title: Assessing and addressing moral distress and ethical climate Part II: neonatal and pediatric perspectives.
abstract: Moral distress remains a pervasive and, at times, contested concept in nursing and other health care disciplines. Ethical climate, the conditions and practices in which ethical situations are identified, discussed, and decided, has been shown to exacerbate or ameliorate perceptions of moral distress. The purpose of this mixed-methods study was to explore perceptions of moral distress, moral residue, and ethical climate among registered nurses working in an academic medical center. Two versions of the Moral Distress Scale in addition to the Hospital Ethical Climate Survey were used, and participants were invited to respond to 2 open-ended questions. Part I reported the findings among nurses working in adult acute and critical care units. Part II presents the results from nurses working in pediatric/neonatal units. Significant differences in findings between the 2 groups are discussed. Subsequent interventions developed are also presented.
authors.affiliation: Jeanie Sauerland, BS, BSN, RN, is a nurse manager of Outpatient Surgery at University Hospital in San Antonio, Texas. She has a Bachelor's degree in Health Education from Texas A&M University and a BSN from the University of Texas Health Science Center in San Antonio, Texas. She is currently a student at MD Anderson working toward a certification in clinical ethics. Her research interest is nurse participation in ethical issues. Kathleen Marotta, BSN, RN, is staff nurse at the Pediatric Intensive Care Unit, University Health System, San Antonio, Texas. She received a Bachelor of Science in Nursing at the University of Texas Health Science Center, San Antonio, Texas; Bachelor of Science in Education, Our Lady of the Elms, Chicopee, Massachusetts; community educator - Shaken Baby Syndrome Research interest: Moral distress and ethical climate . Mary Anne Peinemann, MSN, RN, has received her Diploma of Nursing at St Paul's School of Nursing in Dallas Texas, and her BSN and MSN from Incarnate Word University. She has worked as a CNS nurse educator in pediatrics at University Health SystemWorked at UHS for 25 years. Her research interests include ethics, how children react to different nurses, and how/why nurses change or not change practices when change is recommended by research evidence. Andrea Berndt, PhD, is assistant professor and statistician at The University of Texas Health Science Center, San Antonio, Texas. Catherine Robichaux, PhD, RN, has received her BSN from Cornell University, MSN from Incarnate Word College and PhD from the University of Texas at Austin. She is an assistant professor and adjunct at The University of Texas Health Science Center, San Antonio, Texas and The University of Mary, Bismarck, North Dakota. Her research interest is nurses' participation in ethical issues and continuing education in ethics for staff nurses.
authors.forename: Jeanie
authors.initials: J
authors.lastname: Sauerland
authors.forename: Kathleen
authors.initials: K
authors.lastname: Marotta
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: Peinemann
authors.forename: Andrea
authors.initials: A
authors.lastname: Berndt
authors.forename: Catherine
authors.initials: C
authors.lastname: Robichaux
mesh_terms: D000046:Academic Medical Centers; D000223:Adaptation, Psychological; D000328:Adult; D002055:Burnout, Professional; D064648:Critical Care Nursing; D004993:Ethics, Nursing; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D007588:Job Satisfaction; D008875:Middle Aged; D009014:Morals; D017283:Neonatal Nursing; D009741:Nursing Staff, Hospital / Q000523:psychology*; D015279:Organizational Culture; D010371:Pediatric Nursing; D013315:Stress, Psychological