Moral distress amid COVID-19

Virani, Salima Bano

doi:10.1097/01.nurse.0000800072.35132.c1

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…Health professionals experience moral distress – a painful psychological imbalance resulting from not being in a position to take ethically appropriate action, because in the case of austerity, generating efficiencies are no longer possible. 110 , 112 , 121 , 122 Once again, this results in a diminished view of the profession, apathy and burnout, starting to generate a cyclical and destructive interplay between CMOCs. 109 Moreover, if moral distress is not treated appropriately, can result in ‘moral residue,’ where past moral distress can lie dormant until the next shock, when it resurfaces unexpectedly.…”

Section: Resultsmentioning

confidence: 99%

How International Health System Austerity Responses to the 2008 Financial Crisis Impacted Health System and Workforce Resilience – A Realist Review

Fleming

Caffrey

Belle

et al. 2022

Int J Health Policy Manag

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Background: The Great Recession, following the 2008 financial crisis, led many governments to adopt programmes of austerity. This had a lasting impact on health system functionality, resources, staff (numbers, motivation and morale) and patient outcomes. This study aimed to understand how health system resilience was impacted and how this affects readiness for subsequent shocks. Methods: A realist review identified legacies associated with austerity (proximal outcomes) and how these impact the distal outcome of health system resilience. EMBASE, CINAHL, MEDLINE, EconLit and Web of Science were searched (2007– May’21), resulting in 1,081 articles. Further theory-driven searches resulted in an additional 60 studies. Descriptive, inductive, deductive and retroductive realist analysis (utilising excel and Nvivo) aided the development of Context, Mechanism, Outcomes Configurations (CMOCs), alongside stakeholder engagement to confirm or refute emerging results. Causal pathways, and the interplay between context and mechanisms that led to proximal and distal outcomes, were revealed. The refined CMOCs and policy recommendations focused primarily on workforce resilience. Results: Five CMOCs demonstrated how austerity-driven policy decisions can impact health systems when driven by the priorities of external agents. This created a real or perceived shift away from the values and interests of health professionals, a distrust in decision-making processes and resistance to change. Their values were at odds with the realities of implementing such policy decisions within sustained restrictive working conditions (rationing of staff, consumables, treatment options). A diminished view of the profession and an inability to provide high-quality, equitable, and needs-led care, alongside stagnant or degraded working conditions, led to moral distress. This can forge legacies that may adversely impact resilience when faced with future shocks. Conclusion: This review reveals the importance of transparent, open communication, in addition to co-produced policies in order to avoid scenarios that can be detrimental to workforce and health system resilience.

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Section: Resultsmentioning

confidence: 99%

How International Health System Austerity Responses to the 2008 Financial Crisis Impacted Health System and Workforce Resilience – A Realist Review

Fleming

Caffrey

Belle

et al. 2022

Int J Health Policy Manag

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“…Emergency nurses experience a considerable burden from the increased workload and difficulties of working during a pandemic (González-Gil et al, 2021;Kandemir et al, 2021). Moreover, the scarcity of medical resources during this pandemic and the implementation of no-visit policies made it difficult for medical staff to provide the desired level of end-oflife care to the dying patients, resulting in the staff experiencing emotional distress (Virani et al, 2021). The increased workload and reallocation of resources to lifesaving care during disasters are particularly pronounced in the ED.…”

Section: Introductionmentioning

confidence: 99%

Emergency nurses' perceptions of the changes in the quality of death and distress during the COVID-19 pandemic in Japan: A cross-sectional study

Ito

Tsubaki

Sakaguchi

2024

Health Emergency and Disaster Nursing

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Aim: This study aimed to determine the perceptions of emergency nurses regarding the changes in the quality of death and distress associated with care due to the COVID-19 pandemic. Methods: We conducted a cross-sectional survey among the emergency nurses working in emergency departments in Japan. To recruit the participants, we sent a letter requesting participation to 1,048 nurses in the emergency departments (EDs) of 40 of the 290 hospitals nationwide. We evaluated the perceptions of the emergency nurses of the changes in the quality of death and distress during the COVID-19 pandemic. Results: A total of 284 nurses out of 1,047 participated in the study and completed the questionnaire. The most commonly perceived change in the quality of death during the pandemic was related to the absence of a loved one at the time of death. The emergency nurses strongly agreed that the patients did not receive the best possible care, patients could not maintain their dignity as individuals, and families of the patients regretted that they could not do more to save their relationship. The ED nurses perceived that their capacity to provide appropriate end-of-life care had changed considerably during the pandemic, about which the nurses felt distressed. Conclusions: The COVID-19 pandemic is an unprecedented situation facing emergency nurses. Health authorities must assist emergency nurses in providing their patients with the desired end-of-life care services. At the same time, consideration should be given to the mental health of the emergency nurses, and psychological support should be provided.

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An Ethical Dilemma: Freedom Versus Authority

Burns¹

2023

The Human Impact of the COVID-19 Pandemic

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Moral distress amid COVID-19

Cited by 5 publications

References 24 publications

How International Health System Austerity Responses to the 2008 Financial Crisis Impacted Health System and Workforce Resilience – A Realist Review

How International Health System Austerity Responses to the 2008 Financial Crisis Impacted Health System and Workforce Resilience – A Realist Review

Emergency nurses' perceptions of the changes in the quality of death and distress during the COVID-19 pandemic in Japan: A cross-sectional study

An Ethical Dilemma: Freedom Versus Authority

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