Nurses' responses to initial moral distress in long-term care

Area of Science:

• Nursing Ethics
• Healthcare Management
• Qualitative Research

Background:

• Ethical issues in long-term care are documented, but nurses' experiences with moral distress and their coping mechanisms remain under-explored.
• Moral distress significantly impacts nurses, affecting their well-being and professional practice.
• Understanding nurses' responses to moral distress is crucial for developing effective support systems.

Purpose of the Study:

• To explore long-term care nurses' experiences with initial moral distress.
• To identify helpful and hindering factors in nurses' responses to moral distress.
• To understand the resources and supports utilized by nurses facing moral distress.

Main Methods:

• Qualitative interpretive description approach.
• Semi-structured interviews with 15 long-term care nurses in Canada.
• Thematic analysis of interview data to identify key themes.

Main Results:

• Three primary themes emerged: the importance of situational context, the value of teamwork, and the need for external guidance.
• Discussing ethical conflicts with team members and receiving managerial support facilitated more effective responses.
• Access to objective external perspectives and ethics education were identified as beneficial.

Conclusions:

• Team collaboration and managerial support are vital for nurses navigating moral distress in long-term care.
• Facilitating open communication and providing access to ethical resources can mitigate the negative impact of moral distress.
• Further research should focus on developing targeted interventions to support nurses experiencing moral distress.