Moral distress

McCarthy, Joan; Gastmans, Chris

doi:10.1177/0969733014557139

Cited by 239 publications

(84 citation statements)

References 32 publications

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“…Wilkinson (1987, p. 16) expanded the definition to "the psychological disequilibrium and negative feeling state experienced when a person makes a moral decision but does not follow through by performing the moral behavior indicated by that decision." Moral distress has been described in psychological, emotional, and physiological terms, but there is lack of consensus on its definition, operationalization, and parameters (McCarthy & Gastmans, 2015). In the single study to date of nurses' moral distress in abortion care (Hanna, 2005), moral distress was an inclusion criterion, so the prevalence of moral distress among nurses in abortion care was not determined.…”

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confidence: 99%

Calculus Formation: Nurses’ Decision‐Making in Abortion‐Related Care

McLemore

Kools

Levi

2015

Research in Nursing & Health

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Nurses routinely provide care to patients in ethically challenging situations. To explore the continuum between conscientious objectors and designated staff in the provision of care to women seeking abortions, the aim of this study was to thickly describe decision-making, using abortion as the clinical context to elucidate how nurses approach ethically challenging work. A purposive sample of 25 nurses who worked in abortion clinics, emergency departments, intensive care units, labor, and delivery, operating rooms, and post anesthesia care units were interviewed. Qualitative description and thematic analysis were used to identify the cognitive, emotional, and behavioral processes in nurses' decisions to care for women needing abortions. Nurses developed and used multifaceted, realtime calculi when making decisions about their participation in emergent or routine abortion care. Nurses tacked back and forth between the personal and professional and/or held multiple contradictory positions simultaneously. Nurses weighed the role and opinion of others to determine if they know how to or know why they would provide abortion care to women, particularly in the elective abortion context. The parameters of the nurse-patient relationship were complex and specific to the experiences of both the nurse and patient. Findings from this study further develop the science of ethically challenging decision-making and expand our understanding of factors that influence how nurses develop relationships to ethically challenging work. ß

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confidence: 99%

Calculus Formation: Nurses’ Decision‐Making in Abortion‐Related Care

McLemore

Kools

Levi

2015

Research in Nursing & Health

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“…While the concept of moral distress has been documented extensively in nursing, [1][2][3] there remains disagreement as to how moral distress is operationalized and conceptualized. [4,5] Jameton's [6] definition of moral distress as a response to institutional constraints may not be sufficient to capture the personal experiences of nurses who feel conflicted or challenged. Hanna's [4] definition offers another perspective and identifies moral distress as an "act of interior aversion which occurs with the perception of harm to an objective good."…”

Section: Introductionmentioning

confidence: 99%

“…The many facets of moral distress necessitate the need to further explore and develop this concept as it pertains to nurses in healthcare. [3,5,7,8] As nurses care for patients with diverse backgrounds, it is inevitable that there may be differences in values and that these conflicting beliefs could have a distressing nature. [9,10] The interpersonal aspect of the nurse and the patient places both parties in a relational situation where either could have differing practices.…”

Section: Introductionmentioning

confidence: 99%

Understanding how patient’s personal value systems challenge nurses’ views when providing care

Stanley

2018

JNEP

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Background: Personal conflict as a result of differences in value systems may be a moral challenge faced by nurses when caring for individuals with different cultures and beliefs than their own and is an area of limited study. As nurses care for patients with diverse backgrounds, it is inevitable that there may be differences in values and that these moral conflicts could be distressing. This type of moral distress can cause nurse's personal conflict as their values and beliefs may not match those of their patients. Methods: Moustakas (1994) phenomenological approach was used to elicit meaning from nurse's stories regarding morally challenging situations. Ten nurses were solicited, but only two wrote about their experiences; one worked in a busy emergency department and the other in a rural community setting. Results: Four themes were identified: differences, moral code, weight of the transgression, and internal resolution. Value system conflict was the emergent constituent when nurses shared their stories of caring for patients with different values and beliefs than their own. Conclusions: Nurses may be challenged to care for patients who have different cultural practices than themselves. Value system conflicts may cause strife for nurses who have different beliefs than the patients they care for. Interventions that support strategies to mitigate moral distress such as simulation could be included in future research. Use of simulation as a mechanism for training can assist nurses to work through morally challenging situations.

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“…Second, the nurse also has to deliver care. If the individual's ethical ideology leads to conflict/ disagreement about prescribed medical care or if the nurse believes that other constraints such as availability of resources or the organizational culture conflict with personal values, then he or she will suffer consequences that have been described by researchers, such as burn out [9,10] and moral distress [1,11,12], all of which can reduce the ability to remain with the patient and to function effectively.…”

Section: Introductionmentioning

confidence: 99%

An International Study of Nurses' Ethical Ideology and Religiosity

Dc¹,

Sevigny²,

Fahey-McCarthy³

et al. 2017

J Comm Pub Health Nurs

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To suggest that the nursing landscape is complex is a profound understatement. As nurses care for patients in a continuum of health, they are also confronted with the personal demands of their own value systems and religious belief systems in tandem with values and culture of the hospital. In an effort to shed some light on this complexity, this international study of nurses from four nations explored the relationship between religiosity and ethical ideology. The findings indicate that while there was no significant association between religiosity and ideology, nurses' religiosity, ethical idealism, and ethical relativism differ as a function of country/culture. Future research can investigate whether these differences manifest themselves in behaviour.

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Moral distress

Cited by 239 publications

References 32 publications

Calculus Formation: Nurses’ Decision‐Making in Abortion‐Related Care

Calculus Formation: Nurses’ Decision‐Making in Abortion‐Related Care

Understanding how patient’s personal value systems challenge nurses’ views when providing care

An International Study of Nurses' Ethical Ideology and Religiosity

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