A First in Moral Distress Research: A Study of Burn ICU Nurses
Researchers at Loyola University Medical Center have conducted the first study of moral distress among nurses in an intensive care unit for burn patients, starting to address “a significant gap” in knowledge about responding to the painful feelings that arise in situations where people can’t act according to their ethical ideals, due to barriers such as lack of time and supervisory support, and policy and legal constraints.
Moral distress has been studied in various populations of health care providers, including neonatal ICU nurses, pediatric ICU nurses, genetic professionals, surgical residents, and medical residents. The Loyola study, published in the September/October issue of the Journal of Burn Care & Research, points out that the impact of moral distress on nurses during the provision of care, particularly in critical care settings, is well documented and can result in a wide variety of reactions, including depression, anxiety, emotional withdrawal, frustration, anger, and a variety of physical symptoms.
“Given the intense and potentially distressing nature of nursing” in a burn ICU, with patients who have been in disfiguring and painful accidents, may have self-inflicted injuries, or may have been harmed by another person, “it is reasonable to hypothesize that nurses in these setting are likely to experience some level of moral distress,” wrote authors Jeanie M. Leggett, RN, BSN, MA; Katherine Wasson, PhD, MPH; James M. Sinacore, PhD; and Richard L. Gamelli, MD.
The study included 13 nurses in Loyola’s burn ICU who participated in a four-week educational intervention, consisting of four one-hour weekly sessions intended to decrease moral distress.
Previous research on moral distress has demonstrated that nurses who experience it are more likely to make errors, change positions, become desensitized to moral aspects of care, or leave the profession altogether. The researchers conclude that burn ICU nurses “would be well-served by a larger and more broad-based study involving multiple burn centers and a larger population of nurses working in this important area of nursing.”