MAYWOOD, Il. Loyola University Medical Center researchers have published the first ever study of emotional and psychological anguish, known as "moral distress," experienced by nurses in an intensive care unit for burn patients.
The study by first author Jeanie M. Leggett, RN, BSN, MA and colleagues is published in the Journal of Burn Care and Research.
Moral distress consists of painful feelings and associated emotional and mental anguish. It occurs when a person believes he or she knows the ethically ideal or right action to take, but is prevented from doing so because of internal or institutional barriers.
For example, a nurse has to carry out a physician's orders for what the nurse considers to be unnecessary tests and treatments, or witness healthcare providers giving false hope to a patient or family.
Moral distress can result in depression, anxiety, emotional withdrawal, frustration, anger and a variety of physical symptoms. It also can lead to job burnout.
The concept of moral distress among healthcare workers was first identified in the late 1980s, and research on the topic has accelerated during the past decade. There have been studies of moral distress in neonatal and pediatric intensive care units and among genetic counselors, resident physicians and other healthcare professionals. But until now, there had never been a study examining moral distress among nurses in a burn intensive care unit.
A burn ICU can be an intense work environment. Many patients suffer significant pain and disfigurement. They may be in the ICU for weeks, and require numerous procedures and surgeries.
"Given the intense and potentially distressing nature of nursing in a burn ICU, it is reasonable to hypothesize that nurses in these settings are likely to experience some level of moral distress," Leggett and co-authors Katherine Wasson, PhD, MPH; James M. Sinacore, PhD; and Richard L. Gamelli, MD, FACS wrote
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Loyola University Health System