‘Powerlessness’ or ‘Doing the Right Thing’: Moral Distress amongst Nursing Home Staff Caring for Residents at the End of Life. An Interpretive Descriptive Study

Young, Amanda and Froggatt, Katherine and Brearley, Sarah G. (2017) ‘Powerlessness’ or ‘Doing the Right Thing’: Moral Distress amongst Nursing Home Staff Caring for Residents at the End of Life. An Interpretive Descriptive Study. Palliative Medicine, 31 (9). pp. 853-860. ISSN 1477-030X

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Official URL: http://dx.doi.org/10.1177/0269216316682894

Abstract

Background: Caring for dying people can contribute to moral distress experienced by health care professionals. Moral distress can occur when this caring is restricted by organisational processes, resources or the provision of futile care. These factors apply to end of life care in nursing homes but research is lacking. Aim: To describe how nursing home staff experience moral distress when caring for residents during and at the end of life. Methods: An interpretive descriptive design, using the critical incident technique in semi-structured interviews to collect data from nursing home staff. Data were analysed using a thematic analysis approach. Setting: Four Nursing Homes in one large metropolitan area. Participants: 16 staff:- 2 nurse-managers, 4 nurses and 10 care assistants Findings: Participants described holding ‘good dying’ values which influenced their practice. The four practice-orientated themes of advocating, caring, communicating and relating with residents were found to influence interactions with residents, relatives, GPs, and colleagues. These led staff to be able to ‘do the right thing’ or to experience ‘powerlessness’, which could in turn lead to staff perceiving a ‘bad death’ for residents. Conclusion: When there are incongruent values concerning care between staff and others involved in the care of residents, staff feel powerless to ‘do the right thing’ and unable to influence care decisions in order to avoid a ‘bad death’. This powerlessness is the nature of their moral distress.

Item Type: Journal Article
Keywords: moral distress, care homes, end of life care, nursing homes
Faculty: Faculty of Health, Social Care & Education (for research post September 2011)
Depositing User: Unnamed user with email Amanda.Young@anglia.ac.uk
Date Deposited: 23 Nov 2016 10:46
Last Modified: 04 Feb 2019 11:20
URI: http://arro.anglia.ac.uk/id/eprint/701145

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