Moral Distress in Perinatal Nurses

Moral distress is the psychological inconsistency and negative feeling experienced by professionals when they make a moral decision, but are unable to perform the action stipulated by their decision. Moral distress is the trouble that health professionals have when they are obliged to perform and act in conflict with their personal and professional values, although they plan for suitable and ethical actions. As in all stages of health services, perinatal nurses try to cope with many problems that may cause moral stress in pregnancy, delivery and post-natal period through their professional lives. There are many personal and organizational factors that cause moral stress in perinatal nurses. Perinatal nurses encounter several ethical dilemmas that may cause moral distress in their professional lives. Some of these problems are domestic violence towards pregnant mothers, induced abortion, pregnancy by rape or incest, giving birth to an infant to be given to someone else, the intentional switching of infants, keeping secrets related to their tasks and genital examinations without permission. Other reasons for perinatal nurses’ moral distress include medication errors, errors caused by the insufficient monitoring and evaluation of patients, failing to notice risks and informing the physician late or not at all, exceeding the limits of authority, errors caused by the insufficiency of the system, notification of crimes, record keeping errors and medical intervention errors. Along with physical, psychological and social problems, moral distress may lead to important results, including reduced job satisfaction, burnout and change of profession. All these problems reduce the quality of nursing care. Nurses use both positive strategies, such as planned problem solving and support resources, and negative strategies, such as escape and avoidance, to cope with moral distress. In Turkey, moral distress in perinatal nursing has not been studied yet. So the purpose of this review is to determine the situation regarding the subject and to establish the infrastructure for studies.