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Moral distress, autonomy and nurse–physician collaboration among intensive care unit nurses in Italy |
- Maria N.K. Karanikola PhD, MSc, RN Lecturer1,*,
- John W. Albarran DPhil, MSc, RN Associate Professor2,
- Elio Drigo RN Nurse Coordinator3,
- Margarita Giannakopoulou PhD, RN Associate Professor4,
- Maria Kalafati PhD, MSc, RN Clinical Instructor5,
- Meropi Mpouzika PhD, MSc, RN Lecturer6,
- George Z. Tsiaousis MD, MSc Clinical Cardiologist7,
- Elizabeth DE. Papathanassoglou PhD, MSc, RN Associate Professor8
Article first published online: 14 MAR 2013 DOI: 10.1111/jonm.12046 © 2013 Blackwell Publishing Ltd
Abstract
Aim
To explore the level of moral distress and potential associations between moral distress indices and (1) nurse–physician collaboration, (2) autonomy, (3) professional satisfaction, (4) intention to resign, and (5) workload among Italian intensive care unit nurses.
Background
Poor nurse–physician collaboration and low autonomy may limit intensive care unit nurses' ability to act on their moral decisions.
Methods
A cross-sectional correlational design with a sample of 566 Italian intensive care unit nurses.
Results
The intensity of moral distress was 57.9 ± 15.6 (mean, standard deviation) (scale range: 0–84) and the frequency of occurrence was 28.4 ± 12.3 (scale range: 0–84). The mean score of the severity of moral distress was 88.0 ± 44 (scale range: 0–336). The severity of moral distress was associated with (1) nurse–physician collaboration and dissatisfaction on care decisions (r = −0.215, P < 0.001); and (2) intention to resign (r = 0.244, P < 0.0001). The frequency of occurrence of moral distress was associated with the intention of nurses to resign (r = −0. 209, P < 0.0001).
Conclusion
Moral distress seems to be associated with the intention to resign, whereas poor nurse–physician collaboration appears to be a pivotal factor accounting for nurses' moral distress.
Implications for nursing management
Enhancement of nurse–physician collaboration and nurses' participation in end-of-life decisions seems to be a managerial task that could lead to the alleviation of nurses' moral distress and their retention in the profession.
Full pdf available on (http://onlinelibrary.wiley.com/doi/10.1111/jonm.12046/pdf)
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i.VEN.T.PRO - the invasive ventilation teaching project |
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invasive VENtilation Teaching PROject - a project for teaching and standardisation of mechanical ventilation in children and neonates.
The European Society of Paediatric Neonatal Intensive Care (ESPNIC), the European Society for Paediatric Research (ESPR) and its neonatal branch, the European Society for Neonatology (ESN), are launching an European-wide project for teaching and standardization of mechanical ventilation in children and neonates.
This project is called iVENTPRO (invasive VENtilation Teaching PROject) and consists of a series of initiatives dedicated to young and senior doctors in parallel with the more general effort of these Societies towards an evidence based approach to this field.
For more information see www.iventpro.org
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Newly published guidelines for Insulin therapy for hyperglycaemic patients in the ICU |
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February 2, 2013
Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients
Critical Care Medicine: December 2012 - Volume 40 - Issue 12 - p 3251–3276 |
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Update on Sepsis Guidelines |
January 24, 2013
Surviving Sepsis Campaign: International Guidelines for the Management of Severe Sepsis and Septic Shock 2012
IMPORTANT NEWS!
'International guidelines for the management of severe sepsis and septic shock' have been updated and published by the Surviving Sepsis Campaign.
For more information please look on http://www.sccm.org/Documents/SSC-Guidelines.pdf |
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News from the EU on the Professional Qualification Directive |
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January 23, 2013
News from Ms Barbara Weiler (SPD), German MEP of the Progressive Alliance of Socialists and Democrats and member of the IMCO committee: due to the many inputs received the committee had a lengthy debate last night. Regarding the number of general education prior the nursing school, the decision was to compromise a two-tier system of 10 and 12 years general education, respectively, in order not to jeopardize the suggested catalogue of competencies.
But all countries have to move: the competency catalogue will describe the requirements that need to be achieved at the end of all health care professions, regardless of whether they have 10 or 12 years of general education. That means, that for instance the German Federal Government (Bundesregierung) is in fact stipulated to question the educational system of nurses. "This reform can challenge a debate that would lead to appreciation of the profession, to improved working conditions, more recognition and a more gratifying professional perspective", is Barbara Weiler confident. "The bottom line is that the occupational profile of nurses has to be adapted to the challenges of the 21. Century" she finally clarifies.
Therefore, there is no reason to be disappointed. Just the opposite, our voices had been heard and we will surely work for the catalogue of competencies.
Heike Strunk, RN CCRN CRNA MNAdvisor to EfCCNa | Fellow of EfCCNaEUROPEAN FEDERATION OF CRITICALCARE NURSING ASSOCIATIONS |
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