March 12, 2009 | | Comments 2
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Is moral distress a nursing epidemic?

Being a nurse can be empowering. You and your staff have the knowledge to ease pain, heal injury, fight disease, and save lives. And at times, you may feel that nurses—more than anyone else—know what is best for patients.

But are there ever times when you feel powerless because what you feel is best isn’t carried out?

A recent New York Times article explores the issue of moral distress in nurses and physicians, which is defined as knowing what is ethically appropriate but being unable to act on it due to obstacles inherent in a situation. The article discusses an increasing amount of nurses and physicians feeling the “competing demands of administrators, insurance companies, lawyers, patients’ families and even one another,” who then must act in a manner opposing their personal and professional values.

A 2007 study conducted among 1,200 nurses by the University of Pennsylvania School of Nursing linked concerns protecting patients’ rights, supporting patients through end-of-life decisions, and fairly distributing resources as causes of moral distress. The effect? Twenty-five percent of nurses were found to experience moral distress, causing them to want to leave their positions. Another 41% failed to say they would choose nursing as a profession again.

Is moral distress prevalent at your facility?

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Keri Mucci About the Author: Keri is an Editorial Assistant in the nursing group at HCPro, Inc. She helps maintain two Web sites (including this one), edits the journal Strategies for Nurse Managers, writes articles, and conducts market research within the industry. She earned her bachelor’s degree in journalism from Salem (MA) State College in 2007.

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  1. Moral distress is plays a large role among nursing these days. HIPAA is part of this along with nurses being demanded to work 12 hour shifts. Related to the demand of 12 hour shifts (instead of 8 hours), nurses are tired and more mistakes are being made. Plus, patients suffer because nurses tend to let the smaller, important tasks go and sit and chart (this is their way of resting). More nursing tasks are being put onto techs (who, also, work 12 hours) and beds aren’t getting done, bathing and personal hygiene of patients are not done, just to sit and talk with a patient is not being done. Nursing assessment at the beginning of shifts has been forgotten and not being taught. Medications aren’t given on time. Charting seems to be the main duty of a nurse in GA. Joint Commission has demanded this and this is what is looked at by accreditation companies.
    I am amazed at the lack of knowledge in hands on skills that nurses do not know. Skills that were taught many years ago, are not being taught and preceptors are not teaching skills to new nurses so it continues to decline.
    Hopefully, before it is too late, this will be seen and changed.
    My thoughts to help start improving nursing morale is:
    1-offer 8 hour shifts (this allows older nurses to remain in the field and prevents burn-out).
    2-Have frequent competency check-offs on technical skills (i.e.-IV insertion, flushing of vas caths and infusaports, physical assessments, communication among patients and physicians.)
    3-Re-inforce the importance of positivitiy among fellow co-workers and patients. A smile goes a long way!!!!!
    4-Put in place a policy of repercussions of negative or lazy behavior.
    Thanks for taking the time to read.

    Debbie Brogdon RN

  2. I am presently employed at an ambulatory surgical center which mainly specializes in opthahmic surgery and pain management. I am experiencing moral distress not only with myself but my nursing staff, due to the fact that our surgeons are in such a hurry to get as many cases done as quick as possible, not only for the financial benefits, but also because their schedules are so full. This results in nurses not being able to spend quality time with the patients or their families, only to ask their name,birthdate and site of ther surgery. “Time-out” as we call it in the OR. It has become an “assembly line”, with pts. being taken in and out of the OR, and rushed out of recovery so that there is room for the next patient to be admitted and prepped. This is not quality nursing, and this is not how my staff or myself were trained to provide quality nursing care.
    My ideas to resolve this problem:
    1. SLOW DOWN,DOCS!Let’s look at the QUALITY and not the QUANITY of providing service to our pts.
    2. Management of Time definitely needs improvement! Don’t schedule 30 procedures on a day when you have to be at your office at 2pm!
    3. Consider the patient! They are paying for services that they are not recieving, and the staff that you employ do not have the time to provide those services to the patient.This results in nurses not being satisfied at the end of the day for taking care of patients the way they should be taken care of and the way the nurses were taught to take care of them.
    I know that in these finacially difficult times, time is money, but we are taking care of people here, not shoes or clothes or whatever else thet make on assembly lines.
    I think its time to realize what we all started out to do: take care of people who need us, educate ourselves so that we know the best way to do that, and allow time to provide our patients with the care that they deserve!
    Thank you for listening to my comment!

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