Moral distress in nursing personnel

Barlem, Edison Luiz Devos; Lunardi, Valéria Lerch; Lunardi, Guilherme Lerch; Tomaschewski-Barlem, Jamila Geri; Silveira, Rosemary Silva da; Dalmolin, Graziele de Lima

doi:10.1590/s0104-11692013000700011

Cited by 35 publications

(62 citation statements)

References 17 publications

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“…The stress generated in nurses due to experiences of poor working conditions generates behavior of omission in the service, which reflects in the quality of care and ways of being of nurses [26,27,28].…”

Section: Discussionmentioning

confidence: 99%

Experiences Of Moral Distress In Nurses’ Daily Work

et al. 2016

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Background: Moral distress in the work of nurses has been an emerging ethical problem in the different levels of complexity in the Brazilian scenario. Objective: raise the situations perceived by nurses working in different health services across the country, as generators of moral distress.Methods: This is a descriptive study of quantitative approach, of survey type. The study was developed with 771 nurses that working in health services of different levels of complexity in the Brazilian scenario. The data were collected in open instrument, they were asked to identify work situations triggering potential mental distress/suffering. Data were statistically analyzed using SPSS statistical software and later organized in tables at the 2010 version of Excel®. Findings:In the survey, were cited 2304 situations of Moral Distress.The situations involve Working Conditions; Professional Relations; Professional Competence; Quality of Care; Access; Labor Organization and Conflict. Conclusions: it becomes important to reflect on the role of the nurse and the development of an ethical and autonomous practice in their daily tasks, given that moral distress deprived nurses from their roles.

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Section: Discussionmentioning

confidence: 99%

Experiences Of Moral Distress In Nurses’ Daily Work

et al. 2016

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“…Sometimes, they may face extreme conflicts that manifest in the form of moral distress, and feel impotent pursuing the right course of action. [11][12][13][14] Considering all these implications, why do nurses accept the burden of advocacy if it is potentially troublesome or risky for them? 35 There are always personal implications for any nurse advocating for a patient, questioning the practice of other workers or even the policy of a health institution.…”

Section: Advocate or Not? -Potentials Implicationsmentioning

confidence: 99%

“…Moral distress may be seen as a psychological imbalance caused by painful feelings that arise when nursing workers are unable to provide a morally appropriate response to a situation, that is, in accordance with their conscience. 15 In the Brazilian context, studies conducted by the Center for Nursing and Health Studies and Research [11][12][13][14][39][40] reveal that when nursing workers decide not to confront situations that have the potential to generate moral distress, they opt not to abandon the profession but to abandon their values, beliefs and, finally, their own professional ideals.…”

Section: Advocate or Not? -Potentials Implicationsmentioning

confidence: 99%

“…12 Subsequent studies identified that denying a nurse's role as a patient advocate, which is defined as the potential to claim the rights of patients that was unused by nurses, was an important source of moral distress. 13,41 Nurses can individually recognize the problems of patients in the routine of their work and advocate in their favor, but it is virtually impossible for them to confront and change systemic problems affecting their patients, which may cause them unnecessary distress. Understanding advocacy as an individual responsibility of nurses seems to discourage nursing associations from playing their most important leadership roles, abandoning nurses and their patients.…”

Section: Advocate or Not? -Potentials Implicationsmentioning

confidence: 99%

“…[10][11] Both Brazilian and international studies have identified that the practice of patient advocacy in the face of ethical conflicts can either generate relief or intensify moral distress if nursing workers are prevented from performing the role that corresponds to their ideals. 5,[11][12][13][14] Therefore, nurses experience moral distress when they recognize a need to advocate in favor of their patients but, due to external pressure, are prevented from proceeding with such an action. 15 Therefore, patient advocacy may be a response to the constant moral problems experienced by nurses in healthcare settings, especially given the possibility of nurses, in the face of situations arising in their work environment, taking a stand that can potentially benefit patients and contribute to the profession.…”

Section: Introductionmentioning

confidence: 99%

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Advocacia Do Paciente Na Enfermagem: Barreiras, Facilitadores E Possíveis Implicações

Tomaschewski-Barlem

Lunardi

Barlem

et al. 2017

Texto contexto - enferm.

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Objective: to promote reflection upon the barriers, facilitators and potential implications of patient advocacy on the part of nurses.Results: this reflection results from a thorough reading of the international literature addressing patient advocacy along with Brazilian and international studies addressing moral distress and its relationship with patient advocacy.Conclusion: the barriers imposed on patient advocacy are well-known and such constraints are based on the organizational structure of health institutions and power relationships established between doctors and nurses, challenging and discouraging nurses from acting in accordance with their knowledge and conscience, often leading to a condition known as moral distress.DESCRIPTORS: Health advocacy. Nursing. Nursing ethics. ADVOCACIA DO PACIENTE NA ENFERMAGEM: BARREIRAS, FACILITADORES E POSSÍVEIS IMPLICAÇÕES RESUMOObjetivo: realizar uma reflexão acerca das barreiras, facilitadores e possíveis implicações do exercício da advocacia do paciente pelos enfermeiros.Resultados: essa reflexão resulta de uma leitura minuciosa da literatura internacional acerca da advocacia do paciente, acrescida de estudos nacionais e internacionais acerca do sofrimento moral e suas relações com o exercício da advocacia.Conclusão: as barreiras diante do exercício da advocacia do paciente são notórias, pautando-se na própria estrutura organizacional das instituições de saúde e nas relações de poder entre equipes médica e de enfermagem, desafiando e desencorajando os enfermeiros a agirem de acordo com seus conhecimentos e consciências, implicando, muitas vezes, em situações reconhecidas como de sofrimento moral. DESCRITORES:Advocacia em saúde. Enfermagem. Ética em enfermagem.http://dx.doi.org/10.1590/0104-07072017000100014Texto Contexto Enferm, 2017; 26(3):e0100014Tomaschewski-Barlem JG, Lunardi VL, Barlem ELD, Silveira RS, Ramos AM, Piexak DR 2/7 DEFENSA DEL PACIENTE EN ENFERMERÍA: BARRERAS, FACILITADORES Y LAS POSIBLES IMPLICACIONES RESUMENObjetivo: realizar una reflexión sobre las barreras, facilitadores y las posibles consecuencias del ejercicio de la defensa de los pacientes por enfermeras.Resultados: esta reflexión resulta de una lectura exhaustiva de la literatura internacional en defensa de los pacientes, como estudios nacionales e internacionales acerca de la angustia moral y su relación con la práctica de la defensa de los pacientes.Conclusión: los obstáculos al ejercicio de la defensa de los pacientes son notorios, basándose en la estructura organizativa de las instituciones de salud y de las relaciones de poder entre los equipos de médicos y enfermeros, desafiando y desencorajando los enfermeras para actuar de acuerdo con sus conocimientos y conciencia, resultando a menudo en situaciones consideradas como sufrimiento moral. DESCRIPTORES:Defensa de la salud. Enfermería. Ética en enfermería.

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Chasing the Science

Jones-Bonofiglio

2020

Health Care Ethics Through the Lens of Moral Distress

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Moral distress in nursing personnel

Cited by 35 publications

References 17 publications

Experiences Of Moral Distress In Nurses’ Daily Work

Experiences Of Moral Distress In Nurses’ Daily Work

Advocacia Do Paciente Na Enfermagem: Barreiras, Facilitadores E Possíveis Implicações

Chasing the Science

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