Learning Objective 1: Discuss the moral distress experienced by intensive care nurses in South African academic, urban public hospitals and compare this with their own practice context
Learning Objective 2: Describe how this distress is manifested physically, psychologically, professionally and socially and how it is managed
The purpose of this study was to elicit ICU nurses’ perspectives of the clinical situations in Johannesburg’s urban, academic public hospitals which evoke moral distress; the consequences thereof and means they employed to manage their distress.
HREC no. M 10525.
A short survey /interview guide, derived from Corley, Elswick, Gorman and Clor’s extensively used and validated “Moral Distress Scale” (Corley et al, 2001), requiring narrative descriptions and explanations was distributed to registered nurses (N= 100, n=100) in trauma, general medical and surgical and cardio-thoracic ICUs in tertiary, academic hospitals in Johannesburg. Data were triangulated by augmenting the information recorded from focus group discussions.
Experiences of the situations, many engendered by perceived morality of the treatment and decisions made, as well as participants’ reactions and subsequent actions are described. The findings are compared with those described in the international literature.
South Africa’s health system is complex displaying diverse disease patterns: acute and infectious diseases, high maternal and child mortality, non-communicable diseases and violence and injuries often exacerbated by patients’ HIV status (McNeilly, 2011). these contextual issues impact upon and influence nurses and nursing care in intensive care units.