Abstract
Introduction
Moral distress in nursing has been studied in many settings, but there is a paucity
of research on moral distress as it manifests in the emergency department. One study
suggests a correlation between moral distress and aspects of burnout, and other researchers
report that nurses have considered leaving their position or even their profession
because of moral distress. Further exploration of these issues may provide insight
into their effects on ED patient care and the emergency nursing profession. The purpose
of this study was to explore the nature of moral distress as it is experienced and
described by emergency nurses.
Methods
A qualitative, exploratory design was employed using semi-structured focus groups
for data collection. Using an iterative process, transcripts were analyzed for emerging
themes by the research team. Six researchers analyzed the transcripts using a thematic
analysis approach.
Results
Themes from the data included dysfunctional practice arena, being overwhelmed, and
adaptive/maladaptive coping. Participants described, overall, a profound feeling of
not being able to provide patient care as they wanted to.
Discussion
Causes of moral distress in emergency nurses are environment driven, not incident
driven, as is described in other settings, and include a high-acuity, high-demand,
technical environment with insufficient resources. Interventions should be targeted
to improve environmental factors that contribute to the moral distress of emergency
nurses. Future research should focus on the development and validation of an instrument
to measure moral distress in this setting.
Key words
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Biography
Lisa A. Wolf, Member, Pioneer Valley Chapter, is Director, Institute for Emergency Nursing Research, Emergency Nurses Association, Des Plaines, IL.
Biography
Cydne Perhats is Senior Associate, Institute for Emergency Nursing Research, Emergency Nurses Association, Des Plaines, IL.
Biography
Altair M. Delao is Senior Associate, Institute for Emergency Nursing Research, Emergency Nurses Association, Des Plaines, IL.
Biography
Michael D. Moon, Member, San Antonio Chapter, is Associate Professor, University of the Incarnate Word, San Antonio, TX.
Biography
Paul R. Clark, Member, Kentuckiana Chapter, is Assistant Professor, University of Louisville School of Nursing, Louisville, KY, and System Educator, Norton Healthcare Institute for Nursing, Louisville, KY.
Biography
Kathleen E. Zavotsky, Member, West Central New Jersey Chapter, is Director, Nursing Research, Advanced Practice and Education, Robert Wood Johnson University Hospital, New Brunswick, NJ.
Article info
Publication history
Published online: September 27, 2015
Footnotes
Earn Up to 9.0 CE Hours. See page 94.
Identification
Copyright
© 2016 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
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