Moral distress has been widely reviewed across many care contexts and among a range of disciplines. Interest in this area has produced a plethora of studies, commentary and critique. An overview of the literature around moral distress reveals a commonality about factors contributing to moral distress, the attendant outcomes of this distress and a core set of interventions recommended to address these. Interventions at both personal and organizational levels have been proposed. The relevance of this overview resides in the implications (...) moral distress has on the nurse and the nursing workforce: particularly in regard to quality of care, diminished workplace satisfaction and physical health of staff and increased problems with staff retention. (shrink)

At the centre of responsible management (RM) learning is the development of managerial competence for ethics, responsibility, and sustainability (ERS). Important contributions have been made from each: the ethics, responsibility, and sustainability disciplines. However, we are yet to integrate these disciplinary contributions into a comprehensive interdisciplinary RM competence framework that corresponds to the interdisciplinary nature of RM challenges. We address this priority in this paper and report on the findings of an integrative structured literature review of 224 management competence articles (...) across the ERS disciplines. Our thematic template analysis has produced an interdisciplinary RM competence framework of three layers of personal, behavioural, and intellectual competences and independent and interdependent competence dimensions. The resulting 3 × 2 competence matrix framework accommodates 33 interdisciplinary ERS competence themes and 90 subthemes in the six competence domains of _being_ and _becoming_, _acting_ and _interacting_, _knowing_ and _thinking_. To the RM discussion, we contribute an interdisciplinary competence framework that enables the development of responsible managers who tackle the inherently interdisciplinary issues of RM. To the competence discussion, we contribute the interdependent competence dimension and future research directions through the lens of response-ability. _JBE Section:_ Business Ethics Learning and Education. (shrink)

Background: Hospices are based on a holistic approach which places the physical, psychological, social and spiritual welfare of their patients at the forefront of their work. Furthermore, they draw up their own mission statements which they are at pains to follow and seek to conduct their work in accordance with codes of ethics and standards of care. Research question and design: Our study researched what form the processes and degrees of latitude in decision-making take in practice when questions of an (...) ethical and ethically relevant nature arise. We used a qualitative approach. Data collection and evaluation was based on the methods of grounded theory. Ethical considerations: The study was reported to the relevant Ethics Commission who had raised no objections following the submission of the study protocol. The study at the hospices was approved by the directors of the hospices and the nursing teams. The rights of the participants were protected by obtaining informed consent. Results: Medication in the prefinal phase and questions affecting the provision of solids and liquids in the end-of-life phase have an ethical dimension. In the context of these two fields, decisions are taken collectively. A nurse’s individual (and ethically relevant) leeway in decision-making processes is restricted to the nurse’s own style of administering care. The nurse’s decision-making often depends to a far greater degree on her ability to adapt her concept of ideal care to fit the practical realities of her work than to any conceptual framework. Discussion: An adaptive process is necessary for the nurse because she is required to incorporate the four pillars of hospice care – namely, physical, psychological, social and spiritual care – into the practice of her daily work. Conclusion: Ethically relevant decisions are often characterised by nurses adjusting their aspiration levels to the practical conditions with which they are confronted. (shrink)