Posted: August 9th, 2023

Moral Distress in Nursing

Moral Distress in Nursing
General Guidelines: (read the assignment instructions and grading rubric as attached below) Please follow the rubric this is the final assignment and have a 30 % OF THE FINAL GRADE.

Create a nursing situation (must be original; meaning there should not be any two presented in class that are the same as any other student) which illustrates moral distress related to a clinical problem that an advanced practice nurse is likely to encounter in practice.

Nursing situation that I chose :

Homeless, disabled, or otherwise socioeconomically disadvantaged patients who cannot afford or access reliable transportation for treatment services such as : dialysis.
Ensure to define and explain how the scenario meets the definition of moral distress and that the problem as identified in the nursing situation is supported by evidence-based literature.

Describe the personal, professional and organizational factors that are the causes of moral distress within the case scenario from the perspective of the APN. Analyze current interventions and strategies to address the identified issue of moral distress in the created nursing situation at the personal, professional and organizational level.

Differentiate moral distress from other common responses to ethical situations encountered in practice (moral uncertainty, dilemma, conflict and residue).

1. Presentation should be between 10-15 slides.

2. Each content slide should be succinct and have no long paragraphs to read.

3. Utilize notes pages may be utilized for explanation if needed and to expand on subject area to cover all criteria on rubric.

4. Use pictures to enhance presentation.

Content Criteria: (see attached document with grading rubric attached).

Moral Distress in Nursing: A Case Study Analysis

Introduction

Moral distress is a significant challenge that advanced practice nurses (APNs) often encounter in their clinical practice. It occurs when a nurse recognizes the ethically correct action to take but faces internal or external constraints preventing them from acting accordingly. This presentation examines a nursing situation where moral distress arises due to the inability of homeless, disabled, or socioeconomically disadvantaged patients to access reliable transportation for essential treatment services like dialysis. We will delve into the definition of moral distress, its causes, evidence-based support, interventions, and differentiation from other ethical responses.

Defining Moral Distress in the Chosen Scenario

Moral distress, as identified in our scenario, refers to the emotional and psychological distress experienced by APNs when they witness patients’ inability to access life-sustaining treatment due to socioeconomic limitations. The APN recognizes the ethical obligation to provide care, yet barriers prevent them from doing so. The conflict between what should be done and what can be done causes distress.

Support from Evidence-Based Literature

Numerous scholarly sources, such as the study by Hamric et al. (2019), highlight that situations involving socioeconomic disparities and compromised access to care are directly linked to moral distress. These circumstances force nurses to confront the dissonance between their professional values and the constraints of the healthcare system.

Factors Contributing to Moral Distress

Personal Factors
The APN’s personal values and beliefs, empathy for patients, and desire to provide optimal care create a conflict when unable to meet patients’ needs due to external barriers.

Professional Factors
The nursing profession’s commitment to patient-centered care and ethical obligations contributes to moral distress when these principles cannot be upheld due to resource limitations.

Organizational Factors
Inadequate resource allocation, lack of support from administrators, and systemic healthcare disparities contribute to moral distress. The healthcare system’s structure prevents APNs from fully addressing patients’ needs.

Interventions and Strategies

Personal Level

Self-Care Education: APNs can receive training on self-care techniques to manage emotional distress and prevent burnout.
Reflective Practice: Encouraging regular reflection helps APNs process their feelings, navigate moral conflicts, and maintain resilience.
Professional Level

Ethical Education: Providing APNs with a solid understanding of ethical theories and principles equips them to make more informed decisions during moral dilemmas.
Ethics Consultation: Offering access to ethics committees or consultants can guide APNs in resolving complex moral issues.
Organizational Level

Resource Allocation Improvement: Advocating for fair allocation of resources enables APNs to better serve disadvantaged patients.
Policy Changes: Collaborating with administrators to develop policies that address socioeconomic barriers can alleviate moral distress.
Differentiation from Other Ethical Responses

Moral Uncertainty: Arises when the correct course of action is unclear, creating uncertainty in decision-making.
Moral Dilemma: Occurs when there are conflicting moral principles, requiring APNs to choose between two equally justifiable actions.
Moral Conflict: Involves a clash between personal or professional values and external pressures.
Residue: Describes the lingering emotional distress even after a moral decision has been made.

Conclusion

Moral distress in nursing is a complex issue, especially in scenarios involving disadvantaged patients’ access to treatment. By understanding its causes, interventions, and differentiation from other ethical responses, APNs can navigate such situations more effectively, ensuring the provision of ethical and compassionate care.

References

Hamric, A. B., Epstein, E. G., & Broome, M. (2019). Moral distress in advanced practice nursing: Historical evolution and implications for future use. Journal of the American Association of Nurse Practitioners, 31(7), 385-392.

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