https://scholarworks.seattleu.edu/fss-2019/1003/thumbnail.jp

Han, Soojeong

Kim, Sujeong

English

ScholarWorks @ SeattleU (Seattle University)

• The survival rate of infants in South Korea is lessthan that of Japan and the United States.• NICU nurses frequently experience death of pediatricpatients and related moral distress.• Moral distress - Psychological response to morallychallenging situations including moral constraint ormoral conflict.• Moral constraint - Occurs when an individual knowsbut is unable to pursue the right course of action• Moral conflict - Situation where moral values clashwithin multiple individuals.• Describe nurses’ experience of moral distress whenproviding end-of-life care for infants and theirfamilies• Design - Secondary analysis qualitative study• Sample - 20 nurses working in two neonatalintensive care units in Seoul, Korea.• Analysis - Conventional content analysis wasperformed to develop a codebook and to identifythemes regarding the contents.• Rigor – Obtained by having peer-debriefing, andaudit trail throughout the data management andanalysisBackgroundMethodsAcknowledgementMoral Distress of NICU Nurses in End-of-Life CareSoojeong Han, PhDc, AGNP-BC, OCN, RN1; Sujeong Kim, PhD, RN21 University of Washington School of Nursing, Seattle, WA; 2 Seattle University College of Nursing , Seattle, WA ResultsConclusions and Implications• Seattle University College of Nursing (Dean’s Seed Grant)• Seattle University – Summer Faculty Fellowship• University of Washington School of Nursing (Jeanne BeneliolFellowship, Tripi Scholarship) • The situations causing the most moral distress werewhen nurses lacked knowledge about end-of-life careand when a nurse had to practice given a limited,uncontrollable environment regardless of what theywished to pursue.• The results emphasize the importance of educationfor NICU nurses.• Moral distress can be alleviated by inviting nurses to adecision-making process.Table 1. Internal and external moral constraintsMain Theme: SubthemeExemplar Internal :  • Perceived inadequacy• Different perception towards quality end-of-life care“Even though we are clinicians, we are around 20 or 30’s, young people. So, we have not experienced the death of people around us. This lack of experience, we cannot emphasize very well. I think we need to get educated.”External :• Environmental factors“I think we need to occupy a larger space. Now, the place is too crowded, so all people visiting here should stand.”“The problem is busy work. So, there is no time to take care of the infant’s parents.”Figure 2. Types of moral conflict identified from the nursesMoral Conflict12345A nurseVersusAnother Nurse(s)ParentsVersusNursesParentsVersusInfantsFamily Versus SystemInfantVersusParents and Nurses“From the viewpoint from parents, good end-of-life care refers to as continuous CPR until the end. However, infants should have less pressure. Continuous CPR gives the infant only damage.” “Is it really good for the infant to perform continuous lab checking and management? Can we say the infant is alive even if the infant relies on machines?” Figure 1. Characteristics of  NICU nurses (Number = Frequency)Purpose

Moral Distress of Neonatal Intensive Care Nurses in End-of-Life Care

https://scholarworks.seattleu.edu/cgi/viewcontent.cgi?article=1003&amp;context=fss-2019

Moral Distress of Neonatal Intensive Care Nurses in End-of-Life Care

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