nursing and moral distress

Interesting article from the NYT about the changing ethics of nursing and medicine in general. The article focuses on "moral distress" the condition in which a doctor or nurse feels they know what's best for the client but in some way feels prevented from implementing it. This phenomenon is one I noticed even during my clinical rotations; sometimes a really good nurse would have a useful perspective about a client, but wouldn't talk about it with the team because she'd assume they'd brush her off. That said, I also saw a number of situations in which a nurse would see a problem, talk to the doc, and get someone in there to evaluate pretty quickly.

The study discussed in the article can be found in the February 2007 issue of Critical Care Medicine. As mentioned in the article, nurses at both the surveyed sites reported higher levels of moral distress than physicians. Both groups reported the highest incidence of moral distress when they were pressured to "unwarranted aggressive treatment". RNs who had higer moral distress scores also reported a lower perception of ethical environment, a lower satisfaction with the quality of care, and a lower perception of collaboration.

Thanks to Ella Gray, RN, for drawing my attention to this article.