Moral distress among nurses involved in life-prolonging treatments in patients with a short life expectancy: A qualitative interview study

Susanne A M Arends; Milou Steenbergen; Maureen Thodé; Anneke L Francke; Irene P Jongerden

doi:10.1016/j.pec.2022.01.017

Moral distress among nurses involved in life-prolonging treatments in patients with a short life expectancy: A qualitative interview study

Susanne A M Arends, Milou Steenbergen, Maureen Thodé, Anneke L Francke, Irene P Jongerden

Julius Center, dept. General Practice & Nursing Science

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: To explore whether nurses in hospital settings experience moral distress when involved in potentially life-prolonging treatments in adults with a short life expectancy.

METHODS: A qualitative study using semi-structured interviews.

RESULTS: 23 Registered nurses working in inpatient or outpatient hospital settings participated. The nurses stated they were often not involved in decisions regarding life-prolonging treatments. They reported signs of moral distress such as feeling powerless when they when they were not being listened to in the decision-making process and when confronted with negative treatment outcomes. Nurses felt frustrated when their own values were not reflected in the decision-making or when physicians created unrealistic expectations.

CONCLUSIONS: Hospital nurses experience moral distress when they are involved in life-prolonging treatment because of the patient's advanced condition and their own lack of involvement in the decision-making process about the treatment. In these situations, moral distress is characterised by feelings of powerlessness and frustration.

PRACTICE IMPLICATIONS: Nurses need to be empowered by training programmes that focus on an active role in the decision-making process. Further research is needed to evaluate effective tools and training programmes that help nurses in shared decision-making processes.

Original language	English
Pages (from-to)	2531-2536
Number of pages	6
Journal	Patient Education and Counseling
Volume	105
Issue number	7
DOIs	https://doi.org/10.1016/j.pec.2022.01.017
Publication status	Published - Jul 2022

Keywords

End-of-life-care
Hospital nurses
Inpatient
Life-prolonging treatment
Moral distress
Outpatient
Palliative care
Shared decision-making

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title = "Moral distress among nurses involved in life-prolonging treatments in patients with a short life expectancy: A qualitative interview study",

abstract = "OBJECTIVE: To explore whether nurses in hospital settings experience moral distress when involved in potentially life-prolonging treatments in adults with a short life expectancy.METHODS: A qualitative study using semi-structured interviews.RESULTS: 23 Registered nurses working in inpatient or outpatient hospital settings participated. The nurses stated they were often not involved in decisions regarding life-prolonging treatments. They reported signs of moral distress such as feeling powerless when they when they were not being listened to in the decision-making process and when confronted with negative treatment outcomes. Nurses felt frustrated when their own values were not reflected in the decision-making or when physicians created unrealistic expectations.CONCLUSIONS: Hospital nurses experience moral distress when they are involved in life-prolonging treatment because of the patient's advanced condition and their own lack of involvement in the decision-making process about the treatment. In these situations, moral distress is characterised by feelings of powerlessness and frustration.PRACTICE IMPLICATIONS: Nurses need to be empowered by training programmes that focus on an active role in the decision-making process. Further research is needed to evaluate effective tools and training programmes that help nurses in shared decision-making processes.",

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AB - OBJECTIVE: To explore whether nurses in hospital settings experience moral distress when involved in potentially life-prolonging treatments in adults with a short life expectancy.METHODS: A qualitative study using semi-structured interviews.RESULTS: 23 Registered nurses working in inpatient or outpatient hospital settings participated. The nurses stated they were often not involved in decisions regarding life-prolonging treatments. They reported signs of moral distress such as feeling powerless when they when they were not being listened to in the decision-making process and when confronted with negative treatment outcomes. Nurses felt frustrated when their own values were not reflected in the decision-making or when physicians created unrealistic expectations.CONCLUSIONS: Hospital nurses experience moral distress when they are involved in life-prolonging treatment because of the patient's advanced condition and their own lack of involvement in the decision-making process about the treatment. In these situations, moral distress is characterised by feelings of powerlessness and frustration.PRACTICE IMPLICATIONS: Nurses need to be empowered by training programmes that focus on an active role in the decision-making process. Further research is needed to evaluate effective tools and training programmes that help nurses in shared decision-making processes.

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Moral distress among nurses involved in life-prolonging treatments in patients with a short life expectancy: A qualitative interview study

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