Nursing ethics
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Little is known about the consequences of moral distress. The purpose of this study was to identify clinical situations that caused nurses to experience moral distress, to understand the consequences of those situations, and to determine whether nurses would change their practice based on their experiences. The investigation used a descriptive approach. ⋯ Forty-nine nurses responded to the survey. The majority of nurses had experienced moral distress, and the majority of situations that caused nurses to experience moral distress were related to end of life. The nurses described negative consequences for themselves, patients, and families.
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Researchers have identified the phenomena of moral distress through many studies in Western countries. This research reports the first study of moral distress in Iran. Because of the differences in cultural values and nursing education, nurses working in intensive care units may experience moral distress differently than reported in previous studies. ⋯ A content analysis of the data produced four themes to describe the nurses' moral distress. The four themes were as follows: (a) institutional barriers and constraints; (b) communication problems; (c) futile actions, malpractice, and medical/care errors; (d) inappropriate responsibilities, resources, and competencies. The results demonstrate that moral distress for intensive care unit nurses is different and that the nursing leaders must reduce moral distress among nursing in intensive care.
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The high turnover of nurses has become a global problem. Several studies have proposed that nurses' perceptions of the ethical climate of their organization are related to higher job satisfaction and organizational commitment and thus lead to higher organizational citizenship behaviors. ⋯ The findings of the article suggest that hospitals can increase organizational citizenship behaviors by influencing an organization's ethical climate, job satisfaction, and organizational commitment. Hospital administrators can foster within organizations, the climate types of caring, law and code and rules climate, satisfaction with coworkers, and affective commitment and normative commitment that increase organizational citizenship behavior, while preventing organizations from developing the type of instrumental climate and continuance commitment that decreases it.
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The enduring psychiatric myth is that particular personal, interpersonal and social problems in living are manifestations of 'mental illness' or 'mental disease', which can only be addressed by 'treatment' with psychiatric drugs. Psychiatric drugs are used only to control 'patient' behaviour and do not 'treat' any specific pathology in the sense understood by physical medicine. Evidence that people, diagnosed with 'serious' forms of 'mental illness' can 'recover', without psychiatric drugs, has been marginalized by drug-focused research, much of this funded by the pharmaceutical industry. The pervasive myth of psychiatric drugs dominates much of contemporary 'mental health' policy and practice and raises discrete ethical issues for nurses who claim to be focused on promoting or enabling the 'mental health' of the people in their care.