The Relationship Between Providing Neonatal Palliative Care and Nursesʼ Moral Distress

2014 ◽  
Vol 14 (5) ◽  
pp. 322-328 ◽  
Author(s):  
Christina Cavinder
Keyword(s):  
Palliative Care ◽  
Moral Distress ◽  
The Relationship

Burnout, compassion fatigue, and moral distress in palliative care

2015 ◽  
Author(s):  
Nathan I. Cherny ◽  
Batsheva Werman ◽  
Michael Kearney
Keyword(s):  
At Risk ◽  
Palliative Care ◽  
Work Environment ◽  
Compassion Fatigue ◽  
Moral Distress ◽  
Moral Compass ◽  
Organizational Challenges ◽  
Dying Patients ◽  
Potential Problems ◽  
The Relationship

Clinicians involved in the provision of palliative care constantly confront professional, emotional, and organizational challenges. These challenges can make clinicians vulnerable to experiencing one or more of three well-described interrelated syndromes-burnout, compassion fatigue, and moral distress-each of which can lower the threshold for the development of the others. Burnout results from stresses that arise from the clinician’s interaction with the work environment, compassion fatigue evolves specifically from the relationship between the clinician and the patient, and moral distress is related to situation in which clinicians are asked to carry our acts that run contrary to their moral compass. Clinicians who care for dying patients are at risk of all of these and it is vital that palliative care clinicians are aware of these potential problems and with strategies to mitigate risks and to manage them when they present either in their own individual lives or in the work environment.

Moral distress experienced by health care professionals who provide home-based palliative care

2010 ◽  
Vol 71 (9) ◽  
pp. 1687-1691 ◽  
Author(s):  
Kevin Brazil ◽  
Sharon Kassalainen ◽  
Jenny Ploeg ◽  
Denise Marshall
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Professionals ◽  
Moral Distress ◽  
Home Based

Occupational Stress, Burnout, and Professional Support in Nurses Working with Dying Patients

1996 ◽  
Vol 32 (2) ◽  
pp. 93-109 ◽  
Author(s):  
Anne Plante ◽  
Louise Bouchard
Keyword(s):  
Palliative Care ◽  
Occupational Stress ◽  
Medical Oncology ◽  
Professional Support ◽  
Stress Factors ◽  
Metropolitan Region ◽  
Staff Burnout ◽  
Dying Patients ◽  
The Relationship ◽  
And Training

Nurses working with dying people are exposed to numerous stress factors. Their occupational stress may be so important as to lead to burnout. The aim of the present study is to examine the relationship among occupational stress, burnout, and professional support in nurses working with patients dying from cancer. The study has taken place in four palliative care and three medical oncology units of the Montreal metropolitan region. In all, seventy-six nurses of the N nurses fitting the entrance criteria of the study were selected. Participants completed a French version of the following instruments: the Occupational Stress of Nurses Working with Dying Patients, the Jones Staff Burnout Scale for Health Professionals and the Professional Support Scale. Results indicate that there is a significant relationship between occupational stress and burnout ( r = 0.462, p < 0.001) and between professional support and burnout ( r = −0.449, p < 0.001). Further, the results showed that the level of occupational stress and burnout was significantly lower for the palliative care nurses who received significantly more professional support than their colleagues working in medical oncology units. Professional support and training for nurses working with patients dying from cancer should be implemented in order to minimize the development of burnout.

scholarly journals Relationships Among Palliative Care, Ethical Climate, Empowerment, and Moral Distress in Intensive Care Unit Nurses

2018 ◽  
Vol 27 (4) ◽  
pp. 295-302 ◽  
Author(s):  
Krista Wolcott Altaker ◽  
Jill Howie-Esquivel ◽  
Janine K. Cataldo
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Ethical Climate ◽  
Moral Distress ◽  
Care Delivery ◽  
National Database ◽  
Palliative Care Teams ◽  
Intensive Care Unit Nurses ◽  
Distress Scale

Background Intensive care unit nurses experience moral distress when they feel unable to deliver ethically appropriate care to patients. Moral distress is associated with nurse burnout and patient care avoidance. Objectives To evaluate relationships among moral distress, empowerment, ethical climate, and access to palliative care in the intensive care unit. Methods Intensive care unit nurses in a national database were recruited to complete an online survey based on the Moral Distress Scale–Revised, Psychological Empowerment Index, Hospital Ethical Climate Survey, and a palliative care delivery questionnaire. Descriptive, correlational, and regression analyses were performed. Results Of 288 initiated surveys, 238 were completed. Participants were nationally representative of nurses by age, years of experience, and geographical region. Most were white and female and had a bachelor’s degree. The mean moral distress score was moderately high, and correlations were found with empowerment (r = −0.145; P = .02) and ethical climate scores (r = −0.354; P &lt; .001). Relationships between moral distress and empowerment scores and between moral distress and ethical climate scores were not affected by access to palliative care. Nurses reporting palliative care access had higher moral distress scores than those without such access. Education, ethnicity, unit size, access to full palliative care team, and ethical climate explained variance in moral distress scores. Conclusions Poor ethical climate, unintegrated palliative care teams, and nurse empowerment are associated with increased moral distress. The findings highlight the need to promote palliative care education and palliative care teams that are well integrated into intensive care units.

Fostering medical staff reflection on the technological alienation of parents in the NICU

2021 ◽  
pp. 147775092110618
Author(s):  
Abram Brummett ◽  
Annie B. Friedrich
Keyword(s):  
Medical Staff ◽  
Moral Distress ◽  
Ethical Issues ◽  
Treatment Refusal ◽  
Healthy Newborn ◽  
Incurable Condition ◽  
Life Sustaining Treatment ◽  
Terminal Diagnosis ◽  
The Relationship

We describe a case of parents refusing a tracheostomy for an otherwise healthy newborn. The refusal was not honored because permitting the refusal would have violated state law, which required a child to have a qualifying condition (e.g. a terminal diagnosis, permanent unconsciousness, incurable condition with severe suffering) to remove or withhold life-sustaining treatment. However, this case strained the relationship between the parents and medical staff, who worried about sending the newborn home with a tracheostomy where she was not wanted. While many ethical issues arise in treatment refusal cases like this, we focus on the opportunity for ethicists to help the medical staff reflect on the technological alienation of the parents, which may help foster empathy, reduce moral distress, and strengthen the quality of the doctor-parent-patient triad.

From John Stuart Mill to the Medical Humanities

2019 ◽  
pp. 65-95
Author(s):  
Brittany Pladek
Keyword(s):  
Palliative Care ◽  
Samuel Taylor Coleridge ◽  
John Stuart Mill ◽  
German Romanticism ◽  
New Criticism ◽  
Cultural Education ◽  
Health Humanities ◽  
Whole Person ◽  
Relationship Of ◽  
The Relationship

This chapter traces therapeutic holism from German Romanticism through Victorian proponents of cultural education, represented by John Stuart Mill, down to its contemporary manifestation in the work of major literary health humanists like Rita Charon, Cheryl Mattingly, and Kathryn Montgomery Hunter. It also explains the relationship of therapeutic holism to its sibling discourses, New Criticism and Millian liberalism. The former’s holistic, unified work of art parallels the latter’s proper citizen—a whole person whose wholeness is created and restored by cultural education. These linked discourses helped secure therapeutic holism’s place in interdisciplinary conversations about why medicine needs literature. The final section of the chapter critiques therapeutic holism and explains why palliative poetics offer a necessary corrective, using the work of Samuel Taylor Coleridge to illustrate the heterogeneity of Romantic literary therapies. It also surveys complementary recent work within the health humanities. Health humanists working in fields like nursing, chronic pain, and palliative care have begun to develop palliative poetics that do not expect literature to cure.

scholarly journals The relationship between pain, analgesics and survival in patients with advanced cancer; a secondary data analysis of the international European palliative care Cancer symptom study.

2019 ◽  
Vol 76 (3) ◽  
pp. 393-402 ◽  
Author(s):  
Jason W Boland ◽  
Victoria Allgar ◽  
Elaine G Boland ◽  
Mike I Bennett ◽  
Stein Kaasa ◽  
...  
Keyword(s):  
Palliative Care ◽  
Subgroup Analysis ◽  
Clinical Decision Making ◽  
Secondary Analysis ◽  
Opioid Use ◽  
Sensitivity Testing ◽  
Pain Analgesics ◽  
Prospective Longitudinal ◽  
The Relationship

Abstract Purpose Opioids reduce cancer-related pain but an association with shorter survival is variably reported. Aim: To investigate the relationship between pain, analgesics, cancer and survival within the European Palliative Care Cancer Symptom (EPCCS) study to help inform clinical decision making. Methods Secondary analysis of the international prospective, longitudinal EPCCS study which included 1739 adults with advanced, incurable cancer receiving palliative care. In this secondary analysis, for all participants with date of death or last follow up, a multilevel Weibull survival analysis examined whether pain, analgesics, and other relevant variables are associated with time to death. Results Date of death or last follow-up was available for 1404 patients (mean age 65.7 [SD:12.3];men 50%). Secondary analysis of this group showed the mean survival from baseline was 46.5 (SD:1.5) weeks (95% CI:43.6–49.3). Pain was reported by 76%; 60% were taking opioids, 51% non-opioid analgesics and 24% co-analgesics. Opioid-use was associated with decreased survival in the multivariable model (HR = 1.59 (95% CI:1.38–1.84), p < 0.001). An exploratory subgroup analysis of those with C-reactive protein (CRP) measures (n = 219) indicated higher CRP was associated with poorer survival (p = 0.001). In this model, the strength of relationship between survival and opioid-use weakened (p = 0.029). Conclusion Opioid-use and survival were associated; this relationship weakened in a small sensitivity-testing subgroup analysis adjusting for CRP. Thus, the observed relationship between survival and opioid-use may partly be due to tumour-related inflammation. Larger studies, measuring disease activity, are needed to confirm this finding to more accurately judge the benefits and risks of opioids in advanced progressive disease.

Relationship between perceived organizational justice and moral distress in intensive care unit nurses

2017 ◽  
Vol 26 (2) ◽  
pp. 460-470 ◽  
Author(s):  
Ghazaleh Haghighinezhad ◽  
Foroozan Atashzadeh-Shoorideh ◽  
Tahereh Ashktorab ◽  
Jamileh Mohtashami ◽  
Maasoumeh Barkhordari-Sharifabad
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Organizational Justice ◽  
Moral Distress ◽  
Interactional Justice ◽  
Significant Negative Correlation ◽  
Moral Decision Making ◽  
Informed Consent Form ◽  
Intensive Care Unit Nurses ◽  
The Relationship

Background: The nature of the nursing profession pays more attention to ethics of healthcare than its therapeutic dimension. One of the prevalent moral issues in this profession is moral distress. Moral distress appears more in intensive care units due to the widespread need for moral decision-making regarding treatment and care in emergency situations. In this connection, organizational justice is of high importance and, as a significant motivational tool, leaves important impacts upon attitude and behavior of personnel. Aim/objective: This study aimed at investigation of the relationship between perceived organizational justice and moral distress in intensive care unit nurses. Research design: This is a descriptive-correlational research which examined the relationship between perceived organizational justice and moral distress in intensive care unit nurses. Participants and research context: A total of 284 intensive care unit nurses were selected via census sampling. The data were collected through questionnaires and then were analyzed via SPSS-20 using Pearson and Spearman correlation tests. Ethical considerations: This study was approved by the Committee of Ethics in Medical Research. Completion of informed consent form, guarantee of the confidentiality of information, explanation on purposes of the research, and voluntary participation in the study were moral considerations observed in this study. Findings: There was a statistically significant negative correlation between the total perceived organizational justice and the total moral distress (p = 0.024, r = −0.137) and also between “procedural and interactional justice and errors” and “not respecting the ethics principles.” Meanwhile, no relationship was found by the findings between distributive justice and dimensions of moral distress. Conclusion: According to the results of the study, there was a reverse significant relationship between moral distress and perceived organizational justice; therefore, the head nurses are expected to contribute to reduce moral distress and to increase perceived organizational justice in nurses.

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