaves researchers wondering, could this be the main reason for the shortage of nurses? Moral distress comes into play dramatically with specific nurses such as pediatric intensive care, neonatal intensive care, and intensive care unit. Many of the nurses have to deal with life-or-death situations on a daily basis working in those units. Dealing with that dilemma daily makes it harder for this medical staff to go back to the hospital. All nurses deal with some kind of moral distress, but critical care nurses suffer from a more intense level of distress.

In this script the authors describe and discuss moral courage in nursing; and explore personal characteristics that promote moral courage, including moral reasoning, the ethic of care, and nursing competence.

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.

Nursing, in my view, has always been a field in which moral courage was inherent. Nursing is one of the few fields in which individuals disregard their own personal wellbeing in favor of other people’s health. Moral courage is an elusive topic to define, as it is such an intangible concept. According to Murray, “moral courage is considered to be the pinnacle of ethical behavior; it requires a steadfast commitment to fundamental ethical principles despite potential risks, such as threats to reputation, shame, emotional anxiety, isolation from colleagues, retaliation, and loss of employment (2010.) To exemplify this issue, Murray continued to give an example of moral courage with a novice nurse named Emily.

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

Moral distress is generally defined as the unpleasant feelings when a nurse cannot take an action what he or she perceives as ethically correct because of institutional constraints (Choe, Kang, & Park, 2015). A nurse will likely experience a similar situation in her nursing profession that will leave her very uncomfortable, frustrated, or angry. The physical and psychological stress of caring for sick patients and making the right decision, makes them more prone to fatigue, reduced job satisfaction, higher turnover, and early retirement.