"Moral distress" can play a major contributing role to burnout among emergency nurses, according to a new report commissioned by the Emergency Nurses Association (ENA) and published online in the Journal of Emergency Nursing.
The report finds that nurses in emergency healthcare are increasingly unable to perform their jobs at a level that is fulfilling and which aligns with their inner sense of what quality nursing entails. The stress this causes over time leads to rapid burnout among personnel in emergency departments, particularly nurses.
In the study, six researchers conducted a survey of 28 emergency nurses and found that emergency nurses describe moral distress as an "inability to perform the obligations of nursing at the social justice level and is directly related to a lack of unit support, an overemphasis on technology to the exclusion of patient interaction, and the perception of a distinct disconnection between the administrators and the practitioners delivering care."
Moral distress among ER nurses are "environment driven" rather than "incident driven," according to the report. They often work with insufficient resources in a high-demand, technologically challenging environment with patients who are often extremely ill or badly hurt.
Emergency nurses are also more likely to suffer violence at the hands of patients who are delirious or intoxicated. Their shifts are often chaotic and they find that they cannot treat patients with attentiveness and compassion due to time constraints and metrics-driven administrative requirements that prioritize cost effectiveness and other bureaucratic concerns over patient care.
In addition, many nurses suffer from "compassion fatigue," and job-related stress, according to a 2014 report. The latest research suggests that that "successful interventions will most likely need to be targeted at the work environment and systemic conditions under which care if provided in the emergency department." Support from administrators is absolutely necessary, the study authors said, to "recognize and pre-emptively manage moral discordance" in these essential personnel.