Running head: MORAL DISTRESS IN THE FIELD OF NURSING

Moral Distress in the Field of Nursing Asia K. Lewis Rowan Cabarrus Community College

MORAL DISTRESS IN THE FIELD OF NURSING Moral Distress in the Field of Nursing It doesnt matter what the situation may be, but I have always remembered if I asked my mom to do something that to her seemed outrageous she would ask Is that Godly of is that of the world, and at the end of me asking for whatever it was I wanted the thing would be of the world in her eyes. Being that my family is so faith oriented I felt the sudden urge to look at the ethics of things no matter what it was just for my own knowledge and understanding. But nevertheless I have found that faith is a huge part of any given situation. Have you even felt that you knew what was best from someone but did not feel that you had the power that was capable of encouraging what was best and became frustrated? Have you looked at a situation and wanted to break the rules because you knew that the outcome was something better? Well if you are youre not alone. Everyday nurses are faced with lots of situations where they know what is best for a patient but just feel powerless and incapable of doing anything about it. According to research this sort of frustration is known as Moral Distress. Moral Distress is defined as a phenomenon in which one knows the right action to take, but is constrained from taking it according to Andrew Jameton in 1984. Moral distress is also a sign that ethical challenges are not being addressed adequately (Epstein, Delgado 2010).This distress includes situations of omission, which is care that is perceived to be appropriate but is not able to be provided for a patient, or even situations of commission, which is when the nurse provides the care, even though he/she does not perceive it to be right for the patient. Moral distress which can often be confused with the classical ethical dilemma is different because in an ethical dilemma one recognizes that a problem exists and that two or more ethically justifiable but mutually opposing actions can be taken. Also often, in an ethical dilemma, there are significant downsides to each potential solution (Epstein, Delgado 2010).

MORAL DISTRESS IN THE FIELD OF NURSING There are many given situations that cause Moral Distress among nurses, one being powerlessness. According to history there has always been an imbalance of power between a nurse and a physician in the healthcare world. Being that the physician has the power of giving the order and the nurse would be the done performing the task. With that being said that implies that the nurse has no say or control over the care thats provided for the patient, they must simply follow the order. A nurse spends majority of their time along the bedside of a patient and have the opportunity to get to know the patient on the level that the physician does not so the nurse is able to see things that the physician is unaware of and can influence the decisions of the patient when it comes to care given (Dickerson, 2010). The frustration in nurses is built when a suggestion is made but the physician blocks it out and pursues a plan of care that is not perceived to be in the best interest of the patient (Dickerson, 2010). These sorts of situations began to cause tension between the on staff nurses and physicians. Understanding that there are many people who live their lives based on faith is another cause of moral distress. People decisions are often made based off of religious or spiritual, cultural, familial, or other values. Which are known as morals. The nurses do not seek to voice their opinion to make the patient think differently about their morals. So it is their job to just accept all the things that leads the patient to the decisions that they make regarding their care. After the patient has made their decision they nurse can then recommend other plans of treatment. Some patient go along with the plan recommended but there are some patients who do not choice to, who are then categorized as noncompliant. These sorts of situations where the patient does not agree with the recommended plan is what begin to cause frustration, and anger because the patient did not do as the nurse recommended (Dickerson, 2010). There are many other causes of moral distress among nurses. Like laws that prohibit care, finances, etcetera.

MORAL DISTRESS IN THE FIELD OF NURSING All of these situations have an effect on the nurses lives. Moral distress has had an impact on the health of nurses and their provision of care, job satisfaction, and retention. There have been reported physical symptoms by nurses such as headache, neck pain, and stomach problems due to moral distress (Gallagher, 2010). Nurses also undergo Psychological and emotional symptoms such as anger, guilt, depression, frustration, and feelings of reduced selfworth. There are cases where they may withdraw from family and friends (Gallagher, 2010). Nurses become so unhappy that they maybe even quit their job or the profession altogether. The stress that they nurses undergo can lead to improper care of the patients or errors in caring for the patient. Moral distress is a day-to-day issue in the healthcare world unfortunately. Giving that the nurses may be put in situations that may be uncomfortable, cause problems to their better judgment, cause frustrations and tension it is ultimately their decision as to where to go next. I believe that at the end of the day people will take into consideration other peoples opinions but in the end will shut it down for their own opinion because it is what they are comfortable with. Nurses do their best to provide the best care for their patients. After the nurse gives their all and ends are not being met and the situations occurs almost every day one will become stressed and frustrated. Though there are many solutions to this issue in the end they are majority short term so ultimately, the patient suffers, and the profession of nursing suffers.

MORAL DISTRESS IN THE FIELD OF NURSING References Dickerson, P.S. (2010). Moral Distress: Its Impact on Nursing. Epstein, E.G., & Delgado, S. (2010). "Understanding and Addressing Moral Distress". OJIN: The Online Journal of Issues in Nursing Vol. 15, No. 3, Manuscript 1. Gallagher, A., (March 21, 2010) "Moral Distress and Moral Courage in Everyday Nursing Practice" OJIN: The Online Journal of Issues in Nursing Vol. 16 No. 2.