Living With Moral Distress: The Perspectives and Experiences of Iranian Nurse Preceptors

Abstract

Background and Purpose: Preceptors play a key role in the transition experience of new nurses. Preceptorship is a stressful role and is influenced by contextual factors. There is a lack of sufficient understandings of the perspectives and lived experiences of Iranian nurse preceptors of preceptorship. The aim of this study was to explore the perspective and lived experiences of Iranian nurse preceptors of preceptorship. Methods: A qualitative design using a hermeneutic phenomenological approach was used. Six Iranian nurse preceptors were chosen using a purposeful sampling method from a large paediatric teaching hospital in an urban area of Iran. Data was collected using in-depth semi-structured interviews and was analysed using the Diekelmann et al.’s method of hermeneutic phenomenological analysis. Results: The data analysis resulted in the development of a constitutive pattern of ‘living with moral distress’, which was constituted of two major themes: ‘asking for and being unable’ and ‘the experience of conflict’. Implications for Practice: The findings of this study can improve nurses’ understandings of the preceptor’s role and associated factors influencing the implementation of the preceptorship programme. ‘Moral distress’ caused by the preceptor role can influence nurse preceptors’ mental health and also the patient care outcomes. More studies are required to explore this phenomenon in different contexts and cultures and design strategies for reducing the burden of taking this role on nurse preceptors. Also, policies are needed for developing a formal preceptor support system to help preceptors take this stressful and demanding role in healthcare settings.

Electrocardiogram interpretation competency among emergency nurses and emergency medical service (EMS) personnel: A cross‐sectional and comparative descriptive study

“…In a recent study by Hassankhani et al (2018), emergency nurses considered the recording of 12-lead ECG as their most frequent diagnostic role (Hassankhani et al, 2018). Upon the successful completion of a 4year nursing program, all students are automatically registered as "nurse" by the ministry and receive the permission work at the bedside (Shahbazi et al, 2018).…”

Nurse preceptors’ perceptions of benefits, rewards, support, and commitment to the preceptor role in a new preceptorship program

“…Consistent with other studies, they were nominated by unit managers on the basis of their merits and experience [ 36 ], however, the program coordinators discounted the workload involved in undertaking the preceptor role on top of patient care responsibilities. In another similar study, preceptors described their experience as ‘living with moral distress’: they felt responsible for the professional development of new nurses but could not fulfill their responsibilities as they wished [ 13 ]. A reasonable workload allocation should be considered for preceptor nurses to reduce the risk of compromising one role to another and help optimise the outcomes of the preceptorship program [ 37 , 38 ].…”

“…In the hospital where this study was conducted, the preceptorship program was established in line with preparing the workplace to better support new nurses in adapting to their new work environments [ 10 , 11 ]. In general, the preceptorship program involves the education of newly graduated nurses who enter clinical practice for the first time and orientation of experienced nurses to ensure a smooth transition to a new workplace [ 12 , 13 ]. The duration of the program is usually between two to 4 weeks.…”

“…Their role is to facilitate the new nurse’s transition to safe nursing practice by orienting them to the new physical environment, ward routines, and norms and values of the workplace. The preceptor prioritises nurses’ educational needs, and helps them to increasingly grow independence and carry out nursing interventions safely [ 13 ].…”

Work Index and Contextual Variables as Predictors of Emergency Nurses’ Career Success

“…Although it is not possible to make a more accurate judgment due to the lack of a cut-off point for subscales, it seems that emergency nurses meet Expected Career Progress and Person-Organization Fit of career success more than other wards. Since the work environment of the emergency department is special and complex, it is necessary for the nurses who work there to have special competencies, knowledge, and skills (Shahbazi et al, 2018).…”