moral distress CA final
Sara Hodge
University of Memphis
NURS5000R57- Theoretical Foundations
Spring 2019
,2
MORAL DISTRESS AMONG NURSES
Abstract
Aim: To report a concept analysis of moral distress in nursing.
Background: This analysis is needed to determine how nurses are affected by moral distress and
how that distress affects their ability to provide quality care. This analysis is also necessary to
understand the impact on nurses when they are required to participate/witness care that
contradicts their moral, ethical, and religious beliefs.
Design: Concept analysis
Data Sources: CINAHL, using keywords moral, distress, nurses, abortion, nursing. Results are
limited to full text, English journal articles from 2005-2019.
Methods: Walker & Avant’s Method of concept analysis
Results: The antecedents to moral distress are feelings of powerlessness, unfair treatment of a
patient, and lack of support. The attributes of moral distress are powerlessness, mental unease,
and patient dehumanization. The consequences of moral distress include fear, anger, ineffective
teamwork, reduced quality of patient care, and occupational stress. Consequences can also be
physical symptoms instead of feelings; including heart palpitations, headache, insomnia,
diarrhea, and fatigue.
Conclusion: Moral distress is a vital concept in nursing as it relates to the nurse’s thoughts,
perceptions, and own self-image based on his/her actions and ability to care for a patient. Moral
distress is causing mass exodus in the nursing discipline, as well as contributing to a lower
quality of patient care.
Keywords: nursing, moral distress, ethical, abortion, burnout, end of life
, 3
MORAL DISTRESS AMONG NURSES
Moral Distress Among Nurses
Introduction
The purpose of this concept analysis is to determine how nurses are affected by moral distress
and does that in turn negatively impact patient care. Moral distress is a vital concept in nursing
as it relates to the nurse’s thoughts, perceptions, and own self-image based on his/her actions and
ability to care for a patient. Medical Dictionary (2009) describes moral distress as the response
when a person is unable to comply with their own chosen ethical/moral decision/action.
Lachman (2016) defines moral distress as “the condition of knowing the morally right thing to
do, but institutional, procedural, or social constraints make doing the right thing impossible;
threatens core values and moral integrity.”
Methods
The research method used in this paper is Walker and Avant’s model of concept analysis
of the concept of moral distress in the research. The steps found in Walker & Avant’s (2019)
procedures for concept analysis are as follows:
• Select a concept.
• Determine the aims or purposes of analysis.
• Identify all uses of the concept that you can discover.
• Determine the defining attributes.
• Identify a model case.
• Identify borderline, related, contrary, invented, and illegitimate cases.
• Identify antecedents and consequences.
• Define empirical referents.
Sara Hodge
University of Memphis
NURS5000R57- Theoretical Foundations
Spring 2019
,2
MORAL DISTRESS AMONG NURSES
Abstract
Aim: To report a concept analysis of moral distress in nursing.
Background: This analysis is needed to determine how nurses are affected by moral distress and
how that distress affects their ability to provide quality care. This analysis is also necessary to
understand the impact on nurses when they are required to participate/witness care that
contradicts their moral, ethical, and religious beliefs.
Design: Concept analysis
Data Sources: CINAHL, using keywords moral, distress, nurses, abortion, nursing. Results are
limited to full text, English journal articles from 2005-2019.
Methods: Walker & Avant’s Method of concept analysis
Results: The antecedents to moral distress are feelings of powerlessness, unfair treatment of a
patient, and lack of support. The attributes of moral distress are powerlessness, mental unease,
and patient dehumanization. The consequences of moral distress include fear, anger, ineffective
teamwork, reduced quality of patient care, and occupational stress. Consequences can also be
physical symptoms instead of feelings; including heart palpitations, headache, insomnia,
diarrhea, and fatigue.
Conclusion: Moral distress is a vital concept in nursing as it relates to the nurse’s thoughts,
perceptions, and own self-image based on his/her actions and ability to care for a patient. Moral
distress is causing mass exodus in the nursing discipline, as well as contributing to a lower
quality of patient care.
Keywords: nursing, moral distress, ethical, abortion, burnout, end of life
, 3
MORAL DISTRESS AMONG NURSES
Moral Distress Among Nurses
Introduction
The purpose of this concept analysis is to determine how nurses are affected by moral distress
and does that in turn negatively impact patient care. Moral distress is a vital concept in nursing
as it relates to the nurse’s thoughts, perceptions, and own self-image based on his/her actions and
ability to care for a patient. Medical Dictionary (2009) describes moral distress as the response
when a person is unable to comply with their own chosen ethical/moral decision/action.
Lachman (2016) defines moral distress as “the condition of knowing the morally right thing to
do, but institutional, procedural, or social constraints make doing the right thing impossible;
threatens core values and moral integrity.”
Methods
The research method used in this paper is Walker and Avant’s model of concept analysis
of the concept of moral distress in the research. The steps found in Walker & Avant’s (2019)
procedures for concept analysis are as follows:
• Select a concept.
• Determine the aims or purposes of analysis.
• Identify all uses of the concept that you can discover.
• Determine the defining attributes.
• Identify a model case.
• Identify borderline, related, contrary, invented, and illegitimate cases.
• Identify antecedents and consequences.
• Define empirical referents.
