“It Is Difficult to Always Be an Antagonist”: Ethical, Professional, and Moral Dilemmas as Potentially Psychologically Traumatic Events among Nurses in Canada

Rosemary Ricciardelli, Matthew S. Johnston, Brittany Bennett, Andrea M. Stelnicki and R. Nicholas Carleton
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Rosemary Ricciardelli: Department of Sociology, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
Matthew S. Johnston: Department of Sociology, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
Brittany Bennett: Department of Sociology, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
Andrea M. Stelnicki: Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
R. Nicholas Carleton: Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada

IJERPH, 2022, vol. 19, issue 3, 1-19

Abstract: Aims: We explore social and relational dynamics tied to an unexplored potentially psychologically traumatic event (PPTE) that can impact nurses’ well-being and sense of their occupational responsibilities: namely, the moral, ethical, or professional dilemmas encountered in their occupational work. Design: We used a semi-constructed grounded theory approach to reveal prevalent emergent themes from the qualitative, open-ended component of our survey response data as part of a larger mixed-methods study. Methods: We administered a national Canadian survey on nurses’ experiences of occupational stressors and their health and well-being between May and September 2019. In the current study, we analyzed data from four open text fields in the PPTE section of the survey. Results: In total, at least 109 participants noted that their most impactful PPTE exposure was a moral, professional, and/or ethical dilemma. These participants volunteered the theme as a spontaneous addition to the list of possible PPTE exposures. Conclusions: Emergent theme analytic results suggest that physicians, other nurses, staff, and/or the decision-making power of patients’ families can reduce or eliminate a nurse’s perception of their agency, which directly and negatively impacts their well-being and may cause them to experience moral injury. Nurses also report struggling when left to operationalize patient care instructions with which they disagree. Impact: Nurses are exposed to PPTEs at work, but little is known about factors that can aggravate PPTE exposure in the field, impact the mental wellness of nurses, and even shape patient care. We discuss the implications of PPTE involving moral, professional, and ethical dilemmas (i.e., potentially morally injurious events), and provide recommendations for nursing policy and practice.

Keywords: occupational mental health; potentially psychologically traumatic events; nurses; medical power; moral injury (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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