Moral Distress of Intensive Care Nurses: A Phenomenological Qualitative Study Two Years after the First Wave of the COVID-19 Pandemic

Rosa, Débora; Bonetti, Loris; Villa, Giulia; Allieri, Sara; Baldrighi, Riccardo; Elisei, Rolando Francesco; Ripa, Paola; Giannetta, Noemi; Amigoni, Carla; Manara, Duilio Fiorenzo

doi:10.3390/ijerph192215057

Cited by 7 publications

(14 citation statements)

References 51 publications

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“…The present study showed that many of the situations that generate M.D. and the strategies implemented by students are the same as those described by nurses [ 33 , 36 ]. The feelings and emotions related to the students’ experience of M.D.…”

Section: Discussionsupporting

confidence: 61%

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How Do Nursing Students Perceive Moral Distress? An Interpretative Phenomenological Study

et al. 2023

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Background: Research shows that the longer nurses care for terminally ill patients, the greater they experience moral distress. The same applies to nursing students. This study aims to analyze episodes of moral distress experienced by nursing students during end-of-life care of onco-hematologic patients in hospital settings. Methods: This study was conducted in the interpretative paradigm using a hermeneutic phenomenological approach and data were analyzed following the principles of the Interpretative Phenomenological Analysis. Results: Seventeen participants were included in the study. The research team identified eight themes: causes of moral distress; factors that worsen or influence the experience of moral distress; feelings and emotions in morally distressing events; morally distressing events and consultation; strategies to cope with moral distress; recovering from morally distressing events; end-of-life accompaniment; internship clinical training, and nursing curriculum. Conclusions: Moral distress is often related to poor communication or lack of communication between health care professionals and patients or relatives and to the inability to satisfy patients’ last needs and wants. Further studies are necessary to examine the quantitative dimension of moral distress in nursing students. Students frequently experience moral distress in the onco-hematological setting.

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Section: Discussionsupporting

confidence: 61%

“…Onco-hematology, as well as other care settings investigated in the literature [ 32 , 33 , 34 ], is a care setting in which nursing students often experience M.D. due to its ethical, care, relational, and organizational complexity.…”

Section: Discussionmentioning

confidence: 99%

How Do Nursing Students Perceive Moral Distress? An Interpretative Phenomenological Study

et al. 2023

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“…Previous studies in the COVID‐19 context have primarily focused on the experiences of ICU healthcare personnel 21–24 and relatives 25,26 . Only a limited number of studies have specifically targeted experiences from a patient perspective.…”

Section: Discussionmentioning

confidence: 99%

“…19,20 Although there are surely relevant differences between solitary confinement and being isolated in the ICU, patients did complain of a similar loss of sense of self and profound feeling of loneliness, as substantial aspects of their experience. This extreme loneliness manifested in several ways: Previous studies in the COVID-19 context have primarily focused on the experiences of ICU healthcare personnel [21][22][23][24] and relatives. 25,26 Only a limited number of studies have specifically targeted experiences from a patient perspective.…”

Section: Theme 4: Loneliness and Inter-corporeal Deprivationmentioning

confidence: 99%

Experiences of isolation in patients in the intensive care unit during the COVID‐19 pandemic

Køster

Meyhoff

Andersen

2023

Acta Anaesthesiol Scand

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BackgroundDuring the COVID‐19 pandemic, patients in the intensive care unit have been subjected to strict isolation precautions, and potentially long and complicated patient courses. The aim of the study is to provide an investigation of the experiences of isolation in COVID‐19‐positive patients in the ICU during the first phase of the COVID‐19 pandemic in Denmark.MethodsThe study was performed in a 20‐bed ICU at a university hospital in Copenhagen, Denmark. The study is based on a phenomenological framework, Phenomenologically Grounded Qualitative Research. This approach provides insights into the tacit, pre‐reflective and embodied dimensions of the specific experience under investigation. Methods included a combination of in‐depth structured interviews with ICU patients 6–12 months after ICU discharge, and observations from inside the isolated patient rooms. The descriptions of experiences gathered through the interviews were subjected to systematic thematic analysis.ResultsTwenty‐nine patients were admitted to the ICU in the period 10 March and 19 May 2020. A total of six patients was included in the study. Themes consistently reported across all patients included (1) being objectified to degrees that implied self‐alienation; (2) feeling a sense of being in captivity; (3) being in an experiential state of surrealism, and finally (4) experiencing extreme loneliness and intercorporeal deprivation.ConclusionThis study provided further insights into the liminal patient experiences of being isolated in the ICU due to COVID‐19. Robust themes of experience were achieved through an in‐depth phenomenological approach. Although, similarities in experiences compared to other patient groups exist, the precarious situation constituted by COVID‐19 lead to significant intensifications across multiple parameters.

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“…These studies highlighted similar themes of increased mental/physical distress, but also addressed themes of compromised patient care, limited resources, and altered/distorted professional and personal relationships. 5 – 16 …”

Section: Discussionmentioning

confidence: 99%

Intensive care nurses’ experiences of caring for isolated COVID-positive patients during first wave of COVID-19

Køster

Fernandez

Meyhoff

et al. 2023

Journal of the Intensive Care Society

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Background: COVID-19 has fundamentally changed all fields of health care. Intensive care nurses have been at the forefront of the pandemic facing the massive impact of the disease, both professionally and personally. This study investigated nurses’ experiences of caring for isolated COVID-19 positive patients in the intensive care department during the first wave of the COVID-19 pandemic. The study investigated how isolation affected the nurses themselves, how they related with their patients, and how isolation affected patient care in general. Methods: The study was performed at a 20-bed university hospital intensive care department in Copenhagen, Denmark. COVID-19 positive patients were isolated or cohort isolated. A dedicated nurse cared for each isolated patient and wore full personal protective equipment. The study is based on in-depth phenomenological interviews with intensive care nurses conducted in summer 2020. The interviews were structured according to the principles of “Phenomenologically Grounded Qualitative Research.” The data included observations from within the isolated patient rooms. Findings: Six intensive care nurses participated in the study. The analysis documented following themes consistently reported by all nurses: (1) a general sense of uncanniness, (2) intense feelings of confinement and co-isolation, and (3) heightened senses of bodily objectification, including how nurses’ experienced their patients and also themselves. Conclusion: This is the first Scandinavian phenomenological study to focus on mapping the experiences of intensive care nurses during the extreme circumstances of the first wave of the COVID-19 pandemic. Further studies may explore long-term effects, such as psychiatric morbidity or psychological functioning in these individuals.

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Moral Distress of Intensive Care Nurses: A Phenomenological Qualitative Study Two Years after the First Wave of the COVID-19 Pandemic

Cited by 7 publications

References 51 publications

How Do Nursing Students Perceive Moral Distress? An Interpretative Phenomenological Study

How Do Nursing Students Perceive Moral Distress? An Interpretative Phenomenological Study

Experiences of isolation in patients in the intensive care unit during the COVID‐19 pandemic

Intensive care nurses’ experiences of caring for isolated COVID-positive patients during first wave of COVID-19

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