Moral Distress Events and Emotional Trajectories in Nursing Narratives during the COVID-19 Pandemic

Daniela Lemmo, Roberta Vitale, Carmela Girardi, Roberta Salsano and Ersilia Auriemma
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Daniela Lemmo: Department of Humanities, University of Naples Federico II, 80100 Naples, Italy
Roberta Vitale: Department of Humanities, University of Naples Federico II, 80100 Naples, Italy
Carmela Girardi: Department of Humanities, University of Naples Federico II, 80100 Naples, Italy
Roberta Salsano: Department of Humanities, University of Naples Federico II, 80100 Naples, Italy
Ersilia Auriemma: Department of Humanities, University of Naples Federico II, 80100 Naples, Italy

IJERPH, 2022, vol. 19, issue 14, 1-12

Abstract: The COVID-19 pandemic produced several ethical challenges for nurses, impacting their mental health and moral distress. In the moral distress model the categories of events related to moral distress are: constraint, dilemma, uncertainty, conflict, and tension, each one related to different emotions. This study explored moral events’ memories and emotions in narratives of a sample of 43 Italian nurses who worked during the COVID-19 pandemic. We constructed an ad-hoc narrative interview asking nurses to narrate the memory, and the associated emotion, of an event in which they felt they could not do the right thing for the patient. We conducted a theory-driven analysis, using the categories proposed by the literature, identifying the main emotion for each category. Results show that 36 memories of events are representative of moral distress; among these, 7 are representative of none of the categories considered, and we categorized them as moral compromise. The main emotional trajectories are powerlessness, worthlessness, anger, sadness, guilt, and helplessness. From a clinical psychological point of view, our findings highlight the narration of the memories of moral events as a tool to use in the ethical sense-making of critical experiences, in order to promote well-being and moral resilience among nurses in emergency situations.

Keywords: moral distress; nursing; COVID-19 pandemic; narratives; autobiographical memories; emotions; clinical psychological intervention (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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