Nurses' Perceptions of Caring for Childbearing Women who Misuse Opioids

Abstract

The four themes can have an impact on nursing practice and patient outcomes by providing specific areas for intervention development focusing on this population of vulnerable women. Nurses described several ideas for intervention development including continuing education offerings relevant to caring for mothers who misuse opioids, collaborating with providers to design education, reevaluating pain-management philosophies and practices at all levels, and working with social workers to explore available and needed community resources. Future research includes the evaluation of newly developed personalized interventions; the examination of the empirical linkages among key mother and child health outcomes; the delivery of specific nursing therapeutics; and the exploration of providers' and patients' perceptions and knowledge of opioid misuse during pregnancy, birth, and beyond.

Moral distress of nurses surrounding neonatal abstinence syndrome: Application of a theoretical framework

“…Some nurses, most specifically nurse midwives, avoid moral distress by entering into the path of advocacy . However, much of the literature supports that many nurses struggle with moral conflict surrounding nursing care of infants with NAS . Although the experience of moral distress in this professional circumstance is highly individual, some themes pointing to common internal conflicts are present in the literature.…”

“…However, the literature examining nurses’ feelings toward caring for NAS infants consistently reveals that nurses are committed to the care and welfare of these infants. Nurses may struggle with two moral principles, beneficence and nonmaleficence while caring for infants with symptoms of NAS …”

“…Exemplifying beneficence toward the infant is illustrated by providing comfort, advocating for the infant's needs, and instructing other caregivers, including family, how to meet the infant's needs. The goal of beneficence may be challenged due to difficulty in treating symptoms of withdrawal and difficulty in coping with families who use substances . Treatment of the physical symptoms of withdrawal, such as inconsolable crying, vomiting, and diarrhea, and difficulty feeding can be difficult and overwhelming, as techniques commonly successful with non‐NAS infants are less successful with NAS infants.…”

“…The goal of nonmaleficence may be challenged through the experience of verbal abuse and physical threats from some families of infants with NAS. Nurses fear for the safety of the infant upon discharge in the absence of a healthcare provider to protect the infant from harm . If the nurse perceives that harm to the infant, in any circumstance, is a consequence of their inability to protect them, moral distress may be triggered.…”

“…Nurses consistently report families of NAS infants to be the most difficult to work with due to the inconsistency of visitation, defensive attitudes, and lack of disclosure. 5,[7][8][9]12,13 Often unbeknownst to nurses, mothers may be experiencing a multitude of stressors, anxieties, and fears leading to some of these described behaviors. 7,14,15 Competing priorities of the nurse to meet the needs of all the patients and families under their care creates an environment ripe for moral distress.…”