The Relation between Pediatric Nurses’ Moral Distress and their Performance in Pediatric Critical Care Units

Abstract

Moral distress is a serious problem among pediatric nurses who work in a high stress environment with many ethical situations in their practices and having no voice in the decision-making process. Nurses in pediatric intensive care units are at higher risk for moral distress due to the nature of children's conditions, especially in the light of performance expectations, finite resources, technology advancement and the competitive globalization of healthcare. The aim of the current study was to assess the relation between nurses’ moral distress and their performance in the pediatric critical care units. Study design: Cross sectional analytic study. Settings: This study was carried out in neonatal intensive care units, pediatric intensive care unit, pediatric surgeries intensive care unit, pediatric cardio surgeries intensive care unit and pediatric emergency unit, all are affiliated to Ain Shams University Hospitals. Subjects: A purposive sample of nurses who worked in the previously mentioned settings. Tools: the tools of data collection included a structured questionnaire sheet, moral distress scale, hospital ethical climate scale and 5 observational checklists. Results: the mean age of studied nurses was 26.47 ± 4.06 years and the majority of them were female. All studied nurses had no knowledge about moral distress and hospital ethical climate. More than half of them had moderate level of moral distress & perception of hospital ethical climate. Also, about two thirds of the studied nurses had competent performance and there was a relation between the studied nurses’ moral distress and their performance. Conclusion: It can be concluded that, nurses in pediatric critical care units have variable levels of moral distress as well, their perception of the hospital ethical climate. There was a statistical significant difference between nurses' performance and their level of moral distress and their perception of the hospital ethical climate. Also, the results revealed statistical significant differences between the level of moral distress of the studied nurses and their age, educational level and their years of experience, and no statistical significant difference as regards their gender and marital status. Recommendations: Awareness intervention for the nurses working in the pediatric critical care units about the concept of moral distress, its causes, symptoms and how to cope with this distress.