Expressões da ética e do di stresse moral na prática do enfermeiro intensivista

Abstract

Expressões da ética e do di stresse moral na prática do enfermeiro intensivista Ethics and moral distress expressions in intensive care nursing practice Expresiones de la ética y del distrés moral en la práctica del enfermero intensivista

Registered Nurses' and nursing students' perspectives on moral distress and its effects: A mixed‐methods systematic review and thematic synthesis

“…A sense of powerlessness to intervene regarding care, treatment and decision‐making perceived as generating needless patient suffering and transgressing core professional values contributed to moral distress among RNs (Berhie et al, 2020; Crespo Drago et al, 2020; De Brasi et al, 2021; Deady & McCarthy, 2010; Harrowing & Mill, 2010; Ko et al, 2019; Langley et al, 2015; Nikbakht Nasrabadi et al, 2018; Prompahakul et al, 2021; Sauerland et al, 2014) and nursing students (Escolar Chua & Magpantay, 2019). This was invariably connected with interventions, treatment and care decisions perceived as futile (Asayesh et al, 2018; Browning, 2013; Choe et al, 2015; Ganz et al, 2013; Dodek et al, 2019; Dyo et al, 2016; Emmamally & Chiyangwa, 2020; Hiler et al, 2018; Hou et al, 2021; Karanikola et al, 2014; Ko et al, 2019; Latimer et al, 2021; Rezaee et al, 2019; Robinson & Stinson, 2016; Silverman et al, 2021; Wiegand & Funk, 2012; Wilson et al, 2013), overly aggressive (Rezaee et al, 2019; Wiegand & Funk, 2012) and inappropriate or unnecessary (Asgari et al, 2019; Browning, 2013; Choe et al, 2015; Christodoulou‐Fella et al, 2017; De Brasi et al, 2021; de Sousa Vilela et al, 2021; Fernandez‐Parsons et al, 2013; Forozeiya et al, 2019; Ganz et al, 2013; Ko et al, 2019; Laurs et al, 2020; Nikbakht Nasrabadi et al, 2018; Silverman et al, 2021) particularly, but not exclusively (de Sousa Vilela et al, 2021; Deady & McCarthy, 2010; Rezaee et al, 2019; Wojtowicz et al, 2014), in the context of end‐of‐life care.

We're with the patients a lot more than the providers … we see the futility a lot of the times, because we're like there's no wa...

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“…Others, however, seemingly remained silent. This was primarily on account of interprofessional team hierarchies, notably the perceived enduring power of the medical profession (Atashzadeh Shorideh et al, 2012; Caram et al, 2019; de Sousa Vilela et al, 2021; Deady & McCarthy, 2010; Escolar Chua & Magpantay, 2019; Ko et al, 2019; Langley et al, 2015; Pavlish et al, 2016; Renno et al, 2018; Silverman et al, 2021; Wolf et al, 2016), encapsulated in the following data extract:

Physicians believed [sic] they are above us. They order for patients and they expect us to obey them and not tell them about wrong orders.

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Fatores que interferem na saúde dos profissionais de Enfermagem no Centro Cirúrgico

“…Os enfermeiros apontam à invisibilidade de sua prática à ausência de definição das atribuições da equipe de enfermagem e a sensação de não pertencimento à equipe multidisciplinar, as deficiências na comunicação é uma das situações levantadas pelos enfermeiros, o que pode acarretar desavença entre os componentes da equipe, e sua organização (VILELA G, et al, 2021). A agressividade no campo de trabalho também é causada pelos próprios profissionais, ou seja, os colaboradores de saúde que desempenham cargos semelhantes ou hierarquicamente superiores, e associasse ainda a deficiência e a crise na saúde.…”

Nursing and Health Advocacy: Development Process of an Educational Manual

“…Nursing is considered one of the ideal professions for the practice of health advocacy because of its close relationship with users, and its defense is understood as a professional obligation, a moral good, and an ethical ideal 5 . Health advocacy represents ethics in the work actions of the nursing professional, related to quality care, and also to the defense of the rights and needs of each user of the health servisse 6 .…”