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Published on: July 4, 2018
Being and Sustaining Oneself as a Medical ICU Nurse: A Phenomenologic Study
Cassandra M Godzik1, Timothy J Usset, Jennifer K DiBenedetto
1Author Affiliations: Nurse Scientist/Postdoctoral Research Fellow (Dr Godzik), Dartmouth Hitchcock Health System, Lebanon, and Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Research Chaplain (Dr Usset), School of Public Health, University of Minnesota; Maeine VA Health Care System (Dr Usset), Maine; Postdoctoral Research Fellow (Dr DiBenedetto), Dartmouth Hitchcock Health System, Lebanon, New Hampshire; Geisel School of Medicine at Dartmouth (Dr DiBenedetto), Hanover, New Hampshire; Program Director (Dr Bardach), Levy Incubator, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Assistant Professor of Community and Family Medicine (Dr Pepin), Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Registered Nurse (Stiles), Department of Critical Care, Dartmouth Hitchcock Health System, Lebanon, New Hampshire; Registered Nurse (Klein), Department of Critical Care, Dartmouth Hitchcock Health System, Lebanon, New Hampshire; Assistant Professor (Dr Griggs), Frances Payne Bolton School of Nursing, Case Western University, Cleveland, Ohio; Clinical Research Psychologist (Dr Harris), Maine VA Health System, Chelsea; University of Minnesota School of Medicine (Dr Harris), Minneapolis; and Associate Professor of Emergency Medicine (Dr Barsky), Geisel School of Medicine at Dartmouth, Hanover; Dartmouth Hitchcock Health System (Dr Barsky), Lebanon; Medical Student (Dr Thomason), Geisel School of Medicine at Dartmouth, Hanover; Dartmouth Hitchcock Health System (Dr Thomason), Lebanon; Assistant Professor of Psychiatry (Dr Smith), Geisel School of Medicine at Dartmouth, Hanover; and Dartmouth Hitchcock Health System (Dr Smith), Lebanon, New Hampshire.
Objective/Background:
The purpose of this study was to explore medical ICU (MICU) nurses' lived experiences coping with potentially morally injurious events (PMIEs). Medical ICU nurses directly care for critically ill patients, which increases the likelihood of experiencing PMIEs.
Methods:
Researchers conducted interviews with MICU nurses (N = 25) using a semistructured interview guide designed to identify nurses' ethical and moral values, explore how these values informed the care of patients, and discuss PMIEs in their workplace settings.
Results:
Three major themes were identified for MICU nurses: 1) values; 2) lived experiences; and 3) sustaining oneself. Participants indicated that a lack of resources and insufficient support from institutional leadership both hinder the ability to provide value-aligned care.
Conclusions:
Delivering value-discordant care cultivates stress and frustration. Tools are needed for healthcare organizations to identify and discuss PMIEs and inform resources to mitigate the harm caused by PMIEs.
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