Abstract
Background: Research indicates that newly graduated nurses are often unprepared for meeting challenging situations in clinical practice. This phenomenon is referred to as a “reality shock”. This gap in preparedness may lead to moral distress. The aim of this article is to provide knowledge of moral distress in clinical nursing practice. Methods: Bachelor and further education nursing students were invited to write a story about challenging situations from their own clinical practice, resulting in 36 stories. Analysis was based on hermeneutical reading inspired by a narrative method; therefore, six stories were selected to represent the findings. Results: A finding across the stories is that the students knew the right thing to do but ended up doing nothing. Four themes were related to moral distress: (a) undermining of professional judgement, (b) disagreement concerning treatment and care, (c) undignified care by supervisors, and (d) colliding values and priorities of care. Conclusion: Nursing education should emphasize to a greater extent ethical competency and training for the challenging situations students will encounter in clinical practice.
Highlights
Faculty of Health Studies, VID Specialized University, Ulriksdal 10, 5009 Bergen, Norway; Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, Abstract: Background: Research indicates that newly graduated nurses are often unprepared for meeting challenging situations in clinical practice
We chose stories that both portrayed how students lack the power to act, and stories where students tried to act despite their limited opportunities to be heard. These narratives give insights into different facets of the challenges and dilemmas encountered in clinical practice, and we found that the stories represent central aspects of moral distress
There were four main themes related to moral distress in the narratives: (a) undermining of professional judgement, (b) disagreement concerning treatment and care, (c) undignified care by supervisors, and (d) colliding values and priorities of care
Summary
Faculty of Health Studies, VID Specialized University, Ulriksdal 10, 5009 Bergen, Norway; Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, Abstract: Background: Research indicates that newly graduated nurses are often unprepared for meeting challenging situations in clinical practice. This phenomenon is referred to as a “reality shock”.
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