Nursing Education: Students' Narratives of Moral Distress in Clinical Practice.

Marie Kvamme M��land, Britt S��tre Tingvatn, Linda Rykkje, Sigrunn Drageset
Author Information
  1. Marie Kvamme M��land: Faculty of Health Studies, VID Specialized University, Ulriksdal 10, 5009 Bergen, Norway.
  2. Britt S��tre Tingvatn: Faculty of Health Studies, VID Specialized University, Ulriksdal 10, 5009 Bergen, Norway.
  3. Linda Rykkje: Faculty of Health Studies, VID Specialized University, Ulriksdal 10, 5009 Bergen, Norway. ORCID
  4. Sigrunn Drageset: Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063 Bergen, Norway.

Abstract

BACKGROUND: Research indicates that newly graduated nurses are often unprepared for meeting challenging situations in clinical practice. This phenomenon is referred to as a "reality shock". This gap in preparedness may lead to moral distress. The aim of this article is to provide knowledge of moral distress in clinical nursing practice.
METHODS: Bachelor and further education nursing students were invited to write a story about challenging situations from their own clinical practice, resulting in 36 stories. Analysis was based on hermeneutical reading inspired by a narrative method; therefore, six stories were selected to represent the findings.
RESULTS: A finding across the stories is that the students knew the right thing to do but ended up doing nothing. Four themes were related to moral distress: (a) undermining of professional judgement, (b) disagreement concerning treatment and care, (c) undignified care by supervisors, and (d) colliding values and priorities of care.
CONCLUSION: Nursing education should emphasize to a greater extent ethical competency and training for the challenging situations students will encounter in clinical practice.

Keywords

References

  1. J Bioeth Inq. 2013 Oct;10(3):317-24 [PMID: 23856882]
  2. Nurs Inq. 2018 Apr;25(2):e12227 [PMID: 29277951]
  3. Nurs Ethics. 2016 Aug;23(5):523-34 [PMID: 25904547]
  4. Nurse Educ Pract. 2020 Nov;49:102921 [PMID: 33221579]
  5. J Nurs Manag. 2017 Sep;25(6):477-485 [PMID: 27726233]
  6. Nurse Educ Pract. 2018 Mar;29:64-69 [PMID: 29190589]
  7. Nurs Ethics. 2020 Jun;27(4):1147-1156 [PMID: 32238031]
  8. Eur J Oncol Nurs. 2016 Apr;21:205-11 [PMID: 26521054]
  9. Nurse Educ Pract. 2014 Mar;14(2):106-11 [PMID: 23932667]
  10. Int J Nurs Stud. 2019 Jun;94:139-158 [PMID: 30965203]
  11. Nurs Ethics. 2016 Feb;23(1):104-16 [PMID: 25505083]
  12. Nurs Ethics. 2018 Mar;25(2):243-252 [PMID: 28548602]
  13. Nurs Ethics. 2018 May;25(3):304-312 [PMID: 27194414]
  14. Nurs Health Sci. 2021 Sep;23(3):570-585 [PMID: 33389792]
  15. Nurs Forum. 2018 Apr;53(2):259-266 [PMID: 29034962]
  16. Nurs Ethics. 2015 Feb;22(1):131-52 [PMID: 25505098]
  17. Nurse Educ Today. 2020 May;88:104389 [PMID: 32193068]
  18. Can J Anaesth. 2020 Nov;67(11):1541-1548 [PMID: 32844247]
  19. Nurs Res Pract. 2012;2012:690348 [PMID: 23050136]
  20. Nurs Open. 2020 Sep 29;8(1):380-394 [PMID: 33318846]
  21. Nurs Stand. 2019 Apr 26;34(5):43-50 [PMID: 31468814]
  22. Nurs Ethics. 2019 Nov-Dec;26(7-8):2325-2339 [PMID: 30760104]
  23. Crit Care Nurs Clin North Am. 2012 Mar;24(1):91-100 [PMID: 22405714]
  24. J Prof Nurs. 2016 Jan-Feb;32(1):62-71 [PMID: 26802593]
  25. AMA J Ethics. 2017 Jun 1;19(6):617-628 [PMID: 28644792]
  26. Nurse Educ Pract. 2011 Mar;11(2):159-64 [PMID: 20829115]
  27. J Nurs Scholarsh. 2015 Mar;47(2):117-25 [PMID: 25440758]
  28. Nurse Educ Pract. 2016 Jul;19:19-24 [PMID: 27428687]

Word Cloud

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