In this post, we discus Moral distress in Nursing. Here, we look at the meaning, real life case and things to do if you are affectd by it.
Do you know most people suddenly started hating what they passionately love doing; the zeal, excitement and enthusiasm slowly fizzle away before their own eyes. Some wished they could just disappear from their work place while others wished they could turn back the hand of time to choose a different career path.
All these are as a result of what is known as moral distress.
What the heck does Moral Distress mean?
Nurses face a lot of things in in their career. Moral distress is the stress resulting from the inability of nurses to act or not being able to do right things because of institutional or organizational constraints. These institutional and other external constraints prevent nurses and other health care personnel in doing what is ethically right. These constraints are usually above the control of health care representatives.
In another way, moral distress may arise in situations where nurses know the ethical principles at stake but external factors prevent them from making a decision to minimize the crisis.
More so, moral distress is largely related to dimensional ethics of work with respect to upholding morals and professional principles and values.
I just want you to know that there is a thin line between moral distress and ethical dilemmas. While the former has to do with social and organizational issues in addition to arising personal feelings, the latter has to do with clinical, legal and spiritual elements.
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Moral distress is a threat to one’s personal integrity, isn’t?
It hurt so well that one sees an ill situation where he or she knows what to say or do but can’t voice it out because they feel powerless to take the right actions.
Is this not imprisonment of the highest order? Most people may think. I onced read online when heart-broken husband narrated a story how his wife was destroyed by her job as A&E nurse. This story broke my heart.
Why will these medical professionals be forced to hold back what they know is right? This is more reasons while many of them quit their job.
If one is working without driving joy from the job; the simplest thing to do is to quit the job, right? It may sound weird and absurd to some but until you find yourself in such situations.
Continually condoning such incidences will have a great psychological effect on the person, I mean adverse effect. So, I don’t really think people leaving their jobs as a result of moral distress is odd.
Ways in which they respond to moral distress:
- Resigning: some nurses unable to cope with such inhumane act imposed on them by organizational / institutional constraints quit their jobs because to them; it seems they are not fulfilling their goals.
- Some nurses usually change their position.
- While few others continue to speak up to what is morally right.
Other consequences of moral distress are:
Anger, unsafe and poor quality of patient care, reduced job satisfaction and frustration.
Causes of moral distress in Nursing:
- Inadequate training of the nurses
- Inadequate staffing
- Inadequate communication and lack of collaboration among the health care personnel
- Giving the patients false hope
- The use of inadequate pain relief
- Lack of trust among the health practitioners
Real life cases of moral distress in nursing:
A third year medical student who is a clinical clerk reportedly said that “throughout his rotations there were situation which arose and things were done contrary to his moral value or what he believed.” According to him “the ways such incidents were treated usually pissed him off”.
According to the research of the American Journal of Surgery; medical students are always faced with choice of overruling in the moral and dangerous condition of their patients who seem so helpless.
Another case of moral distress for nurses is the feeling they have when medical doctors deliver bad news to their patients without empathy.
Another nurse said that, “what distresses her most is when health personnel speak ill of the patients they are meant to care for and treat.”
The nurses seem so helpless because they possess little decision-making power.
What to do about moral distress in nursing
To tackle moral distress cases the root of the cause must be address if we need a society or better put; health sector devoid of moral distresses. The structure which had made it very difficult for nurses to express how they feel inside in face of certain health incidences must be overhauled.
- Health care personnel should be properly enlightened and made to understand the relationships among structural determinants of moral distress, moral agency, ethical action;
Therefore health practitioners are called upon to take ethics education seriously, since it help them in development of moral reasoning and also make them to be able to apply ethical framework in decision making. In so doing; prevents ethical dilemmas in everyday practice.
This education strengthens and equips the nurses with the right responses to certain issues that may arise.
- Health institutions should try as much as possible to always employ enough staff to prevent over burdening one staff with numerous tasks.
- More so, there should be proper communication among the nurses and other health care holders. Unalloyed trust must equally be seen among them.
- Nurses should stop giving patients false hope to avoid been walked up and stressed when the expected results did not manifest.
- Clarity in research: It has been very difficult to address this issue because in one way or the other various researches on moral distress lacked clearness. Consequently, researchers are advised to always employ simple techniques in presenting research results.
- Research should be carried out not just with nurses in acute care sector but also with those that have mild or little challenges.
- To tackle this issues the use of one or more tools must be employed in developing specific context. Various tools need to be employed ranging from simple to complicated or advanced ones thus, making the research understandable, reproducible, and applicable.
- Invariable and unlimited attention should be paid to the relationship among moral distress, moral agency and ethical climate.
- Elimination of little or no attention to intervention approaches: intervention approaches should be put in place to help ease the suffering of these health care attendants. It could be in form of time to time seminars and workshop addressing the challenges they face during practice and proffering possible solution to reduce such difficulties.