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  1. Multi-professional perspectives to reduce moral distress: A qualitative investigation.Sophia Fantus, Rebecca Cole, Timothy J. Usset & Lataya E. Hawkins - 2024 - Nursing Ethics 31 (8):1513-1523.
    Background Encounters of moral distress have long-term consequences on healthcare workers’ physical and mental health, leading to job dissatisfaction, reduced patient care, and high levels of burnout, exhaustion, and intentions to quit. Yet, research on approaches to ameliorate moral distress across the health workforce is limited. Research Objective The aim of our study was to qualitatively explore multi-professional perspectives of healthcare social workers, chaplains, and patient liaisons on ways to reduce moral distress and heighten well-being at a southern U.S. academic (...)
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  • What is ‘moral distress’ in nursing? A feminist empirical bioethics study.Georgina Morley, Caroline Bradbury-Jones & Jonathan Ives - 2020 - Nursing Ethics 27 (5):1297-1314.
    Background The phenomenon of ‘moral distress’ has continued to be a popular topic for nursing research. However, much of the scholarship has lacked conceptual clarity, and there is debate about what it means to experience moral distress. Moral distress remains an obscure concept to many clinical nurses, especially those outside of North America, and there is a lack of empirical research regarding its impact on nurses in the United Kingdom and its relevance to clinical practice. Research aim To explore the (...)
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  • Moral distress and ethical climate in intensive care medicine during COVID-19: a nationwide study.Walther N. K. A. van Mook, Sebastiaan A. Pronk, Iwan van der Horst, Elien Pragt, Ruth Heijnen-Panis, Hans Kling, Nathalie M. van Dijk, Math J. J. M. Candel, Vincent J. H. S. Gilissen & Moniek A. Donkers - 2021 - BMC Medical Ethics 22 (1):1-12.
    BackgroundThe COVID-19 pandemic has created ethical challenges for intensive care unit (ICU) professionals, potentially causing moral distress. This study explored the levels and causes of moral distress and the ethical climate in Dutch ICUs during COVID-19.MethodsAn extended version of the Measurement of Moral Distress for Healthcare Professionals (MMD-HP) and Ethical Decision Making Climate Questionnaire (EDMCQ) were online distributed among all 84 ICUs. Moral distress scores in nurses and intensivists were compared with the historical control group one year before COVID-19. ResultsThree (...)
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  • Developing ethical policies—a possible option to promote ethical competences in university nursing education?Annette Riedel - 2019 - Ethik in der Medizin 31 (4):361-390.
    Die Anforderungen an die ethische Kompetenzentwicklung im Rahmen der hochschulischen Pflegeausbildung sind anspruchsvoll und methodisch zu konkretisieren. Der Beitrag geht zunächst der Frage nach, wie Ethikkompetenz in Bezug auf die hochschulische Pflegeausbildung zu konturieren ist. Basierend auf dieser definitorischen Rahmung liegt das Augenmerk auf dem Prozess der Ethik-Leitlinienentwicklung als mögliche zu diskutierende Methode der Ethikkompetenzentwicklung. Hierbei ist die Frage leitend, ob der Prozess der Ethik-Leitlinienentwicklung im Rahmen des Studiums – analog zu den bis dato vielfach realisierten Fallanalysen – eine weitere (...)
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  • Enhancing Understanding of Moral Distress: The Measure of Moral Distress for Health Care Professionals.Elizabeth G. Epstein, Phyllis B. Whitehead, Chuleeporn Prompahakul, Leroy R. Thacker & Ann B. Hamric - 2019 - AJOB Empirical Bioethics 10 (2):113-124.
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  • Moral sensitivity, moral distress, and moral courage among baccalaureate Filipino nursing students.Rowena L. Escolar-Chua - 2018 - Nursing Ethics 25 (4):458-469.
    Background:Moral distress, moral sensitivity, and moral courage among healthcare professionals have been explored considerably in recent years. However, there is a paucity of studies exploring these topics among baccalaureate nursing students.Aim/objective:The purpose of this study was to explore the relationship between and among moral distress, moral sensitivity, and moral courage of undergraduate baccalaureate nursing students.Research design:The research employed a descriptive-correlational design to explore the relationships between and among moral distress, moral sensitivity, and moral courage of undergraduate nursing students.Participants and research (...)
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  • Searching for ethical leadership in nursing.Kara Schick Makaroff, Janet Storch, Bernie Pauly & Lorelei Newton - 2014 - Nursing Ethics 21 (6):642-658.
    Background: Attention to ethical leadership in nursing has diminished over the past several decades. Objectives: The aim of our study was to investigate how frontline nurses and formal nurse leaders envision ethical nursing leadership. Research design: Meta-ethnography was used to guide our analysis and synthesis of four studies that explored the notion of ethical nursing leadership. Participants and research context: These four original studies were conducted from 1999-2008 in Canada with 601 participants. Ethical considerations: Ethical approval from the original studies (...)
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  • Moral Distress Reexamined: A Feminist Interpretation of Nurses' Identities, Relationships, and Responsibilites. [REVIEW]Elizabeth Peter & Joan Liaschenko - 2013 - Journal of Bioethical Inquiry 10 (3):337-345.
    Moral distress has been written about extensively in nursing and other fields. Often, however, it has not been used with much theoretical depth. This paper focuses on theorizing moral distress using feminist ethics, particularly the work of Margaret Urban Walker and Hilde Lindemann. Incorporating empirical findings, we argue that moral distress is the response to constraints experienced by nurses to their moral identities, responsibilities, and relationships. We recommend that health professionals get assistance in accounting for and communicating their values and (...)
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  • A study of nurses’ ethical climate perceptions.Anne Humphries & Martin Woods - 2016 - Nursing Ethics 23 (3):265-276.
    Background: Acting ethically, in accordance with professional and personal moral values, lies at the heart of nursing practice. However, contextual factors, or obstacles within the work environment, can constrain nurses in their ethical practice – hence the importance of the workplace ethical climate. Interest in nurse workplace ethical climates has snowballed in recent years because the ethical climate has emerged as a key variable in the experience of nurse moral distress. Significantly, this study appears to be the first of its (...)
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  • Moral Distress and Advanced Practice Nursing: The Need for Morally Habitable Work Environments: Comment on “Moral Distress in Uninsured Health Care” by Anita Nivens and Janet Buelow. [REVIEW]Natalie Beavis - 2013 - Journal of Bioethical Inquiry 10 (3):425-426.
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  • Nurses' Responses to Initial Moral Distress in Long-Term Care.Marie P. Edwards, Susan E. McClement & Laurie R. Read - 2013 - Journal of Bioethical Inquiry 10 (3):325-336.
    While researchers have examined the types of ethical issues that arise in long-term care, few studies have explored long-term care nurses’ experiences of moral distress and fewer still have examined responses to initial moral distress. Using an interpretive description approach, 15 nurses working in long-term care settings within one city in Canada were interviewed about their responses to experiences of initial moral distress, resources or supports they identified as helpful or potentially helpful in dealing with these situations, and factors that (...)
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  • Framing the Issues: Moral Distress in Health Care. [REVIEW]Bernadette M. Pauly, Colleen Varcoe & Jan Storch - 2012 - HEC Forum 24 (1):1-11.
    Moral distress in health care has been identified as a growing concern and a focus of research in nursing and health care for almost three decades. Researchers and theorists have argued that moral distress has both short and long-term consequences. Moral distress has implications for satisfaction, recruitment and retention of health care providers and implications for the delivery of safe and competent quality patient care. In over a decade of research on ethical practice, registered nurses and other health care practitioners (...)
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  • (1 other version)Take me to my leader.Janet Storch, Kara Schick Makaroff, Bernie Pauly & Lorelei Newton - 2013 - Nursing Ethics 20 (2):150-157.
    Although ethical leadership by formal nurse leaders is critical to enhancing ethical health-care practice, research has shown that many nurses feel unsupported by their leaders. In this article, we consider the limited attention directed toward ethical leadership of formal nurse leaders and how our own research on ethical nurse leadership compares to other research in this field. In searching Nursing Ethics since its inception 20 years ago, we found only a dozen articles that directly addressed this topic. We then reviewed (...)
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  • Ethical concerns of visiting nurses caring for older people in the community.Kwisoon Choe, Kisook Kim & Kyoung-Sook Lee - 2015 - Nursing Ethics 22 (6):700-710.
    Background: An understanding of the ethical concerns encountered by visiting nurses in the community is needed. Yet, there is a lack of research on this topic. Objectives: The purpose of this study was to explore the ethical concerns that visiting nurses experience when caring for vulnerable older people living in a community. Design and sample: A qualitative thematic analysis was used to explore the nature of the ethical issues experienced by visiting nurses (N = 13) who care for vulnerable older (...)
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  • Moral Distress: Tensions as Springboards for Action. [REVIEW]Colleen Varcoe, Bernadette Pauly, George Webster & Janet Storch - 2012 - HEC Forum 24 (1):51-62.
    In the previous four papers in this series, individual versus structural or contextual factors have informed various understandings of moral distress. In this final paper, we summarize some of the key tensions raised in previous papers and use these tensions as springboards to identify directions for action among practitioners, educators, researchers, policymakers and others. In particular, we recognize the need to more explicitly politicize the concept of moral distress in order to understand how such distress arises from competing values within (...)
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  • (1 other version)Acquisition of ethical competence in practice—requirements and impulses for professional nursing practice.Sonja Lehmeyer & Annette Riedel - 2019 - Ethik in der Medizin 31 (4):391-406.
    Die Anforderungen an das ethisch-professionelle Handeln Pflegender und somit auch die Forderungen an die professionelle Ethikkompetenz Pflegender im praktischen Berufsfeld wandeln sich sowohl qualitativ als auch quantitativ. Dies wird auch in den veränderten normativen Rahmungen der Pflegebildung deutlich. Der Lernort Praxis als ein zentraler Ort pflegebezogener (Aus‑)Bildungsprozesse rückt somit nochmals stärker in den Fokus der Ethikkompetenzentwicklung professionell Pflegender. Der Beitrag konturiert zentrale Anforderungen und veränderte Bezüglichkeiten für die Ethikbildung im beruflichen Handlungsfeld professioneller Pflege und formuliert davon ausgehend zentrale Prämissen an (...)
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  • (1 other version)Ethikkompetenzerwerb im Handlungsfeld – Voraussetzungen und Impulse für die professionelle Pflegepraxis.Sonja Lehmeyer & Annette Riedel - 2019 - Ethik in der Medizin 31 (4):391-406.
    Die Anforderungen an das ethisch-professionelle Handeln Pflegender und somit auch die Forderungen an die professionelle Ethikkompetenz Pflegender im praktischen Berufsfeld wandeln sich sowohl qualitativ als auch quantitativ. Dies wird auch in den veränderten normativen Rahmungen der Pflegebildung deutlich. Der Lernort Praxis als ein zentraler Ort pflegebezogener Bildungsprozesse rückt somit nochmals stärker in den Fokus der Ethikkompetenzentwicklung professionell Pflegender. Der Beitrag konturiert zentrale Anforderungen und veränderte Bezüglichkeiten für die Ethikbildung im beruflichen Handlungsfeld professioneller Pflege und formuliert davon ausgehend zentrale Prämissen an (...)
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  • Nurses’ perception of ethical climate, medical error experience and intent-to-leave.Jee-In Hwang & Hyeoun-Ae Park - 2014 - Nursing Ethics 21 (1):28-42.
    We examined nurses’ perceptions of the ethical climate of their workplace and the relationships among the perceptions, medical error experience and intent to leave through a cross-sectional survey of 1826 nurses in 33 Korean public hospitals. Ethical climate was measured using the Hospital Ethical Climate Survey. Although the sampled nurses perceived their workplace ethical climate positively, 19% reported making at least one medical error during the previous year, and 25% intended to leave their jobs in the near future. Controlling for (...)
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  • Preventing moral conflicts in patient care: Insights from a mixed-methods study with clinical experts.Jan Https://Orcidorg Schürmann, Gabriele Vaitaityte & Stella Reiter-Theil - 2023 - Clinical Ethics 18 (1):75-87.
    Background and aim Healthcare professionals are regularly exposed to moral challenges in patient care potentially compromising quality of care and safety of patients. Preventive clinical ethics support aims to identify and address moral problems in patient care at an early stage of their development. This study investigates the occurrence, risk factors, early indicators, decision parameters, consequences and preventive measures of moral problems. Method Semi-structured expert interviews were conducted with 20 interprofessional healthcare professionals from 2 university hospitals in Basel, Switzerland. A (...)
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  • Conceptualising moral resilience for nursing practice.Tiziana M. L. Sala Defilippis, Katherine Curtis & Ann Gallagher - 2019 - Nursing Inquiry 26 (3):e12291.
    The term ‘moral resilience’ has been gaining momentum in the nursing ethics literature. This may be due to it representing a potential response to moral problems such as moral distress. Moral resilience has been conceptualised as a factor that inhibits immoral actions, as a favourable outcome and as an ability to bounce back after a morally distressing situation. In this article, the philosophical analysis of moral resilience is developed by challenging these conceptualisations and highlighting the risks of such limiting perspectives. (...)
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  • Ethical leadership, nursing error and error reporting from the nurses’ perspective.Maasoumeh Barkhordari-Sharifabad & Narges-Sadat Mirjalili - 2020 - Nursing Ethics 27 (2):609-620.
    Background: Nursing errors endanger patient safety, and error reporting helps identify errors and system vulnerabilities. Nursing managers play a key role in preventing nursing errors by using leadership skills. One of the leadership approaches is ethical leadership. Aim: This study determined the level of ethical leadership from the nurses’ perspective and its effect on nursing error and error reporting in teaching hospitals affiliated to Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Research design: This was a cross-sectional descriptive study. Participants (...)
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  • Ethical decision-making climate, moral distress, and intention to leave among ICU professionals in a tertiary academic hospital center.Michele Zimmer, Julie Landon, Samantha Dove, Kerri Bouchard, Eunsung Cho, Melissa Davis-Gilbert, Rachel Hausladen, Karen McQuillan, Ali Tabatabai, Trishna Mukherjee, Raya Kheirbek, Samuel Tisherman, Tracey Wilson & Henry Silverman - 2022 - BMC Medical Ethics 23 (1):1-15.
    BackgroundCommentators believe that the ethical decision-making climate is instrumental in enhancing interprofessional collaboration in intensive care units. Our aim was twofold: to determine the perception of the ethical climate, levels of moral distress, and intention to leave one's job among nurses and physicians, and between the different ICU types and determine the association between the ethical climate, moral distress, and intention to leave.MethodsWe performed a cross-sectional questionnaire study between May 2021 and August 2021 involving 206 nurses and physicians in a (...)
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  • Ethikkompetenzentwicklung in der (zukünftigen) pflegeberuflichen Qualifizierung – Konkretion und Stufung als Grundlegung für curriculare Entwicklungen.Annette Riedel & Constanze Giese - 2019 - Ethik in der Medizin 31 (1):61-79.
    ZusammenfassungDie aktuellen Entwicklungen und Anforderungen in der pflegeberuflichen Bildung, das Ausbildungsziel im Pflegeberufegesetz vom 17. Juli 2017 und die Explikationen in der dazugehörigen Ausbildungs- und Prüfungsverordnung für die Pflegeberufe fordern eine stärkere Ausrichtung auf die Entwicklung ethischer Kompetenzen explizit ein. Bislang liegen tendenziell übergreifende Definitionen und Darlegungen zu ethischen Kompetenzen in der Pflege vor, deren Verdienst es ist, das Spezifische der Pflegeethik zu konturieren und erstmals ethische Kompetenzen für das Feld zu konkretisieren. In methodischer und didaktischer Hinsicht ist indes eine (...)
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  • Towards democratic institutions: Tronto’s care ethics inspiring nursing actions in intensive care.Annie-Claude Laurin & Patrick Martin - 2022 - Nursing Ethics 29 (7-8):1578-1588.
    Care as a concept has long been central to the nursing discipline, and care ethics have consequently found their place in nursing ethics discussions. This paper briefly revisits how care and care ethics have been theorized and applied in the discipline of nursing, with an emphasis on Tronto’s political view of care. Adding to the works of other nurse scholars, we consider that Tronto’s care ethics is useful to understand caring practices in a sociopolitical context. We also contend that this (...)
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  • Healthcare professionals' perspectives on environmental sustainability.Jillian L. Dunphy - 2014 - Nursing Ethics 21 (4):414-425.
    Background: Human health is dependent upon environmental sustainability. Many have argued that environmental sustainability advocacy and environmentally responsible healthcare practice are imperative healthcare actions. Research questions: What are the key obstacles to healthcare professionals supporting environmental sustainability? How may these obstacles be overcome? Research design: Data-driven thematic qualitative analysis of semi-structured interviews identified common and pertinent themes, and differences between specific healthcare disciplines. Participants: A total of 64 healthcare professionals and academics from all states and territories of Australia, and multiple (...)
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  • Moral distress among nurses: A mixed-methods study.Chuleeporn Prompahakul, Jessica Keim-Malpass, Virginia LeBaron, Guofen Yan & Elizabeth G. Epstein - 2021 - Nursing Ethics 28 (7-8):1165-1182.
    Background: Moral distress is recognized as a problem affecting healthcare professionals globally. Unaddressed moral distress may lead to withdrawal from the moral dimensions of patient care, burnout, or leaving the profession. Despite the importance, studies related to moral distress are scant in Thailand. Objective: This study aims to describe the experience of moral distress and related factors among Thai nurses. Design: A convergent parallel mixed-methods design was used. The quantitative and qualitative data were collected in parallel using the Measure of (...)
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  • An examination of the moral habitability of resource-constrained obstetrical settings.Priscilla N. Boakye, Elizabeth Peter, Anne Simmonds & Solina Richter - 2021 - Nursing Ethics 28 (6):1026-1040.
    Background: While there have been studies exploring moral habitability and its impact on the work environments of nurses in Western countries, little is known about the moral habitability of the work environments of nurses and midwives in resource-constrained settings. Research objective: The purpose of this research was to examine the moral habitability of the work environment of nurses and midwives in Ghana and its influence on their moral agency using the philosophical works of Margaret Urban Walker. Research design and participants: (...)
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  • Truth-telling, decision-making, and ethics among cancer patients in nursing practice in China.Dong-Lan Ling, Hong-Jing Yu & Hui-Ling Guo - 2019 - Nursing Ethics 26 (4):1000-1008.
    Background: Truth-telling toward terminally ill patients is a challenging ethical issue in healthcare practice. However, there are no existing ethical guidelines or frameworks provided for Chinese nurses in relation to decision-making on truth-telling of terminal illness and the role of nurses thus is not explicit when encountering this issue. Objectives: The intention of this paper is to provide ethical guidelines or strategies with regards to decision-making on truth-telling of terminal illness for Chinese nurses. Methods: This paper initially present a case (...)
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  • Moral distress in critical care nursing: The state of the science.Natalie Susan McAndrew, Jane Leske & Kathryn Schroeter - 2018 - Nursing Ethics 25 (5):552-570.
    Background: Moral distress is a complex phenomenon frequently experienced by critical care nurses. Ethical conflicts in this practice area are related to technological advancement, high intensity work environments, and end-of-life decisions. Objectives: An exploration of contemporary moral distress literature was undertaken to determine measurement, contributing factors, impact, and interventions. Review Methods: This state of the science review focused on moral distress research in critical care nursing from 2009 to 2015, and included 12 qualitative, 24 quantitative, and 6 mixed methods studies. (...)
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  • Nurses’ attitudes toward ethical issues in psychiatric inpatient settings.Nurhan Eren - 2014 - Nursing Ethics 21 (3):359-373.
    Background: Nursing is an occupation that deals with humans and relies upon human relationships. Nursing care, which is an important component of these relationships, involves protection, forbearance, attention, and worry. Objectives: The aim of this study is to evaluate the ethical beliefs of psychiatric nurses and ethical problems encountered. Research Design: The study design was descriptive and cross-sectional. Research context: Methods comprised of a questionnaire administered to psychiatric nurses (n = 202) from five psychiatric hospitals in Istanbul, Turkey, instruction in (...)
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  • Gender and the experience of moral distress in critical care nurses.Christopher B. O’Connell - 2015 - Nursing Ethics 22 (1):32-42.
    Background: Nursing practice is complex, as nurses are challenged by increasingly intricate moral and ethical judgments. Inadequately studied in underrepresented groups in nursing, moral distress is a serious problem internationally for healthcare professionals with deleterious effects to patients, nurses, and organizations. Moral distress among nurses has been shown to contribute to decreased job satisfaction and increased turnover, withdrawal from patients, physical and psychological symptoms, and intent to leave current position or to leave the profession altogether. Research question: Do significant gender (...)
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  • Transgressive Acts: Michel Foucault's Lessons on Resistance for Nurses.Cristina Moreno-Mulet, Joaquín Valdivielso-Navarro, Margalida Miró-Bonet, Alba Carrero-Planells & Denise Gastaldo - 2025 - Nursing Philosophy 26 (1):e70008.
    In this paper, we bring together Foucault's biography and oeuvre to explore key concepts that support the analysis of nurses' acts of resistance. Foucault reflected on the power relations taking place in health services, making his contribution especially useful for the analysis of resistance in this context. Over three decades, he proposed a nonnormative philosophy while concomitantly engaging in transgressive practices guided by values such as human rights and social justice. Hence, Foucault's philosophy and public activism are an apparent contradiction, (...)
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  • Organizational Influences on Health Professionals’ Experiences of Moral Distress in PICUs.Sarah Wall, Wendy J. Austin & Daniel Garros - 2016 - HEC Forum 28 (1):53-67.
    This article reports the findings of a qualitative study that explored the organizational influences on moral distress for health professionals working in pediatric intensive care units across Canada. Participants were recruited to the study from PICUs across Canada. The PICU is a high-tech, fast-paced, high-pressure environment where caregivers frequently face conflict and ethical tension in the care of critically ill children. A number of themes including relationships with management, organizational structure and processes, workload and resources, and team dynamics were identified. (...)
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  • (1 other version)Take me to my leader The importance of ethical leadership among formal nurse leaders.Janet Storch, Kara Schick Makaroff, Bernie Pauly & Lorelei Newton - 2013 - Nursing Ethics 20 (2):150-157.
    Although ethical leadership by formal nurse leaders is critical to enhancing ethical health-care practice, research has shown that many nurses feel unsupported by their leaders. In this article, we consider the limited attention directed toward ethical leadership of formal nurse leaders and how our own research on ethical nurse leadership compares to other research in this field. In searching Nursing Ethics since its inception 20 years ago, we found only a dozen articles that directly addressed this topic. We then reviewed (...)
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  • Nurse managers’ perspectives on working with everyday ethics in long-term care.Siri Andreassen Devik, Hilde Munkeby, Monica Finnanger & Aud Moe - 2020 - Nursing Ethics 27 (8):1669-1680.
    Background:Nurse managers are expected to continuously ensure that ethical standards are met and to support healthcare workers’ ethical competence. Several studies have concluded that nurses across various healthcare settings lack the support needed to provide safe, compassionate and competent ethical care.Objective:The aim of this study was to explore and understand how nurse managers perceive their role in supporting their staff in conducting ethically sound care in nursing homes and home nursing care.Design and participants:Qualitative individual interviews were performed with 10 nurse (...)
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  • Situating moral distress within relational ethics.Sadie Deschenes & Diane Kunyk - 2020 - Nursing Ethics 27 (3):767-777.
    Nurses may, and often do, experience moral distress in their careers. This is related to the complicated work environment and the complex nature of ethical situations in everyday nursing practice. The outcomes of moral distress may include psychological and physical symptoms, reduced job satisfaction and even inadequate or inappropriate nursing care. Moral distress can also impact retention of nurses. Although research has grown considerably over the past few decades, there is still a great deal about this topic that we do (...)
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  • Narratives of aggressive care.Elizabeth Peter, Shan Mohammed & Anne Simmonds - 2014 - Nursing Ethics 21 (4):461-472.
    Background: While witnessing and providing aggressive care have been identified as predominant sources of moral distress, little is known about what nurses “know” to be the “right thing to do” in these situations. Research objectives: The purpose of this study was to explore what nurses’ moral knowledge is in situations of perceived overly aggressive medical care. Research design: A critical narrative approach was used. Participants: A total of 15 graduate nursing students from various practice areas participated. Findings: Four narrative types (...)
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  • Refining moral agency: Insights from moral psychology and moral philosophy.Aimee Milliken - 2018 - Nursing Philosophy 19 (1):e12185.
    Research in moral psychology has recently raised questions about the impact of context and the environment on the way the human mind works. In a 2012 call to action, Paley wrote: “If some of the conclusions arrived at by moral psychologists are true, they are directly relevant to the way nurses think about moral problems, and present serious challenges to favoured concepts in nursing ethics, such as the ethics of care, virtue, and the unity of the person” (p. 80). He (...)
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  • Ethical conflicts in nursing: An interview study.Gerli Usberg, Ere Uibu, Reet Urban & Mari Kangasniemi - 2021 - Nursing Ethics 28 (2):230-241.
    Background: A growing body of evidence about nurses’ ethical conflicts has been added to nursing science in recent decades, but no research has been done in Estonia. Ethical conflicts are a cultural and context sensitive phenomenon, so the historical, legal, social, economic and political backgrounds and position of nursing have had an impact on ethical conflict experiences. Aim: Describe nurses’ experiences of ethical conflicts. Method: A qualitative, descriptive study was conducted among nurses (n = 21) in May-October 2018 in Estonia. (...)
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  • Sustaining hope as a moral competency in the context of aggressive care.Elizabeth Peter, Shan Mohammed & Anne Simmonds - 2015 - Nursing Ethics 22 (7):743-753.
    -/- Background: Nurses who provide aggressive care often experience the ethical challenge of needing to preserve the hope of seriously ill patients and their families without providing false hope. -/- Research objectives: The purpose of this inquiry was to explore nurses’ moral competence related to fostering hope in patients and their families within the context of aggressive technological care. A secondary purpose was to understand how this competence is shaped by the social–moral space of nurses’ work in order to capture (...)
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  • Moral distress experienced by non-Western nurses: An integrative review.Chuleeporn Prompahakul & Elizabeth G. Epstein - 2020 - Nursing Ethics 27 (3):778-795.
    Background: Moral distress has been identified as a significant issue in nursing practice for many decades. However, most studies have involved American nurses or Western medicine settings. Cultural differences between Western and non-Western countries might influence the experience of moral distress. Therefore, the literature regarding moral distress experiences among non-Western nurses is in need of review. Aim: The aim of this integrative review was to identify, describe, and synthesize previous primary studies on moral distress experienced by non-Western nurses. Review method: (...)
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  • Ethical Awareness Scale: Replication Testing, Invariance Analysis, and Implications.Aimee Milliken, Larry Ludlow & Pamela Grace - 2019 - AJOB Empirical Bioethics 10 (4):231-240.
    Ethical awareness enables nurses to recognize the ethical implications of all practice actions, and is an important component of safe and high quality nursing care (Milliken 2016; Milliken and Grac...
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  • Giving nurses a voice during ethical conflict in the Intensive Care Unit.Natalie S. McAndrew & Joshua B. Hardin - 2020 - Nursing Ethics 27 (8):1631-1644.
    Background:Ethical conflict and subsequent nurse moral distress and burnout are common in the intensive care unit (ICU). There is a gap in our understanding of nurses’ perceptions of how organizational resources support them in addressing ethical conflict in the intensive care unit.Research question/objectives/methods:The aim of this qualitative, descriptive study was to explore how nurses experience ethical conflict and use organizational resources to support them as they address ethical conflict in their practice.Participants and research context:Responses to two open-ended questions were collected (...)
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  • Phenomenon of moral distress through the aspect of interpretive interactionism.Hsun-Kuei Ko, Chi-Chun Chin, Min-Tao Hsu & Shu-Li Lee - 2019 - Nursing Ethics 26 (5):1484-1493.
    Background: Most previous studies on moral distress focused on the factors that cause moral distress, paying inadequate attention to the moral conflict of nurses’ values, the physician–nurse power hierarchy, and the influence of the culture. Research objective: To analyze the main causes for moral distress with interpretive interactionism. Research design: A qualitative study was adopted. Participants: Through purposeful sampling, 32 nurses from 12 different departments were chosen as the samples. Ethical considerations: Approval from the Institutional Review Board of the Kaohsiung (...)
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  • Relationships among Climate of Care, Nursing Family Care and Family Well-being in ICUs.Natalie S. McAndrew, Rachel Schiffman & Jane Leske - 2019 - Nursing Ethics 26 (7-8):2494-2510.
    Background: Frequent exposure to ethical conflict and a perceived lack of organizational support to address ethical conflict may negatively influence nursing family care in the intensive care unit. Research aims: The specific aims of this study were to determine: (1) if intensive care unit climate of care variables (ethical conflict, organizational resources for ethical conflict, and nurse burnout) were predictive of nursing family care and family wellbeing and (2) direct and indirect effects of the climate of care on the quality (...)
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  • In search of salience: phenomenological analysis of moral distress.Duilio F. Manara, Giulia Villa & Dina Moranda - 2014 - Nursing Philosophy 15 (3):171-182.
    The nurse's moral competences in the management of situations which present ethical implications are less investigated in literature than other ethical problems related to clinical nursing. Phenomenology affirms that emotional warmth is the first fundamental attitude as well as the premise of any ethical reasoning. Nevertheless, it is not clear how and when this could be confirmed in situations where the effect of emotions on the nurse's decisional process is undiscovered. To explore the processes through which situations of moral distress (...)
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