It is known that the psychological and emotional responses associated with discomfort or moral distress from ethically wrong actions can increase sometime after the situation (Saragih et al., 2021). These responses include feelings of helplessness, self-blame, anger, frustration, exhaustion, anxiety, and depression (Dragiot et al., 2022). End of life care is challenging especially when the family or loved ones make decisions for the end of life. Balancing the wishes of the family sometimes is difficult, especially when the patient is unable to make decisions. Moral distress and Personal judgement come in when a provider has to prescribe medicine to terminate one’s life. Also, a nurse who administers medicine may feel uncomfortable to administer end of life medicine due to the nurse’s beliefs of death which can sometimes conflict with medical advice or standard practice. Sometimes the patient does not get the right dosage simply because of the fear and beliefs from the providers and the patient ends up suffering more. Privacy and confidentiality can be challenging and broad. Sharing or discussing a patient information with some one who is not providing care for the patient, disclosing the patient information even to family members or friends and accessing electronic charting for a patient who is not under your care is a bleach of privacy. Advance directives, palliative care and end of life decisions should be obtained upon admission and especially when the patient is able to make own decisions. Confidentiality, privacy and dignity should be an obligation when disclosing the information of the patient, especially when there is a challenging situation. “Duty to Warn” requires mandatory reporting of a threat to law enforcement and directly warn the victim about imminent threats such as intentional killing, serious bodily injury, or kidnapping.
Clinical Question: How do situations that conflict with core nursing values and ethical codes impact the mental health and job satisfaction of nurse practitioners, and what interventions can mitigate these effects?
References
Dragioti, E., Tsartsalis, D., Mentis, M., Mantzoukas ,S., Gouva, M. (2022). Impact of the COVID-19 pandemic on the mental health of hospital staff: An umbrella review of 44 meta-analyses. International Journal of Nursing Studies.131:104272. doi: 10.1016/j.ijnurstu.2022.104272.
Saragih I.D., Tonapa S.I., Saragih, I.S., Advani, S., Batubara, S.O., Suarilah, I., Lin, C.J. (2021). Global prevalence of mental health problems among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Internaional Journal of Nursing Studies.121:104002. doi: 10.1016/j.ijnurstu.2021.104002.
