Browsing by Author "Voget, Ursula"
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- ItemProfessional nurses’ lived experiences of moral distress at a district hospital(Stellenbosch : Stellenbosch University, 2017-03) Voget, Ursula; Van der Heever, Mariana; Van der Merwe, A.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.ENGLISH SUMMARY : Background: Nurses have the most contact with patients and are therefore confronted by situations of moral conflict. Since nurses are trained to provide care sustaining life, situations that impede their ability to provide quality care, pose a risk of causing moral distress. Ethical practices are guided by various nursing regulations as well as national and international guidelines. The South African context adds unique stressors to the healthcare system. There is a demand for quality healthcare to be delivered with a budget shortfall of R600 million, coupled with challenges such as the burden of disease, excessive workloads, increased patient deaths, daily exposure to multidrug-resistant tuberculosis (MDR-TB) and a severe shortage of staff along all health professions. The public health sector work environment is stressful and unsupportive with severely disproportionate nurse–patient ratios. Such conditions could sway ethical decision making and compromise the provision of quality nursing care and enhance moral distress. Due to the adversities, many nurses believe they are no longer providing proper health care and seek other job opportunities or leave the profession. Methods: A descriptive phenomenological design was applied. One-on-one interviews were conducted with professional nurses permanently employed at a district hospital in the Cape Town Metro District Health Services, using a semi-structured interview guide. Thematic analysis of the data was performed. Results: Seven interviews were conducted and results indicate that moral distress is experienced irrespective of age and work experience. Newly qualified and newly appointed professional nurses seem more at risk for experiences of moral distress due to challenges in their work environment. The major distressing factors relate to staffing (shortage as well as disrespect from colleagues), management, complaints, resources and doctors. Consequences as a result of moral distress include emotional, personality and behavioural aspects as well as the intent to leave their position. Different coping mechanisms were employed in an effort to cope with the daily challenges the professional nurses experienced. Conclusion: Moral distress is experienced by professional nurses in medical and surgical wards. It can be elicited from different situations encountered in their daily work, which necessitates them to compromise their professional, moral and ethical standards.