Nursing Ethics & Moral Distress Rels 300 / Nurs 330 9 October 2014

Nurses as advocates Within the health care team, no one is likely to provide greater continuity of care than the nurse If the nurse is witness to patient dissatisfaction with treatment orders, or confusion or disagreement among the patient’s family, the nurse is uniquely positioned to make the decision-making process explicit Where teamwork is valued, the nurse can make valuable contributions to the ethical process by raising alternative paths & voicing the patient’s concerns 300/330 - appleby

This may lead to experiences of Nursing Roadblocks In some situations, nurses may have to carry out orders that conflict with their ethical judgement This may lead to experiences of Moral distress – over sub-optimal care plans Moral uncertainty – when a decision seems to lead to turmoil or patient distress Subversion of moral agency – when nurses cannot exercise their own capacity for moral choice or action Moral residue - personal feelings of guilt, remorse or inadequacy in providing an excellent standard of nursing care 300/330 - appleby

MORAL DISTRESS “80% of nurses experience moral distress at work. It's one of the main reasons why nurses quit the profession.” (click here) (up to 18:00) http://www.cbc.ca/whitecoat/blog/2011/03/24/moral-distress-show/ http://www.cbc.ca/video/news/audioplayer.html?clipid=1856555522 (27:30) 300/330 - appleby

CNA Code of Ethics (2008) excerpts: http://www. cna-aiic 300/330 - appleby

CNA Code of Ethics (2008) excerpts: http://www. cna-aiic 300/330 - appleby

What is a person to do? Be ethically knowledgeable know your moral theories know your principles of health care ethics learn to analyze and articulate your own moral concerns and judgements Be alert for and aware of power dynamics between doctor & patient between doctor & other health care professionals among nurses, patients and loved ones Ensure communication excellence on behalf of health care providers and patients Learn to be advocates for colleagues and patients 300/330 - appleby