title: An overview of moral distress and the paediatric intensive care team.
abstract: A summary of the existing literature related to moral distress (MD) and the paediatric intensive care unit (PICU) reveals a high-tech, high-pressure environment in which effective teamwork can be compromised by MD arising from different situations related to: consent for treatment, futile care, end-of-life decision making, formal decision-making structures, training and experience by discipline, individual values and attitudes, and power and authority issues. Attempts to resolve MD in PICUs have included the use of administrative tools such as shift worksheets, the implementation of continuing education, and encouragement to report. The literature does not yet show these approaches to be effective in the resolution of MD. The need to acknowledge MD among PICU teams is discussed and an argument made that, to facilitate understanding among team members, practice stories need to be shared.
authors.affiliation: University of Alberta, Edmonton, AB, Canada. wendy.austin@ualberta.ca
authors.forename: Wendy
authors.initials: W
authors.lastname: Austin
authors.forename: Julija
authors.initials: J
authors.lastname: Kelecevic
authors.forename: Erika
authors.initials: E
authors.lastname: Goble
authors.forename: Joy
authors.initials: J
authors.lastname: Mekechuk
mesh_terms: D002170:Canada; D003220:Conflict, Psychological; D003657:Decision Making / Q000941:ethics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000941:ethics; D008020:Life Support Care / Q000941:ethics*; D010348:Patient Care Team / Q000941:ethics*; D010371:Pediatric Nursing / Q000941:ethics*; D013315:Stress, Psychological