Melissa A Wilson1, John R Cutcliffe2, Col Nicole H Armitage3, Kayla N Eaton4. 1. En Route Care Research Division, United States Air Force School of Aerospace Medicine, Dayton, OH. Electronic address: melissa.wilson.18@us.af.mil. 2. Cutcliffe Consulting, Amherstview, Ontario, Canada. 3. United States Air Force, Nurse Corp, Dayton, OH. 4. En Route Care Research Division, United States Air Force School of Aerospace Medicine, Dayton, OH.
Abstract
BACKGROUND: Moral distress in healthcare providers occurs when the perceived right action cannot or is not taken and results in a loss of moral integrity. Critical Care Air Transport (CCAT) nurses are elite U.S. Air Force (USAF) clinicians who provide healthcare during transport of injured military members. CCAT nurses are vulnerable to physical and psychological stressors, including fatigue, multiple traumas, limited resources and ethical dilemmas. PURPOSE: The purpose of this study was to explore moral distress in USAF CCAT nurses. METHODS: Using interpretative hermeneutic phenomenology, we described the lived experience of moral distress in 15 CCAT nurses. FINDINGS: Seven themes emerged to describe the CCAT nurses experiences of moral distress. These include: Not Prepared, Agent of Healing or Agent of Harm, Live or Let Die, Robbing Peter to Pay Paul, Ever Decreasing Circles, Cultural Dissonance, and Incongruence with Colleagues. DISCUSSION: This study highlighted both similarities and differences in moral distress than those described previously in the literature. Military unique situations contribute to the experience of moral distress in USAF CCAT nurses. These findings will guide future research aimed at understanding and mitigating moral distress effects in military nurses and other healthcare providers. Crown
BACKGROUND: Moral distress in healthcare providers occurs when the perceived right action cannot or is not taken and results in a loss of moral integrity. Critical Care Air Transport (CCAT) nurses are elite U.S. Air Force (USAF) clinicians who provide healthcare during transport of injured military members. CCAT nurses are vulnerable to physical and psychological stressors, including fatigue, multiple traumas, limited resources and ethical dilemmas. PURPOSE: The purpose of this study was to explore moral distress in USAF CCAT nurses. METHODS: Using interpretative hermeneutic phenomenology, we described the lived experience of moral distress in 15 CCAT nurses. FINDINGS: Seven themes emerged to describe the CCAT nurses experiences of moral distress. These include: Not Prepared, Agent of Healing or Agent of Harm, Live or Let Die, Robbing Peter to Pay Paul, Ever Decreasing Circles, Cultural Dissonance, and Incongruence with Colleagues. DISCUSSION: This study highlighted both similarities and differences in moral distress than those described previously in the literature. Military unique situations contribute to the experience of moral distress in USAF CCAT nurses. These findings will guide future research aimed at understanding and mitigating moral distress effects in military nurses and other healthcare providers. Crown