Exploring the Relationship Between Moral Distress and Coping in Emergency Nursing

Background: Emergency Department (ED) nurses practice in environments that are highly charged and unpredictable in nature and can precipitate conflict between the necessary prescribed actions and the individual’s sense of what is morally the right thing to do. As a consequence of multiple moral dilemmas ED staff nurses are at risk for experiencing distress and how they cope with these challenges may impact their practice. Objectives: Is to examine moral distress in ED nurses and its relationship to coping in that specialty group. Methods: Using survey methods approach. One hundred ninety eight ED nurses completed a moral distress, coping and demographic collection instruments. Advanced statistical analysis was completed to look at relationships between the variables. Results: Data analysis did show that moral distress is present in ED nurses (M=80.19, SD=53.27) and when separated into age groups the greater the age the less the experience of moral distress. A positive relationship between moral distress and some coping mechanisms and the ED environment were also noted. Conclusion: This study’s findings suggest that ED nurses experience moral distress and could receive some benefit from utilization of appropriate coping skills. This study also suggests that the environment with which ED nurses practice has a significant impact on the experience of moral distress. Since health care is continuing to evolve it is critical that issues like moral distress and coping be studied in ED nurses to help eliminate human suffering

Exploring the Relationship Between Moral Distress and Coping in Emergency Nursing

Background: Emergency Department (ED) nurses practice in environments that are highly charged and unpredictable in nature and can precipitate conflict between the necessary prescribed actions and the individual’s sense of what is morally the right thing to do. As a consequence of multiple moral dilemmas ED staff nurses are at risk for experiencing distress and how they cope with these challenges may impact their practice. Objectives: Is to examine moral distress in ED nurses and its relationship to coping in that specialty group. Methods: Using survey methods approach. One hundred ninety eight ED nurses completed a moral distress, coping and demographic collection instruments. Advanced statistical analysis was completed to look at relationships between the variables. Results: Data analysis did show that moral distress is present in ED nurses (M=80.19, SD=53.27) and when separated into age groups the greater the age the less the experience of moral distress. A positive relationship between moral distress and some coping mechanisms and the ED environment were also noted. Conclusion: This study’s findings suggest that ED nurses experience moral distress and could receive some benefit from utilization of appropriate coping skills. This study also suggests that the environment with which ED nurses practice has a significant impact on the experience of moral distress. Since health care is continuing to evolve it is critical that issues like moral distress and coping be studied in ED nurses to help eliminate human suffering

Advancement of the German version of the moral distress scale for acute care nurses : a mixed methods study

Aim: Moral distress experienced by nurses in acute care hospitals can adversely impact the affected nurses, their patients and their hospitals; therefore, it is advisable for organizations to establish internal monitoring of moral distress. However, until now, no suitable questionnaire has been available for use in German‐speaking contexts. Hence, the aim of this study was to develop and psychometrically test a German‐language version of the Moral Distress Scale. Design: We chose a sequential explanatory mixed methods design, followed by a second quantitative cross‐sectional survey. Methods: An American moral distress scale was chosen, translated, culturally adapted, tested in a pilot study and subsequently used in 2011 to conduct an initial web‐based quantitative cross‐sectional survey of nurses in all inpatient units at five hospitals in Switzerland's German‐speaking region. Data were analysed descriptively and via a Rasch analysis. In 2012, four focus group interviews were conducted with 26 nurses and then evaluated using knowledge maps. The results were used to improve the questionnaire. In 2015, using the revised German‐language instrument, a second survey and Rasch analysis were conducted. Results: The descriptive results of the first survey's participants (n = 2153; response rate: 44%) indicated that moral distress is a salient phenomenon in Switzerland. The data from the focus group interviews and the Rasch analysis produced information valuable for the questionnaire's further development. Alongside the data from the second survey's participants (n = 1965; response rate: 40%), the Rasch analysis confirmed the elimination of previous deficiencies on its psychometrics. A Rasch‐scaled German version of the Moral Distress Scale is now available for use

Resilience and Coping After Hospital Mergers

Objective: The aim of this study was to explore the relationship between resilience and coping in frontline nurses working in a healthcare system that has recently undergone a merger. Background: Hospital mergers are common in the current healthcare environment. Mergers can provide hospital nurses the opportunity to use and develop positive coping strategies to help remain resilient during times of change. Methods: An anonymous-survey, quantitative, exploratory, descriptive study design was used. Data were obtained from an electronic survey that was made available to all nurses working in a 3-hospital system located in the northeast. Results: Overall, the results showed that, when nurses reported using positive coping strategies, they report higher levels of resilience. The levels of resilience also varied from campus to campus. The campus that has been through 2 recent mergers reported the highest levels of resilience. Conclusion: This study suggests that, during times of change in the workplace, if nurses are encouraged to use positive coping strategies, they may have higher levels of resilience. This changing environment provides the clinical nurse specialists/clinical nurse educators the opportunity to foster and support frontline nurses in the use of healthy coping strategies and to help improve and maintain a high level of resilience, which is critical in today\u27s healthcare environment

Emergency nurses\u27 perception of geriatric readiness in the ED setting: A mixed-methods study

INTRODUCTION: The Centers for Disease Control and Prevention (CDC) reports 136.9 million ED visits in 2015, of which 21.4 million (15.6%) were by patients who were 65 or older. This US population demographic is expected to grow by 112% over the next 40 years, becoming just below 25% of the total US population. Emergency nurses will play an increasingly important part in the development of nursing care for geriatric patients. The purpose of this study was to explore emergency nurses\u27 perception of their ability to care for geriatric patients in the emergency setting. METHODS: This was a mixed-methods sequential design using quantitative survey data and qualitative focus group data, which were analyzed separately and then given equal priority during the data-interpretation phase. RESULTS: Less than 50% of survey respondents (N = 1,610) reported geriatric-specific screenings, accommodations, and communication with outside agencies as always available in their care settings. Qualitative analysis (N = 23) yielded the categories of Triage/Assessment, Care in the Emergency Environment, Discharge Planning, and Facilitators and Barriers, which generally reflected the trajectory of care for the older patient. The overarching concern was keeping patients safe in both the community and in the emergency department. DISCUSSION: Emergency departments should develop integrated systems to facilitate appropriate care of older patients. Identified barriers to improved care include a lack of integration between emergency care and community care, deficits in geriatric-specific education, inconsistent use of early screening for frailty, and lack of resources in the emergency care environment to intervene appropriately