scholarly journals Moral Distress in the Neonatal Intensive Care Unit: What Is It, Why It Happens, and How We Can Address It

2020 ◽  
Vol 8 ◽  
Author(s):  
Manisha Mills ◽  
DonnaMaria E. Cortezzo
2000 ◽  
Vol 9 (3) ◽  
pp. 400-403 ◽  
Author(s):  
Anita J. Catlin ◽  
Brian S. Carter

The Spring 1999 issue of Cambridge Quarterly (Volume 8, Number 2) adds to the growing body of academic inquiry into the goals of neonatal intensive care practices. Muraskas and colleagues thoughtfully presented the possibility of nontreatment for neonates born at or under 24 weeks gestation. Jain, Thomasma, and Ragas explained that quality of future life must not be ignored in clinical deliberation. And Hefferman and Heilig described once again the dilemmas nurses face when caring for potentially devastated neonates kept alive by technology. These authors take brave steps by publicly questioning the trend of intensive medical support for most every American-born product of conception. But many questions addressing the goals of neonatal intensive care remain, and few authors have actually tried to distill these goals.


2020 ◽  
Vol 48 (4) ◽  
pp. 416-422 ◽  
Author(s):  
Peter Barr

AbstractBackgroundInformed by the person-environment transactional model of stress, the purpose of the study was to explore the relationships of environment-related moral distress and person-related anxious and avoidant adult attachment insecurities, and personality proneness to guilt and shame with burnout in neonatal intensive care unit (NICU) nurses.MethodsThis was a multicenter cross-sectional self-report questionnaire cohort study comprising 142 NICU nurses currently working on six Level 3–4 NICUs in New South Wales, Australia.ResultsBurnout was reported by 37% of NICU nurses. Moral distress, anxious and avoidant attachment, and guilt- and shame-proneness had moderate-large zero-order correlations with burnout. Overall, these predictor variables explained 40% of the variance in burnout. Moral distress (β = 0.40, P < 0.001), anxious attachment (β = 0.18, P < 0.05) and shame-proneness (β = 0.22, P < 0.01) were unique predictors of burnout. Shame-proneness partially mediated the effect of anxious attachment on burnout [indirect effect, B = 0.12, confidence interval (CI) (0.051–0.201)].ConclusionThe management of burnout in NICU nurses requires attention not only to environment-related moral distress but also to person-related anxious and avoidant adult attachment insecurities and personality proneness to guilt and shame.


2010 ◽  
Vol 10 (3) ◽  
pp. 145-156 ◽  
Author(s):  
Terri A. Cavaliere ◽  
Barbara Daly ◽  
Donna Dowling ◽  
Kathleen Montgomery

2019 ◽  
Vol 16 (2) ◽  
pp. em116
Author(s):  
Fariba Borhani ◽  
Zahra Noghanchi Saleh ◽  
Laleh Loghmani ◽  
Maryam Rasouli ◽  
Maliheh Nasiri

2014 ◽  
Vol 35 (3) ◽  
pp. 214-217 ◽  
Author(s):  
P Sannino ◽  
M L Giannì ◽  
L G Re ◽  
M Lusignani

1999 ◽  
Vol 8 (2) ◽  
pp. 173-178 ◽  
Author(s):  
PAM HEFFERMAN ◽  
STEVE HEILIG

Advances in life-sustaining medical technology as applied to neonatal cases frequently present ethical concerns with a strong emotional component. Neonates delivered in the “gray area” gestation period of approximately 23–25 weeks may result in situations where various people involved in such cases may feel “held hostage” to technological imperatives. Legal decisions and standards have evolved that are discordant with the views of many clinicians most familiar with the treatment of such patients. Increasing concerns regarding such scenarios have fueled much academic and professional debate about the need for consensus about ethical limits to clinical interventions with high probability of nonbeneficial impact. While at least some clinicians and ethicists may be inching toward consensus regarding limits to such treatment, the voices of some bedside personnel, particularly neonatal intensive care unit (NICU) nurses, have been relatively muted in this debate. At least one previous survey of clinicians, which included nurses, indicated that many nurses experienced a high level of “moral distress” regarding aggressive courses of treatment for some patients. Some of this distress results from a feeling of powerlessness regarding treatment decisions, coupled with a high intensity of hands-on contact with the patients and family. Lack of authority coupled with high responsibility may itself be a recipe for a different kind of futility.


2007 ◽  
Vol 27 (4) ◽  
pp. 203-208 ◽  
Author(s):  
A Janvier ◽  
S Nadeau ◽  
M Deschênes ◽  
E Couture ◽  
K J Barrington

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