Paper
Wednesday, 19 July 2006
This presentation is part of : Cultural Competence in Nursing Students
Moral Distress Among Nursing Students
Rochelle Roberts, BA, RN, MSN, Nursing Division, Mount Saint Mary College, Newburgh, NY, USA and Sharon K. Holmberg, PhD, RN, Decker School of Nursing, SUNY Binghamton, Binghamton, NY, USA.
Learning Objective #1: Understand the primacy of ethical conflicts experienced by student nurses in clinical settings and difficulties in learning resulting from these stressful experiences.
Learning Objective #2: -
There is limited research in how nursing students experience moral distress as developing professional nurses.  A descriptive, quantitative design using the Moral Distress Scale (MDS) consisted of 38 items reflecting stressful, ambiguous nursing care situations, which call for moral or ethical judgments.  The MDS tool, which consisted of 38 items reflecting stressful, ambiguous nursing care situations, has demonstrated good reliability and validity.  The study compared the experience of moral distress between student nurses and practicing nurses based on Jameton’s conceptualization of moral distress and the principles of biomedical ethics.  A 7-point Likert scale (0-6) was used with a higher score indicating greater moral distress.  Results:  Overall, participants experienced moderately high levels of moral distress.  The item with the highest mean score was “being required to care for patients one is not competent to care for.”  Previous research indicated that practicing nurses also experienced moderately high levels of moral distress.  Practicing nurses considered understaffing as their most serious ethical concern.  In contrast, nursing students were most concerned about incompetent caregiving, whether given by themselves, practicing nurses, physicians, or other health personnel.  These findings support implications for nursing curriculum that include peer and faculty guidance, teaching positive coping strategies, identifying effective role models and developing collaborative relationships.  Creating opportunities to reflect and explore experiences in the clinical arena can facilitate nursing students’ ability to evaluate difficult ethical dilemmas.   

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