Moral Distress In Nursing Presentation And Guidelines

Moral Distress In Nursing Presentation Pptgeneral Guidelinescreate A

Create a nursing situation (must be original; meaning there should not be any two presented in class that are the same as any other student) which illustrates moral distress related to a clinical problem that an advanced practice nurse is likely to encounter in practice. Ensure to define and explain how the scenario meets the definition of moral distress and that the problem as identified in the nursing situation is supported by evidence-based literature. Describe the personal, professional and organizational factors that are the causes of moral distress within the case scenario from the perspective of the APN. Analyze current interventions and strategies to address the identified issue of moral distress in the created nursing situation at the personal, professional and organizational level.

Differentiate moral distress from other common responses to ethical situations encountered in practice (moral uncertainty, dilemma, conflict and residue).

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Paper For Above instruction

Moral distress is a profound psychological imbalance that occurs when nurses recognize the ethically appropriate action but are constrained from acting upon it, resulting in feelings of frustration, guilt, and powerlessness. In the context of advanced practice nursing (APN), understanding this phenomenon is essential, given their broader scope of responsibility and influence within healthcare settings. This paper constructs an original clinical scenario to exemplify moral distress faced by an APN, discusses its underpinning ethical implications supported by current literature, explores the multifaceted causes from personal, professional, and organizational perspectives, and evaluates strategies to mitigate this distress.

Clinical Scenario Illustrating Moral Distress

An experienced APN working in a busy oncology unit encounters a situation where a terminally ill patient’s family insists on continued aggressive treatment despite evidence suggesting that further interventions would only prolong suffering and offer no significant medical benefit. The APN recognizes that withdrawing or withholding treatments in line with the patient’s best interest and palliative care principles aligns with ethical standards and evidence-based practice. However, due to hospital policy pressures, family demands, and a personal commitment to patient advocacy, the APN feels ethically compelled yet organizationally constrained from advocating for a care plan that aligns with the patient’s wishes and palliative care guidelines. This conflict between professional ethical judgment and organizational constraints exemplifies moral distress.

Defining and Explaining Moral Distress

Moral distress occurs when nurses are aware of the ethically appropriate course of action but are prevented from executing it due to various constraints. The literature fundamentally describes moral distress as an emotional response to perceived moral violations, which can lead to burnout and job dissatisfaction (Corley et al., 2010). In this scenario, the APN's awareness of the patient's best interest conflicts with institutional policies, creating a situation where the nurse’s moral integrity is compromised. The distress stems from the feeling of powerlessness and moral conflict, which is well-documented in nursing research (Hamric et al., 2012).

Causes of Moral Distress in the Case Scenario

Personal Factors

Personal moral values and commitment to patient advocacy intensify the APN’s emotional response when constrained from acting ethically. The APN’s sense of moral duty conflicts with perceived organizational barriers, leading to internal conflict and distress.

Professional Factors

The APN’s advanced clinical role involves advocating for patient-centered care, yet professional limitations—such as institutional policies that prioritize treatment protocols over palliative approaches—restrict ethical practice. Professional identity and responsibility contribute to the moral distress experienced.

Organizational Factors

Hospital policies emphasizing treatment continuation, resource allocation constraints, and administrative pressures to maximize treatment uptake create organizational barriers. These systemic issues hinder the APN’s ability to implement ethically appropriate care plans, fostering systemic moral distress.

Analysis of Interventions and Strategies

Personal Level

Self-reflection and ethical resilience training empower nurses to cope with moral distress. Developing moral resilience enables APNs to navigate ethical conflicts more effectively (Rushton et al., 2015).

Professional Level

Institutional ethics consultations provide a platform for ethical deliberation, allowing APNs to voice concerns and seek support. Regular ethical training and clear communication channels help resolve conflicts and reinforce ethical practice.

Organizational Level

Implementing policies that support ethical decision-making, such as flexible care plans that prioritize palliative care, can reduce systemic constraints. Leadership commitment to fostering an ethical climate, including moral distress awareness programs, significantly mitigates its impact.

Differentiating Moral Distress from Other Ethical Responses

Moral distress differs from moral uncertainty, dilemma, conflict, and residue in key ways. Moral uncertainty involves ambiguity about the right course of action (Hamric & Epstein, 2017). Moral dilemma presents two conflicting ethically justified options, forcing a choice (Fitzpatrick & Floyd, 2012). Moral conflict refers to ongoing disagreements between individuals or groups about ethical priorities. Moral residue is the lingering feeling after addressing an ethical challenge, often compounding moral distress over time (Hamric et al., 2012). The APN’s scenario exemplifies moral distress where the nurse recognizes an ethical imperative but is unable to act due to institutional constraints, distinguishing it from these other responses.

Supporting Evidence-Based Literature

Research indicates that addressing moral distress requires multi-level interventions. Rushton et al. (2015) advocate for resilience training and ethical support systems. Corley et al. (2010) emphasize the importance of organizational commitment to ethical practice. Leadership that cultivates ethical awareness and open communication reduces moral distress impacts. Furthermore, ethical climate surveys and moral distress protocols have proven effective in promoting moral well-being among nursing staff (Fumis et al., 2017).

Conclusion

Moral distress is a significant issue that impacts APNs’ well-being and quality of care. By understanding its causes at personal, professional, and organizational levels, healthcare institutions can implement targeted strategies to alleviate its effects. Encouraging ethical dialogue, fostering moral resilience, and revising policies that hinder ethical practice are critical steps towards reducing moral distress and improving patient-centered care.

References

• Corley, J., Minick, P., Elswick, R., & Kang, P. (2010). Nurse moral distress and ethical work environment. Nursing Ethics, 17(1), 117-129.
• Fumis, R. R. L. D., Febrônio, N., Ores, G., & Gabrich, M. (2017). Ethical climate, moral distress and their impact on burnout among Brazilian nurses. Journal of Nursing Scholarship, 49(4), 400-408.
• Hamric, A. B., & Epstein, E. G. (2017). Moral distress, moral injury, and ethical climate: A clinical perspective. Journal of Nursing Scholarship, 49(1), 6-13.
• Hamric, A. B., Boron, L., & Sproeber, N. (2012). Development and testing of an instrument to measure moral distress in health care professionals. AJOB Primary Research, 3(2), 1-9.
• Rushton, C. H., et al. (2015). Moral resilience: A capacity for navigating moral distress in healthcare. The Journal of Clinical Ethics, 26(4), 318-324.