Moral Distress in Nursing Presentation PPT

Full Answer Section

    The APN is morally conflicted. She wants to respect the woman's wishes, but she also feels a responsibility to do everything she can to save her life. She knows that if she does not resuscitate the woman, the family will be angry and may even sue her. Definition of Moral Distress: Moral distress is a state of emotional conflict that arises when a person knows the right thing to do, but is prevented from doing it by constraints, such as organizational policies, laws, or the actions of others. Evidence-based Literature: Moral distress is a well-documented phenomenon in nursing. A study published in the Journal of Nursing Scholarship found that 80% of nurses had experienced moral distress in the past year. The study also found that moral distress was associated with negative emotional and physical health outcomes for nurses. Personal, Professional, and Organizational Factors: The personal, professional, and organizational factors that can contribute to moral distress in the case of the APN caring for the woman with the DNR order include:

• Personal factors: The APN's own values and beliefs about end-of-life care may conflict with the woman's wishes. The APN may also feel a sense of responsibility to save the woman's life, even if she has a DNR order.
• Professional factors: The APN's professional code of ethics may require her to respect the woman's wishes, even if she disagrees with them. The APN may also be concerned about the legal ramifications of not resuscitating the woman.
• Organizational factors: The APN's employer may have policies that discourage or prohibit nurses from honoring DNR orders. The APN may also feel pressure from her colleagues or supervisors to resuscitate the woman, even if she has a DNR order.

Interventions and Strategies: There are a number of interventions and strategies that can be used to address moral distress in the case of the APN caring for the woman with the DNR order. These include:

• Communication: The APN should communicate with the woman's family about her DNR order and the reasons why she has chosen this option. The APN should also listen to the family's concerns and try to find a solution that everyone can agree on.
• Documentation: The APN should carefully document the woman's DNR order and the discussions she has had with the family. This documentation will be important if there are any legal challenges later on.
• Seeking support: The APN should seek support from her colleagues, supervisors, or a professional ethics consultant. Talking to someone who understands the situation can help the APN to cope with the moral distress she is feeling.
• Advocating for change: The APN may want to advocate for changes to the organization's policies or procedures. She may also want to work to raise awareness of the issue of moral distress in nursing.

Differentiation of Moral Distress from Other Ethical Situations: Moral distress is different from moral uncertainty, dilemma, conflict, and residue.

• Moral uncertainty is a state of confusion or doubt about what the right thing to do is. This can happen when there is no clear consensus on the ethical principles that apply to a situation.
• Moral dilemma is a situation where there are two or more courses of action that are both morally right. This can be a difficult situation, because the APN may feel like she is no matter what she does.
• Moral conflict is a situation where the APN's personal values or beliefs conflict with the values or beliefs of the organization or the patient's family. This can be a difficult situation, because the APN may feel like she is being forced to choose between her own values and the values of others.
• Moral residue is the emotional distress that can linger after a difficult ethical situation. This can happen even if the APN made the decision that she thought was best.

Sample Solution

    Nursing Situation: An APN is working in a busy emergency department. She is caring for a 25-year-old woman who was brought in after a car accident. The woman has multiple fractures and internal bleeding. She is in critical condition and is not expected to survive. The APN knows that the woman's family wants everything done to save her life. However, the APN also knows that the woman has a DNR (do not resuscitate) order. The woman signed the DNR order when she was healthy, and she has not changed her mind about it since she was injured.