Essay Sample on Nursing: Endless Opportunities, Difficult Challenges

Introduction

Nursing is a profession in the health sector that provides endless opportunities to impact individuals, families, and communities on what could be the worst of their lives, and influence them through experiences that are unfamiliar and scary. All this is done in a bid to ensure optimal health as well as the quality of life. In as much as nursing is highly rewarding, it can also result in feelings of burnout, compassion fatigue as well as moral distress. Jameton (1984) happens to be the first person to come up with a solid definition of moral distress as it relates to nursingand he stated that "the feelings and experiences which result from a moral conflict where one knows the correct action to take but constraints lead to either inability to implement this action or an attempt to carry out moral action which fails to resolve the conflict" (Jameton, 1984). On the other hand, in the view of compassion fatigue, Henson (2017) highlights that "Caring and compassion, which provide nurses with satisfaction and fulfilment in patient care can contribute to the exhaustion of those emotions and lead to compassion fatigue." The problem that we identified over the period in the institution is that during the process of offering services, nurses end up experiencing incidences of feelings of burnout, compassion fatigue and moral distress. This happens to be a chronic problem, as in some cases, the nurses are forced to quit the nursing profession for good.

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The practicum site is an eighteen-bed medical-surgical-neurological intensive care unit in which I was based for most of my time. There were twelve-hour shifts, and during these periods, interactions of the nurses with the patients, families as well as other multidisciplinary team were observed. Multidisciplinary rounds and family conferences were also attended by the nurses and taken into account. Majority of the patients within the unit are high acuity, on ventilators, vasopressors, continuous renal replacement therapy, and have complicated family dynamics and psychological needs. Extended lengths of stay were typical while patients received tracheostomies, feeding tubes, and also as others waited for care placement in the facility. Nurses have to indulge in complex family dynamics whenever a patient was too ill to make their own decisions. Nonetheless, nurses were involved in intense and exhausting physical care for the patients admitted, which happens to impose considerable emotional stress.

In this view, it is also essential to note that this problem is not unique to this particular intensive care unit alone. In 2017, the American Nurses Association honoured the National Nurse's week as the year of the healthy nurse, initiating a webinar titled "A Nurse's Guide to Preventing Compassion Fatigue, Moral Distress, and Burnout." The intended goals for this webinar were to curb emotional and physical consequences arising from the complex moral situations, elevate confidence levels and self-resilience to minimise moral distress and preclude burnout and utilise current research to identify, prevent and battle compassion fatigue (Lippincott Nursing Solutions, 2017). This depicts how moral distress, compassion fatigue and burnout present a substantial threat to the nursing profession. All these issues are prone to negatively impacting the physical and mental health life of nurses. As it was experienced, some nurses opted to prematurely quit the profession because they can no longer offer safe and compassionate care.

According to Browning (2013), it can be derived that "As critical care nurses develop a more active voice in collaboration with physicians, ethics committees, and members of the multidisciplinary health care team; empowerment of the nurses might decrease moral distress and in turn enhance patient care outcomes at the end of life." A study by Browning in 2013 reveals that the majority of the nurses who took part in the conferences regarding empowerment, experienced a change as they discovered increased feelings of psychological empowerment as well as decreased moral distress.

A proposed solution to the issues of moral distress experienced in the eighteen-bed medical-surgical-neurological intensive care unit is to ensure that bedside nurses are relieved of the bedside duties so that they can attend conferences occasionally so that they participate and advocate for their patients; thus leading to increased feelings of empowerment with decreased feelings of burnout, moral distress and compassion fatigue.

References

Browning, A. M. (2013). CNE article: moral distress and psychological empowerment in critical care nurses caring for adults at end of life. American Journal of Critical Care, 22(2), 143-151. Retrieved from http://ajcc.aacnjournals.org/content/22/2/143.short

Choe, K., Kang, Y., & Park, Y. (2015). Moral distress in critical care nurses: a phenomenological study. Journal of Advanced Nursing, 71(7), 1684-1693. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/jan.12638

Dodek, P. M., Wong, H., Norena, M., Ayas, N., Reynolds, S. C., Keenan, S. P., ... & Alden, L. (2016). Moral distress in intensive care unit professionals is associated with profession, age, and years of experience. Journal of critical care, 31(1), 178-182. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S0883944115005407

Gutierrez, K. M., (2005). Critical care nurses' perceptions of and responses to moral distress. Dimensions of Critical Care Nursing, 24(5), 229-241. Retrieved from https://journals.lww.com/dccnjournal/Abstract/2005/09000/Critical_Care_Nurses__Perceptions_of_and_Responses.11.aspxJameton, A., (1984). Nursing practice: The ethical issues. Englewood Cliffs, NJ.

Lippincott Nursing Solutions. (2017, May 05). Celebrate National Nurses Week 2017 | Lippincott Nursing Education. Retrieved from http://nursingeducationsuccess.com/celebrate-national-nurses-week-2017/

Han, M. Y., Lee, M. S., Bae, J. Y., & Kim, Y. S., (2015). Effects of the nursing practice environment, compassion fatigue and compassion satisfaction on burnout in clinical nurses. Journal of Korean Academy of Nursing Administration, 21(2), 193-202. Retrieved from https://synapse.koreamed.org/search.php?where=aview&id=10.11111/jkana.2015.21.2.193&code=0163JKANA&vmode=FULL

Moss, M., Good, V. S., Gozal, D., Kleinpell, R., & Sessler, C. N. (2016). An official critical care societies collaborative statement: Burnout syndrome in critical care health care professionals: a call for action. American Journal of Critical Care, 25(4), 368-376. Retrieved from http://ajcc.aacnjournals.org/content/25/4/368.short

Oh, Y., & Gastmans, C. (2013, October 3). Moral distress experienced by nurses: A quantitative literature review. Retrieved from http://journals.sagepub.com/doi/abs/10.1177/0969733013502803