Read The Article: Moral Distress And Psychological Empowerme

Read The Articlemoral Distress And Psychological Empowerment In Criti

Read the article, Moral Distress and Psychological Empowerment in Critical Care Nurses Caring for Adults at End of Life . Identify common causes of moral distress in critical care nurses who are caring for dying patients. Describe the concept of psychological empowerment and the 4 cognitions it encompasses. Discuss the study findings as related to the relationship between moral distress intensity and frequency, psychological empowerment, and participant demographics. Think about a situation where moral distress would be an issue in the last hours of life in your patient. Then, describe why it would be an example of moral distress.

Paper For Above instruction

Moral distress is a significant issue among critical care nurses who provide care for dying patients, particularly in end-of-life scenarios where complex emotional, ethical, and clinical factors converge. The article "Moral Distress and Psychological Empowerment in Critical Care Nurses Caring for Adults at End of Life" explores the causes of moral distress, the concept of psychological empowerment, and how these factors interplay within the nursing practice in critical care settings.

Causes of Moral Distress

Critical care nurses frequently encounter situations that invoke moral distress, which occurs when nurses recognize the ethically appropriate action but are constrained from acting accordingly. Common causes include incompatible care goals between nurses and physicians, perceived futile interventions, institutional policies that limit certain actions, and family wishes that conflict with clinical judgment. For example, nurses may feel distressed when they perceive that continued aggressive treatment prolongs suffering without benefit, yet are unable to advocate for comfort-focused care due to institutional or familial pressures. Situations involving withholding or withdrawal of life-sustaining treatments also often trigger moral distress among nurses, especially when they believe these actions align with patient wishes but feel ethically conflicted due to legal or policy constraints.

Psychological Empowerment and Its Four Cognitions

Psychological empowerment in nursing refers to a feeling of control and influence over one's work environment, leading to increased motivation and job satisfaction. The concept encompasses four cognitions: meaning, competence, self-determination, and impact.

- Meaning: The degree to which nurses perceive their work as significant and aligned with their personal values.

- Competence: Nurses' confidence in their ability to effectively perform their duties.

- Self-determination: The sense of autonomy in decision-making and actions at work.

- Impact: The perception that one's efforts make a difference in patient outcomes and organizational goals.

These cognitions collectively contribute to nurses' resilience against moral distress, by fostering a sense of agency and purpose, even in ethically challenging situations.

Study Findings on Moral Distress, Empowerment, and Demographics

The study reported that higher levels of psychological empowerment were associated with lower intensity and frequency of moral distress. Nurses who felt more empowered reported greater confidence in managing end-of-life decisions and were better able to cope with moral distress. Conversely, those with lower empowerment experienced increased moral distress, which could lead to burnout and turnover. Demographic factors such as years of experience and educational background influenced perceived empowerment levels; more experienced nurses tended to report higher empowerment, which mediated the impact of moral distress. Additionally, organizational support systems, such as ethics committees and communication protocols, played a role in mitigating distress levels.

A Scenario Demonstrating Moral Distress at End of Life

Consider a nurse caring for an elderly patient with advanced terminal illness. The family requests full resuscitation efforts despite medical advice that these may be futile and could cause additional suffering. The nurse understands that honoring the family's wishes prolongs the patient's suffering and conflicts with the principles of beneficence and non-maleficence. However, institutional policies require compliance with family demands, and the healthcare team may be hesitant to oppose the family's wishes. The nurse feels morally distressed because they agree that comfort care would be more appropriate but are constrained from acting accordingly, leading to feelings of guilt, frustration, and professional conflict—classic indicators of moral distress.

Conclusion

Understanding the causes of moral distress and fostering psychological empowerment are essential in supporting critical care nurses through ethically challenging circumstances. Implementing institutional strategies that promote autonomy, ethical dialogue, and debriefings can reduce moral distress and promote nurse well-being. Acknowledging and addressing moral distress is crucial for maintaining ethical standards, improving patient care, and sustaining a resilient nursing workforce.

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