Research on moral distress has paid limited attention to nurses’ responses and actions. In a survey of nurses’ perceptions of moral distress and ethical climate, 292 nurses answered three open-ended questions about situations that they considered morally distressing. Participants identified a range of situations as morally distressing, including witnessing unnecessary suffering, being forced to provide care that compromised values, and negative judgments about patients. They linked these situations to contextual constraints such as workload and described responses, including feeling incompetent and (...) distancing themselves from patients. Participants described considerable effort to effect change, calling into question the utility of defining moral distress as an “inability to act due to institutional constraints” or a “failure to pursue a right course of action.” Various understandings of moral distress operated, and action was integral to their responses. The findings suggest further conceptual work on moral distress and effort to support system-level change. (shrink)

This article examines Michel Foucault’s critical investigation of neoliberalism in the course published as Naissance de la biopolitique: Cours au Collège de France, 1978-1979. Foucault’s lectures are interrogated along two axes. First, examining the way in which neoliberalism can be viewed as a particular production of subjectivity, as a way in which individuals are constituted as subjects of “human capital.” Secondly, Foucault’s analyses is augmented and critically examined in light of other critical work on neoliberalism by Wendy Brown, David Harvey, (...) Christian Laval, Maurizo Lazzarato, and Antonio Negri. Of these various debates and discussions, the paper argues that the discussion of real subsumption in Marx and Negri is most important for understanding the specific politics of neoliberalism. Finally, the paper argues that neoliberalism entails a fundamental reexamination of the tools of critical thought, an examination of how freedom can constitute a form of subjection. (shrink)

Although the need to theorize ethics within the complexities of nursing practice has been identified within the nursing literature, to date the link between ethics epistemology and specific nursing actions has received limited attention. In particular, little exploration has been carried out to examine how nurses ‘know’ what is ethical and the knowledge they draw upon to inform their nursing actions within the complexities of their everyday practice. This study describes a participatory inquiry project that focused on developing and articulating (...) an epistemology of ethics while in the midst of everyday nursing work. Epistemological and methodological insights are discussed in light of the challenges nurses face in contemporary healthcare contexts. (shrink)

A new approach to understanding the nature of ethics and ethical decision making, not only in the context of business, but also in other life contexts.

climate are both linked to an organization's ability to retain healthcare professionals and increase their level of job satisfaction, leaders have a corollary responsibility to address moral distress. We recommend that leaders should provide access to ethics education and resources, offer interventions such as ethics debriefings, establish ethics committees, and/or hire a bioethicist to develop ethics capacity and to assist with addressing healthcare provider moral distress....