Annotated Bibliography on Moral Distress and Critical Care Nurses

Browning, A. M. (2013). CNE article: moral distress and psychological empowerment in critical care nurses caring for adults at end of life. American Journal of Critical Care, 22(2), 143-151. Retrieved from http://ajcc.aacnjournals.org/content/22/2/143.short

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The article talks about critical nurses who provide care for adults at the end of life and how they may experience moral distress in cases where they are unable to perform activities based off of what they believe to be ethically correct. The article aims at describing the relationships between moral distress, psychological empowerment, and demographics in critical care nurses handling patients at the end of life. In the research revealed in the article, about 277 critical care nurses were involved in the survey which included employing a Moral Distress Scale as well as the Psychological Empowerment instrument where the results were recorded on a Likert scale of 1 to 7. The article's findings depicted that there are high rates of moral distress in nurses; however, not that frequent. On the other hand, there exists a reasonable rate of Psychological Empowerment among the nurses, which are facilitated by the conferences as well as end-of-life-care education. The article concludes the fact that moral distress and psychological empowerment are inversely proportional, where an increase in psychological empowerment leads to a decrease in the moral distress experienced among nurses.

Choe, K., Kang, Y., & Park, Y. (2015). Moral distress in critical care nurses: a phenomenological study. Journal of Advanced Nursing, 71(7), 1684-1693. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.12638

The article explores and gives a detailed analysis of the cases of moral distress experienced by critical care nurses in Korea. Here, the idea of moral distress amid critical care nurses is explored more broadly by employing a qualitative approach. The research used Giorgi's phenomenological approach, which entailed developing a sample population of about 14 critical care nurses. Detailed interviews were conducted to the nurses to understand their perspective about moral distress in line with their profession. Through these interviews, five critical issues were noted: ambivalence towards treatment and care, suffering resulting from lack of ethical sensitivity, dilemmas resulting from nurses' limited autonomy in treatments, conflict with physicians, and conflicts with institutional policy. As a result, the article infers that the ethical suffering experienced by nurses leads to members of staff quitting their jobs. Such staff shortages ultimately lead to insufficient patient satisfaction because the services are deteriorated.

Dodek, P. M., Wong, H., Norena, M., Ayas, N., Reynolds, S. C., Keenan, S. P., ... & Alden, L. (2016). Moral distress in intensive care unit professionals is associated with profession, age, and years of experience. Journal of critical care, 31(1), 178-182. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0883944115005407

This article explains the demographic characteristics associated with moral distress in the intensive care unit (ICU) professionals. The article takes the path of quantitative data analysis method in which a survey is made to measure the moral distress among these professionals who are based in British Columbia, Canada. The sample population comprised of the personnel from 13 ICUs present in the country. Attributes of the respondents such as age, sex, and years of experience were collected, and multivariate regression was employed to determine the relationships between moral distress and how they relate with demographic characteristics. The results pointed out that nurses experienced higher moral distress scores compared to physicians. Most of the moral distress that projected high scores were associated with cost constraints and end-of-life controversies. Nonetheless, the article captures the fact that the higher the number of years of experience in nurses, the more the moral distress as well as the tendency to quit the job.

Gutierrez, K. M., (2005). Critical care nurses' perceptions of and responses to moral distress. Dimensions of Critical Care Nursing, 24(5), 229-241. Retrieved from https://journals.lww.com/dccnjournal/Abstract/2005/09000/Critical_Care_Nurses__Perceptions_of_and_Responses.11.aspx

This article reveals that nurses undergo conflict when it comes to making some healthcare decisions, yet are expected to execute actions which they believe to be morally wrong. The article is presented as a research paper in which the study describes the adverse effects caused by such morally unrelated undertakings, created moral distress, on the welfare of the nurses. The paper has also determined that such immorality results in nurse turnover, burnout, and in some cases, nurses having to quit practicing the profession. The article acknowledges the fact that moral distress has severe consequences for nurses and goes further to explore the extents to which moral distress affects the nurses' provision of care.

Lippincott Nursing Solutions. (2017, May 05). Celebrate National Nurses Week 2017 | Lippincott Nursing Education. Retrieved from http://nursingeducationsuccess.com/celebrate-national-nurses-week-2017/

This article talks about the American Nurses Association which happened to honor the National Nurse's week as the year of the healthy nurse, initiating a webinar titled "A Nurse's Guide to Preventing Compassion Fatigue, Moral Distress, and Burnout." The intended goals for this webinar were to curb emotional and physical consequences arising from the complex moral situations, elevate confidence levels and self-resilience to minimize moral distress and preclude burnout and utilize current research to identify, prevent and battle compassion fatigue (Lippincott Nursing Solutions, 2017). Therefore this article's coverage depicts how moral distress, compassion fatigue, and burnout present a substantial threat to the nursing profession. All these issues are prone to negatively impacting the physical and mental health life of nurses. As it was experienced, some nurses opted to prematurely quit the profession because they can no longer offer safe and compassionate care.

Moss, M., Good, V. S., Gozal, D., Kleinpell, R., & Sessler, C. N. (2016). An official critical care societies collaborative statement: Burnout syndrome in critical care health care professionals: a call for action. American Journal of Critical Care, 25(4), 368-376. Retrieved from http://ajcc.aacnjournals.org/content/25/4/368.short

This article dwells entirely on the Burnout Syndrome (BOS), which is experienced by several healthcare professionals who deal with critically ill patients. It goes on further to acknowledge the fact that BOS is associated with an imbalance of personal attributes of a worker and work-related issues or other internal factors within an organization. More often than not, BOS is linked with several adverse outcomes such as escalated levels of staff turnover, condensed patient contentment, and subsided quality of care. The article further progresses to claim that BOS has a direct effect on mental health as well as the physical well-being of the several critical care nurse, physicians, and other healthcare professionals globally. BOS was recently recognized as a psychological disorder along with the others. There has been a campaign by Critical Care Societies Collaborative (CCSC) to create awareness regarding BOS. The article progresses to review further the diagnostics, prevalence, causes, and consequences of BOS. Later in the section is a discussion on the possible intervention actions that can be taken to avoid as well as treat BOS in the future. The article goes an extra mile to urge relevant stakeholders to contribute their quotas in helping curb the development of BOS among critical care nurses and other healthcare professionals in an attempt to eliminate the dreadful consequences of BOS.