Department of Sociology, Memorial University of Newfoundland, St. John's, NL A1C 5S7, Canada.
Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada.
Int J Environ Res Public Health. 2022 Jan 27;19(3):1454. doi: 10.3390/ijerph19031454.
We explore social and relational dynamics tied to an unexplored potentially psychologically traumatic event (PPTE) that can impact nurses' well-being and sense of their occupational responsibilities: namely, the moral, ethical, or professional dilemmas encountered in their occupational work.
We used a semi-constructed grounded theory approach to reveal prevalent emergent themes from the qualitative, open-ended component of our survey response data as part of a larger mixed-methods study.
We administered a national Canadian survey on nurses' experiences of occupational stressors and their health and well-being between May and September 2019. In the current study, we analyzed data from four open text fields in the PPTE section of the survey.
In total, at least 109 participants noted that their most impactful PPTE exposure was a moral, professional, and/or ethical dilemma. These participants volunteered the theme as a spontaneous addition to the list of possible PPTE exposures.
Emergent theme analytic results suggest that physicians, other nurses, staff, and/or the decision-making power of patients' families can reduce or eliminate a nurse's perception of their agency, which directly and negatively impacts their well-being and may cause them to experience moral injury. Nurses also report struggling when left to operationalize patient care instructions with which they disagree.
Nurses are exposed to PPTEs at work, but little is known about factors that can aggravate PPTE exposure in the field, impact the mental wellness of nurses, and even shape patient care. We discuss the implications of PPTE involving moral, professional, and ethical dilemmas (i.e., potentially morally injurious events), and provide recommendations for nursing policy and practice.
我们探讨了与一个未被探索的潜在心理创伤事件（PPTE）相关的社会和关系动态，这些事件可能会影响护士的幸福感和职业责任感：即在职业工作中遇到的道德、伦理或职业困境。
我们使用半结构化扎根理论方法，从我们调查响应数据的定性、开放式部分中揭示普遍出现的主题，作为更大的混合方法研究的一部分。
我们在 2019 年 5 月至 9 月期间对加拿大的护士进行了一项关于职业压力源及其健康和幸福感的全国性调查。在本研究中，我们分析了调查中 PPTE 部分的四个开放文本字段中的数据。
总共有至少 109 名参与者指出，他们最具影响力的 PPTE 暴露是道德、专业和/或道德困境。这些参与者自愿将主题作为可能的 PPTE 暴露列表的补充。
新兴主题分析结果表明，医生、其他护士、工作人员和/或患者家属的决策权力可以减少或消除护士对其代理机构的感知，这直接且负面地影响他们的幸福感，并可能导致他们经历道德伤害。护士在执行他们不同意的患者护理指令时也会感到挣扎。
护士在工作中会接触到 PPTE，但对于可能加剧现场 PPTE 暴露、影响护士心理健康甚至影响患者护理的因素知之甚少。我们讨论了涉及道德、专业和伦理困境的 PPTE 的含义（即潜在的道德伤害事件），并为护理政策和实践提供了建议。
