Have you ever come home from a nursing shift in ‘moral distress’?
Almost 50 percent of 400 hospital-based nurses surveyed in New Zealand have considered quitting after struggling with moral issues beyond their control.
The ‘moral distress’ survey was conducted by Massey University School of Health and Social Services researchers.
Dr Martin Woods, a nursing ethicist who led the study, says preliminary results show 48 percent of nurses had considered leaving their current position and 16 percent were currently considering leaving due to moral or ethical difficulties.
“It’s very disturbing; half the nursing workforce at some stage have had such moral disquiet that they wanted to leave … Moral distress is a reality nurses are struggling with – and they are really struggling. Stories of burnout and leaving not just a given position but nursing itself must be taken seriously.”
Dr Martin Woods
The New Zealand Nurses Organisation is backing the study. Professional services manager Susanne Trim said it supported what the organisation had been telling district health boards for years. “There is a serious missmatch between the nursing hours available to meet patient needs. Ten years ago that was happening on occasions but now it is a more common occurrence and that’s what causes the rise in moral distress that the study has identified. That is also why we are seeing a large number of nurses reconsidering whether nursing is a career for them.”
Dr Woods said that moral distress occurs when professionals cannot carry out what they believe to be ethically appropriate actions because of internal or external constraints.
The survey revealed five major issues of moral difficulty challenging nurses.
- Moral concerns over the delivery of less than optimal care due to pressures from management to reduce costs
- Watching patient care suffer because of a lack of provider continuity
- Working with nurses or other health care workers who are not as competent as the patient’s care requires
- Carrying out physician’s orders for what was considered by the nurse to be unnecessary tests and treatments
- Initiating extensive life-saving actions when the nurse thought she/he was only (unnecessarily) prolonging the dying process.
One participant summed up the mood: “I am considering leaving the job that I generally enjoy due to the lack of leadership and pressures from management to accept more numbers of patients or patients with high acuity of care with no increase in resources.”
Younger nurses aged 25-34, experienced higher moral distress (63 percent) than other age groups – a concern when the average age of the nursing workforce is over 40.
Nurse Uncut is sure that these pressures and dilemmas are present in Australian nursing too. Do you agree?
Image credit: Massey University