Moral Distress: An Increasing Problem Among Nurses

moral distress

An ICU nurse struggles to reconcile repeated surgeries and transfusions for a comatose patient who has little chance of recovery. An oncology nurse knows a patient wants to refuse treatment but doesn’t do so because his physician and family want him to “fight on.” A nurse on a geriatric unit knows she’s not giving needed care to patients because of poor staffing.

Situations such as these are all too common and can give rise to moral distress. Moral distress occurs when nurses recognize their responsibility to respond to care situations but are unable to translate their moral choices into action.

As explained in “Moral Distress: A Catalyst in Building Moral Resilience,” one of the CE articles in our July issue, this “inability to act in alignment with one’s moral values is detrimental not only to the nurse’s well-being but also to patient care and clinical practice as a whole.” […]

2016-11-21T13:01:03-05:00July 18th, 2016|Ethics, Nursing, patient safety|0 Comments
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Recent Decline in U.S. Opioid Prescriptions: Good News But Some Concerns

by frankieleon/ via flickr by frankieleon/ via flickr

It was widely reported in the past week that there have been steady declines in the number of opioid prescriptions in the U.S. for the past three years, with the declines the steepest in some of the states considered to have the worst opioid misuse crises.

This is good news, suggesting that efforts to address some problem areas like renegade pain clinics prescribing for profit, patients who go from doctor to doctor seeking opioid prescriptions, and the diversion of legitimate opioid prescriptions may be starting to bear fruit.

A balanced overview of the situation can be found in this New York Times article. The authors also acknowledge that patients in pain are now facing new hurdles to pain relief, quoting the director of one prominent medical school’s program on pain research education and policy: “The climate has definitely shifted. . . . It is now one of reluctance, fear of consequences and encumbrance with administrative hurdles. A lot of patients who are appropriate candidates for opioids have been caught up in that response.”

Much of the reporting on the opioid epidemic lumps all people who take opioids into one big statistical brew. While startling and alarming numbers about overdoses from legal and illegal opioids steal the headlines, little media and scholarly analysis focuses on the lower […]

2016-11-21T13:01:12-05:00May 26th, 2016|health care policy, Nursing, nursing perspective, pain management, patient experience, patient safety, Patients|1 Comment
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Napping on the Night Shift: What a Pilot Study Revealed

By Sylvia Foley, AJN senior editor

Table 1. Guidelines for Hospital Nurses on Implementing Naps on the Night Shift (click to enlarge)Nurses who work the night shift often struggle with high levels of sleepiness. But while onsite napping is effectively used to counter worker fatigue in other safety-sensitive industries, the practice has yet to win wide acceptance in nursing.

Curious about why this is so, nurse researchers Jeanne Geiger-Brown and colleagues recently conducted a pilot study. They report their findings in this month’s CE–Original Research feature, “Napping on the Night Shift: A Two-Hospital Implementation Project” (for some night shift napping ground rules, see, at right, Table 1: Guidelines for Hospital Nurses on Implementing Naps on the Night Shift—click table to enlarge).

Here’s an overview:

Purpose: To assess the barriers to successful implementation of night-shift naps and to describe the nap experiences of night-shift nurses who took naps.

Methods: In this two-hospital pilot implementation project, napping on the night shift was offered to six nursing units. Unit nurse managers’ approval was sought, and further explanation was given to a unit’s staff nurses. A nap experience form, which included the Karolinska Sleepiness Scale, was used to assess pre-nap sleepiness level, nap duration and perceived sleep experience, post-nap sleep inertia, and the perceived helpfulness of the nap. Nurse managers and staff nurses were also interviewed at the end of the three-month study period.

Results: Successful implementation occurred on only one of the six units, with partial success seen on […]

2016-11-21T13:01:12-05:00May 16th, 2016|Nursing, nursing perspective, nursing research, patient safety|3 Comments
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Why I Like Nurses Week

Safety Plan Safety Plan/Plougmann/via Flickr

By Shawn Kennedy, AJN editor-in-chief

Here’s why I like Nurses Week. I’m sure some folks groan over the idea that for only one week out of the year, health care administrators actually think about all that nurses do and show their appreciation. My perspective is that at least we have one solid week with the spotlight on nursing, when we can toot our horns and make sure that people know the critical role of nursing in health care.

Sure, there are some people who will never “get” what nurses do beyond the old stereotype that nurses are doctors’ helpers. I’m always flabbergasted, though, when physicians—after so much time working alongside nurses as medical students, interns, and residents—still don’t have a more nuanced view of nursing.

In this month’s editorial, I address the American Nurses Association Nurses Week theme, “Culture of Safety: It Starts with You.” How many times, in the dead of night, have nurses called physicians to alert them to a critical change—or questioned an inappropriately ordered medication that, if given as ordered, could have had dire consequences? I also addressed this issue in a 2014 blog post about Arnold Relman, now deceased […]

2016-11-21T13:01:13-05:00May 11th, 2016|Nursing, nursing perspective, patient safety|1 Comment
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The Nurses Week Prizes We Really Need

Amanda Anderson, formerly a graduate intern at AJN, is now a contributing editor

Culture_of_Safety_2016My first Nurses Week as a nurse, my mother sent me a card and a small gift. When I opened it, I was surprised by its message—no one had ever given me anything for Nurses Week during nursing school. I had no idea that the holiday even existed.

As an English Literature major–turned nursing student, I was pretty clueless about the world of nursing when I launched my career. I spent most of my first year fumbling around in the dark, looking for Florence’s light.

As years passed, I learned more about nursing, claimed it as my own, and became versed in the industry secrets. I started to take pride in Nurses Week, seeing it as a venue for speaking out about nursing.

One year, for the thirty days preceding the holiday, I wrote to Google about 30 living nurse legends, in hopes that they would post a nursing-themed Google Doodle for our week. On another, I penned (and never sent) a scathing letter to a hospital president who had sent a kitschy card I took offense to.

[…]

2023-01-30T10:51:51-05:00May 5th, 2016|career, Nursing, nursing perspective, patient safety|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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