Journal
NURSING ETHICS
Volume 27, Issue 8, Pages 1681-1693Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/0969733020935952
Keywords
Metaethnography; metasynthesis; critical care; moral distress; literature review; qualitative synthesis
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Background: Moral distress has detrimental effects on nurses which impacts the entire healthcare cycle. Described as a crescendo effect, resolved situations of moral distress leave residue on the nurse with three potential outcomes: moral numbing, conscious objection to the situation, and burnout. Objective: This metaethnography strives to achieve a fuller understanding of moral distress by interpreting the body of qualitative work of moral distress in emergency and critical care nurses. Method: This study used the Noblit and Hare's approach of interpretative synthesis. Ten studies met the criteria and were used in this synthesis. Ethical considerations: Ethical issues were minimal since no human subjects were involved. Ethical requirements were respected in all study phases. Results: The synthesis of qualitative research on moral distress resulted in one central theme, the battle within, and five subthemes. Conclusions: The unique nature of this nursing specialty resulted in a lasting inner conflict for nurses that is consistent with the previously described crescendo effect. The effects are complex and long lasting and may potentially affect the nurses' future patient care.
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