The impact of moral distress on the provision of nursing care amongst critical care nurses in the eThekwini District

Abstract

Introduction Moral distress is a widely recorded phenomenon in the nursing profession. It can be described as a form of distress that occurs when one knows the ethically correct thing to do, but is prevented from acting on that perceived obligation. Moral distress impacts patients, nurses and the organization. If the nurse is unable to advocate for her or his patient and avoidance behaviour occurs, increased patient suffering result. Moral distress results in high staff turnover, decreased quality patient care and low patient satisfaction. Unrelieved moral distress jeopardizes nurse’s sense of self-worth and threatens their integrity.

Aim of the study The aim of the study was to determine the impact of moral distress on the provision of nursing care amongst critical care nurses.

Methodology A quantitative descriptive design was used to determine the intensity and frequency of moral distress amongst critical care nurses, to assess the impact of moral distress on the provision of nursing care to the patient as well as to evaluate the effectiveness of organisational strategies implemented to reduce moral distress. Critical care nurses from both private and public hospitals were selected to participate in the study. Data was collected by means of a survey using the moral distress scale which was revised to meet the objectives of the study. A non-probability purposive sampling technique was utilised to gather data from a sample size of 100 critical care nurses currently working in the critical care environment.

Results The study indicates that the frequency and intensity of moral distress is related to specific clinical situations in the critical care environment. The study also specifies that moral distress continues to have a negative effect on the provision of nursing care. Critical care nurses feel that some strategies are effective whereas others are not at all effective.

Impact of the research study This study reveals that there is a significant negative effect of moral distress on the provision of nursing care. Nurses experience challenges in the clinical environment that result in them experiencing moral distress. Nurses more attuned to the ethical dimensions of care may be more at risk for moral distress since these nurses see the moral dimensions of nursing being neglected. Nurses may find themselves distancing themselves from patient care, resulting in a perceived lack of care and concern for the patient.