Emergency nurses’ experience of coping with moral distress

Abstract

Purpose: We explored emergency nurses’ experiences of coping with moral distress.Methods: A qualitative research design was used. We conducted in-depth interviews with 11 nurses working at a regional emergency medical center in South Korea. Data were analyzed using conventional content analysis.Results: The main theme of nurses’ coping with moral distress was “a passive emotion-based response.” We also extracted three categories of coping strategies: “uncritical adaptation to anguished situation,” “self-justification for not acting,” and “flight from ethical decision making.”Conclusion: Nurses coped with moral distress in a passive and emotional way, possibly because of perceived incompetence and compliance to an organizational hierarchy. The findings imply that effective approaches to addressing moral distress in emergency nurses are needed at the individual and organizational levels.

How do ethically competent nurses behave in clinical nursing practice? A qualitative study

“…Furthermore, in South Korea, intensive care unit nurses often suffer from moral distress, such as ambivalence toward treatment and care, a lack of ethical sensitivity, their own limited autonomy in treatment plans, conflicts with physicians, and conflicts with institutional policy (Choe et al, 2015). Furthermore, Korean emergency room nurses reportedly face various ethical difficulties; for example, Lee and Hwang (2020) outline a situation wherein the family caregivers of a patient, who had consented to a do not resuscitate (DNR), had changed their mind and then requested cardiopulmonary resuscitation (CPR). Another example found in previous studies was when a terminal cancer patient begged to be allowed to kill himself after taking pesticides because the pain could not be controlled even with narcotic analgesics (Lee & Hwang, 2020).…”

“…Furthermore, Korean emergency room nurses reportedly face various ethical difficulties; for example, Lee and Hwang (2020) outline a situation wherein the family caregivers of a patient, who had consented to a do not resuscitate (DNR), had changed their mind and then requested cardiopulmonary resuscitation (CPR). Another example found in previous studies was when a terminal cancer patient begged to be allowed to kill himself after taking pesticides because the pain could not be controlled even with narcotic analgesics (Lee & Hwang, 2020). In addition, Korean paediatric nurses have reported a sense of ethical numbness, such as failing to follow standard protocol in their nursing practice, because of the rapid completion of tasks under a heavy workload (Choe et al, 2019).…”