Discussion 5: Ethical Considerations & Moral Distress – Coach Cary Brown

From No unread replies.No replies.All initial (primary) posts are due on Wed 11:59. A 10% deduction per day will occur up to 72 hours after which the initial will not be accepted. Responses are due on Sunday 11:59 and will not be accepted late and will receive a zero. 

The experience of moral distress can be distinguished from the experience of moral dilemmas.  In moral distress, a nurse knows the morally right course of action to take, but institutional structure and conflicts with colleagues create obstacles.  A nurse who fails to act in the face of obstacles also may have reactive distress in addition to the initial distress.  Both kinds of distress pose dilemmas about individual and collective moral responsibility.  Coping with these dilemmas effectively requires taking at least some successful actions to resolve distress.

For this discussion you are to reflect on a morally distressing clinical experience:

Primary Post

1. Describe a distressing clinical experience you have had as a nurse when you either were involved in or witnessed care or behaviors that you would describe as unethical. Ensuring confidentiality in your description of the event, place, and persons, include in your description:

a. the setting in which the conflict occurred (e.g., ICU, hospital inpatient unit, LTC, OR)

b. disease or patient group (e.g., geriatric, cancer, NICU, dementia) or healthcare team (e.g., physician-nurse, nurse-nurse)

c. the type of conflict (e.g., withdrawal of life support, nutrition, hydration; HIPAA violation, pain management)

d. all those involved in the conflict (e.g., nurse, physician, patient, family member)

e. cultural factors identified as influencing the clinical experience (e.g., ethnicity, poverty)

2. How do you think this experience affected you as a nurse?

a. What emotions do you recall having in the aftermath of the situation (e.g., advocacy, anger, career change, guilt, betrayal, and so on)?  

b. How do you feel about it now?

3. How do you think these experiences affect the profession of nursing?

4. When confronted with a similar situation what do you imagine doing differently?

5. What resource would you recommend to another nurse coping with a similar circumstance? (cite resource- can be a website, professional source or other source that supports coping with moral distress)