Abstract
Significant research has been done on the impact of moral distress among nurses, particularly in acute and intensive care settings. However, little research to date has investigated the experiences that nursing students have with moral distress. Additionally, there is a dearth of research on the role of nursing instructors’ perceptions of their responsibilities to their students when encountering morally distressing situations. This manuscript describes a qualitative study conducted with eight mental health nursing instructors who acknowledged a responsibility for helping students deal with moral distress and ethical issues, but who also struggled with ways to do so. Additionally, instructors expressed frustration with their “guest” status on inpatient psychiatric units and their powerlessness to effect moral change in a medical model of psychiatric care.
References
Alber, L., Augustus, L., Hahn, S., Penkert, J., Sauer, R., & DeSocio, J. (2009). Applying Benner’s model to psychiatric mental health nurse practitioner self-ratings of role competence. Journal of the American Psychiatric Nurses Association, 15(2), 126–137. doi:10.1177/1078390309333181Search in Google Scholar
Austin, W., Bergum, V., & Goldberg, L. (2003). Unable to answerthe call of our patients: Mental health nurses’ experience of moral distress. Nursing Inquiry, 10(3), 177–183.doi:10.1046/j.1440-1800.2003.00181.xSearch in Google Scholar
Austin, W., Lemermeyer, G., Goldberg, L., Bergum, V., & Johnson, M. S. (2005). Moral distress in healthcare practice: The situation of nurses. HEC Forum, 17(1), 33–48. doi:10.1007/s10730-005-4949-1Search in Google Scholar
Awty, P., Welch, A., & Kuhn, L. (2010). A naturalistic inquiry of registered nurses’ perspectives and expectations of psychodynamic therapeutic care in acute psychiatric inpatient facilities. Archives of Psychiatric Nursing, 24(2), 104–113. doi:10.1016/j.apnu.2009.05.001Search in Google Scholar
Bowen, G. A. (2008). Naturalistic inquiry and the saturation concept: A research note. Qualitative Research, 8(1), 137–152. doi:10.1177/1468794107085301Search in Google Scholar
Brown, J., Stevens, J., & Kermode, S. (2012). Supporting student nurse professionalisation: The role of the clinical teacher. Nurse Education Today, 32(5), 606–610. doi:10.1016/j.nedt.2011.08.007Search in Google Scholar
Burston, A. S., & Tuckett, A. G. (2013). Moral distress in nursing: Contributing factors, outcomes and interventions. Nursing Ethics, 20(3), 312–324. doi:10.1177/0969733012462049Search in Google Scholar
Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, & Social Sciences and Humanities Research Council of Canada. (2010). Tri-council policy statement: Ethical conduct for research involving humans. Ottawa, ON: Author.Search in Google Scholar
Canadian Nurses Association. (2008). Code of ethics for registered nurses. Ottawa, ON: Author.Search in Google Scholar
Corley, M. C., Minick, P., Elswick, R. K., & Jacobs, M. (2005). Nurse moral distress and ethical work environment. Nursing Ethics, 12(4), 381–390. doi:10.1191/0969733005ne809oaSearch in Google Scholar
Cummings, C. L. (2010). Moral distress and the nursing experience. Nurse Leader, 8(6), 37–39. doi:10.1016/j.mnl/2010.03.014Search in Google Scholar
Deady, R., & McCarthy, J. (2010). A study of the situations, features, and coping mechanisms experienced by Irish psychiatric nurses experiencing moral distress. Perspectives in Psychiatric Care, 46(3), 209–220. doi:10.1111/j.1744-6163.2010.00260.xSearch in Google Scholar
DiCicco-Bloom, B., & Crabtree, B. F. (2006). The qualitative research interview. Medical Education, 40(4), 314–321. doi:10.1111/j.1365-2929.2006.02418.xSearch in Google Scholar
Erlandson, D. A., Harris, E. L., Skipper, B. L., & Allen, S. D. (1993). Doing naturalistic inquiry: A guide to methods. Newbury Park, CA: Sage.Search in Google Scholar
Garity, J. (2009). Fostering nursing students’ use of ethical theory and decision-making models: Teaching strategies. Learning in Health & Social Care, 8(2), 114–122. doi:10.1111/j.1473-6861.2009.00223.xSearch in Google Scholar
Heikkinen, H. L. T., Huttunen, R., & Syrjälä, L. (2007). Action research as narrative: Five principles for validation. Educational Action Research, 15(1), 5–19. doi:10.1080/09650790601150709Search in Google Scholar
Hinchey, P. H. (2008). Action research primer. New York, NY: Peter Lang.Search in Google Scholar
Hunink, G., van Leeuwen, R., Jansen, M., & Jochemsen, H. (2009). Moral issues in mentoring sessions. Nursing Ethics, 16(4), 487–498.10.1177/0969733009104611Search in Google Scholar PubMed
Kitzinger, J. (1994). The methodology of focus groups: The importance of interaction between research participants. Sociology of Health & Illness, 16(1), 103–121.10.1111/1467-9566.ep11347023Search in Google Scholar
Leech, N. L., & Onwuegbuzie, A. J. (2007). An array of qualitative data analysis tools: A call for data analysis triangulation. School Psychology Quarterly, 22(4), 557–584. doi:10.1037/1045-3830.22.4.557Search in Google Scholar
Lützén, K., Blom, T., Ewalds-Kvist, B., & Winch, S. (2010). Moral stress, moral climate and moral sensitivity among psychiatric professionals. Nursing Ethics, 17(2), 213–224. doi:10.1177/0969733009351951Search in Google Scholar
Marshall, C., & Rossman, G. B. (2011). Designing qualitative research (5th ed.). Los Angeles, CA: Sage.Search in Google Scholar
Nathaniel, A. K. (2006). Moral reckoning in nursing. Western Journal of Nursing Research, 28(4), 419–438. doi:10.1177/0193945905284727Search in Google Scholar
Norwood, S. L. (2010). Research essentials: Foundations for evidence-based practice. Upper Saddle River, NJ: Pearson Prentice Hall.Search in Google Scholar
Taylor-Powell, E., & Renner, M. (2003). Analyzing qualitative data. Madison, WI: Cooperative Extension Publishing Operations. Retrieved from http://learningstore.uwex.edu/assets/pdfs/g3658-12.pdfSearch in Google Scholar
Theobald, A. (2013). Moral distress in baccalaureate nursing students. Kentucky Nurse, 61(2), 5–6.Search in Google Scholar
Thorne, S. E. (2008). Data analysis in qualitative research. In R. B. Haynes, S. Marks, N. Cullum, & D. Ciliska (Eds.), Evidence-based nursing: An introduction (pp. 93–100). Oxford, UK: Blackwell.Search in Google Scholar
Ulrich, C. M., Hamric, A. B., & Grady, C. (2010). Moral distress: A growing problem in the health professions?Hastings Center Report, 40(1), 20–22. doi:10.1353/hcr.0.0222Search in Google Scholar
Wojtowicz, B., Hagen, B., & Van Daalen-Smith, C. (2014). No place to turn: Nursing students’ experiences of moral distress in mental health settings. International Journal of Mental Health Nursing, 23(3), 257–264.10.1111/inm.12043Search in Google Scholar PubMed
Yoes, T. (2012). Addressing moral distress: Challenge and strategies for nursing faculty. Oklahoma Nurse, 57(2), 14–14.Search in Google Scholar
Ziebland, S., & McPherson, A. (2006). Making sense of qualitative data analysis: An introduction with illustrations from DIPEx (personal experiences of health and illness). Medical Education, 40(5), 405–414. doi:10.1111/j.1365-2929.2006.02467Search in Google Scholar
©2014 by De Gruyter
Articles in the same Issue
- Frontmatter
- Telehealth: Preparing Advanced Practice Nurses to Address Healthcare Needs in Rural and Underserved Populations
- Beyond Survival: Fostering Growth and Innovation in Doctoral Study – A Concept Analysis of the Ba Space
- A Faculty Created Strategic Plan for Excellence in Nursing Education
- Co-supervision of Doctoral Students: Enhancing the Learning Experience
- Effectiveness of a Poverty Simulation in Second Life®: Changing Nursing Student Attitudes toward Poor People
- Evaluating Preceptor Perception of Support Using Educational Podcasts
- An Evaluation of Mental Health Simulation with Standardized Patients
- Bologna Process, More or Less: Nursing Education in the European Economic Area: A Discussion Paper
- Motivation and International Clinical Placements: Shifting Nursing Students to a Global Citizenship Perspective
- Pre-Course Simulation as a Predictor of Satisfaction with an Emergency Nursing Clinical Course
- Teacher Stories of Blame When Assigning a Failing Grade
- Empowerment and Mentoring in Nursing Academia
- Development, Implementation and Evaluation of a Peer Review of Teaching (PRoT) Initiative in Nursing Education
- A Guest in the House: Nursing Instructors’ Experiences of the Moral Distress Felt by Students during Inpatient Psychiatric Clinical Rotations
- Developing Students’ Qualitative Muscles in an Introductory Methods Course
- Enhancing Quantity and Quality of Clinical Experiences in a Baccalaureate Nursing Program
- Effects of Incivility in Clinical Practice Settings on Nursing Student Burnout
- Approaches to Study in Undergraduate Nursing Students in Regional Victoria, Australia
Articles in the same Issue
- Frontmatter
- Telehealth: Preparing Advanced Practice Nurses to Address Healthcare Needs in Rural and Underserved Populations
- Beyond Survival: Fostering Growth and Innovation in Doctoral Study – A Concept Analysis of the Ba Space
- A Faculty Created Strategic Plan for Excellence in Nursing Education
- Co-supervision of Doctoral Students: Enhancing the Learning Experience
- Effectiveness of a Poverty Simulation in Second Life®: Changing Nursing Student Attitudes toward Poor People
- Evaluating Preceptor Perception of Support Using Educational Podcasts
- An Evaluation of Mental Health Simulation with Standardized Patients
- Bologna Process, More or Less: Nursing Education in the European Economic Area: A Discussion Paper
- Motivation and International Clinical Placements: Shifting Nursing Students to a Global Citizenship Perspective
- Pre-Course Simulation as a Predictor of Satisfaction with an Emergency Nursing Clinical Course
- Teacher Stories of Blame When Assigning a Failing Grade
- Empowerment and Mentoring in Nursing Academia
- Development, Implementation and Evaluation of a Peer Review of Teaching (PRoT) Initiative in Nursing Education
- A Guest in the House: Nursing Instructors’ Experiences of the Moral Distress Felt by Students during Inpatient Psychiatric Clinical Rotations
- Developing Students’ Qualitative Muscles in an Introductory Methods Course
- Enhancing Quantity and Quality of Clinical Experiences in a Baccalaureate Nursing Program
- Effects of Incivility in Clinical Practice Settings on Nursing Student Burnout
- Approaches to Study in Undergraduate Nursing Students in Regional Victoria, Australia