A study from the University of Pennsylvania School of Nursing has found that 25 percent of practicing nurses and social workers experience "moral distress" causing them to want to leave their current positions, and fully 41 percent failed to say they would chose their profession again.
In one of the first studies to investigate the relationship between ethics and intent to leave, Penn Nursing assistant professor Connie Ulrich, PhD, RN, found "moral distress" led to feelings of powerlessness (32.5 percent), feeling overwhelmed (34.7 percent), frustration (52.8 percent) and fatigue (40 percent), noting that the nurses' desire to leave is in part fueled by experiencing more "ethical stress" and an inadequate level of institutional support for dealing with ethical decisions, as well as a perception of little respect for their profession. The study's findings were published in Social Science and Medicine.
Issues causing moral distress include protecting patients' rights, supporting them through difficult decisions at the end of life, and fairly distributing resources. "Nurses reported feeling that they cannot adequately protect patient's rights or the informed decisions of patients and must balance these and other conflicting issues with a hospital's bottom line," Ulrich said.
Click here to read more.
Subscribe to:
Post Comments (Atom)
.jpg)
8 comments:
"Moral Distress", I was asked recently by a dying man's brother..What would you do if this was your brother? Would you give him a chance and put in a feeding tube or could you go through life wondering if you made the wrong decision?
I think its ok to be honest with your answers regarding your own thoughts and beliefs, thats what patients and familys want to hear, not some pre-recorded verbal diarrhea that you have been trained to recite.
You have to have thick skin and know what battles are worth fighting in this profession. I do not think nursing schools are equipped in preparing todays RN's.
moral distress??? nursing shortage??? really!!!! i worked for mem hosp for 31 years as a registered nurse and they fired me because i needed 5 weeks more than the allotted 6 months medical leave! now i could be out for a broken thumb for 6 months or the infamous sore back for 6 months but as long as one is back in 6 months--no problem!! where is the hospital's morality?? compassion?? respect for their seasoned nurses?? and no, the union did nothing for me!!!!!!!!!!
Moral distress has been a big issue when it come to end of life issues where I work. No doctor and most nurse know how to be straight forward with patients and their family. I think most are still disturbed about the natural order of things and to admit we will all die someday.
The UNAP is well-known for its vigilance in enforcing the rights of individual members. But, no union contract or personnel policy provides for UNLIMITED leaves of absence, and it sounds like that yours unfortunately exceeded the maximum leave.
Having worked a variety of states in a variety of settings, I know we all have our horror stories that have much to do with administration not supporting us so that we can BE nurses and DO nursing. The results are trinkled down to the patient, I fear. When we are over worked, given too many patients who are critical or bordering critical, without enough supportive staff to get our job safely done.. when doctors and other disciplines do not respect our experienced opinions regarding assessment or care of their patients... when we receive patients from the ER at the same time, and cannot do assessments accurately or correctly, and worse, immediately needed interventions... when interdisciplines are rude and demeaning to one another because they simply cannot take on another bit of information or task... when we pray that another call light will not go on, because we do not have the time to answer it, even though it may be a true emergency.. and because of things like this, the nursing staff is apathetic, worn out, burnt out, and are laying their personal integrity and their license on the line each day, it is time to let the public know what we go through to protect them, so that we CAN protect them.
In my more than twenty five years of nursing, I have worked in only two hospitals that I can honestly say were wonderful for nurses to BE nurses. The first was my first job, and it's environment no longer exists as it once did. The second was my final job, where I loved working so much that it nearly did me in when I had to quit due to the physical stress on my own body after years of lifting, stooping, bending and so forth. It was, and is, the ideal hospital in my mind, and I found it accidentally while travel nursing to California from the East Coast.
The ideal job is an environment where the team loves to work together and is supportive to one another when someone's patient load turns out to be more critical than anticipated. The various departments work together with respect and happiness in each encounter as they face the challenges of illness, rather than administration, physicians, and burnt out staff. The docs respect us and ask us about their patients. The docs don't get irritable when we phone them. The patients know we care about them and advocate their needs and well being. Our nurse:patient ratio is workable, and it's alright to legitimately say, "I have all I can handle right now," knowing the result will be either assistance, or reassigning of further patients in a fair and favorable way. If someone comes on staff who is rude, cranky, or just hard to work with, they are counselled as to why they are not happy, and resolution is sought in a sincere way. If no resolution is found, then they are offered to leave their unhappy setting, so as not to taint the rest of the staff with personal discontent. It's ok and encouraged to say to the patient that they might try several options, and the doctors are naturally brought into the discussion as to what might be realistic for the given situation. Nurses work to educate patients and doctors about "last things" and patient preferences without fears of being sued for performing palliative care instead of endless proceedures and tests in a situation that prefers comfort. Things such as these make nursing very rewarding. And the wage is reasonble.
I would like to see the patients not be afraid to go to a hospital. There are enough problems with Managed Care without patients having to fear hospital error that is only waiting to happen due to heavy burdens of the stressors mentioned above. The patients cannot be content with their care when staff is spent and exhausted mentally and physically and morally and ethically.
It may be time to let the public know what we do for them to protect them. Perhaps with the public supporting us, we can advocate for our ability to support them appropriately. Who knows? It might help all of us to do what we so much love to do.
I think you have said it all! Right on target!
I think you have said it all! Right on target!
I think it goes beyond moral distress. There is no moral support from employers.
Nurses are burnt out from understaffing, quick patient turn around, lack of available resources - the list could go on. We have become task driven as opposed to being nurses. How can you possibly educate patients about their conditions, a new medication, discharge instructions or end of life issues when you have 5 or more ill patients (not the mention that two of them are in isolation)?
With expectations high and resources low, its no wonder nurses are leaving. Give us the moral support we need and watch our "morale" climb.
Post a Comment