Moral Distress of Nurses and Midwives

Topic: Nursing
Words: 630 Pages: 2

In the result of the meta-aggregation for the qualitative study, it was discovered that nurses and midwives who experienced a post-critical incident are prone to suffer from moral distress. Apart from this, they transform their professional identity, have decreased professional quality of life scale, and show signs of post-traumatic cognitions inventory. Nurses and midwives expect that hospital administration and colleagues will support them. They also hope that a critical incident will be investigated, and the organizational culture will be altered to prevent the repetition of similar incidents in the future. Finally, nurses and midwives develop defensive mechanisms and tamper with the human connection to cope with their negative experiences and move on. The current section discusses the aforementioned findings of the qualitative study. The first set of findings is related to the effects of a post-critical incident on nurses and midwives. In addition to the already mentioned impacts, when post-critical incidents were not fully investigated, nurses experience unreasonable self-blame and fail to cope with the constant feeling of panic [1]. In addition to that, other scholars note that as a reaction to an incident, some nurses might not believe that it happened, overthink, have untypical behavior reactions, and even doubt their religion and worldview [2]. Overall, the general idea behind these findings is that even though stress is a normal and expected reaction to such situations, medical personnel experience excessive stress that provokes a wide range of psychological and physical symptoms in most cases. The second set of findings targets the perceptions of support of nurses who faced a post-critical incident. The study reveals that nurses expect support primarily from their colleagues. Indeed, peer support is believed to be one of the principal instruments that help to overcome the effects of an incident [3, 4, 5, 6]. The essence of peer support is that it makes distressed midwives and nurses feel that they are not alone and that there are people who understand them entirely without disapproval. It is curious to note that the preceding studies do not cover the issue of reactive and proactive case investigation as a means of nurses support. The possible explanation for this is that it has become a normal practice for hospitals to analyze critical incidents, and this practice is not affected by the emotional state of medical staff members. The reaction of nurses and other specialists to post-critical incidents greatly depends on the organizational culture. More precisely, the administrative personnel must establish a supportive culture where nurses rely on their colleagues and managers [7, 13, 14]. Furthermore, a proper organizational culture could decrease nurses stress, burnout, and turnover and raise their satisfaction with the job [8, 9]. Additionally, it is suggested that nurses should work in a culture where mistakes are parsed and where there are no unfair punishments for the errors [10, 11, 12]. It also seems a viable idea to establish a critical incident stress management system in hospitals in which peer nurses will educate their colleagues on how to cope with stress and move on [18, 19]. The existing literature does investigate the relationship between nurses dealing with the effects of a post-critical incident and the organizational culture of a hospital. Nonetheless, it is way easier to go through this challenging stage of life in a respectful and supportive environment. The third set of findings is about the defensive practices applied by nurses. Such methods include fear processing and developing ways to avoid repeating similar errors in the future [15]. For instance, after post-critical incident cases, some midwives became more cautious and began to conduct more interventions and tests that are unnecessary in some cases [16, 17]. This way, nurses decide to play safe to avoid repeating the same situations, and this fear might evaporate only through years of experience.


Winton M, Cooper S, & Latchford G. Pediatric intensive care staff experiences of debriefing post critical incident; a qualitative study of the leeds ‘time out’ method. Research Square. 2020; 1-14. Web.

Maxwell W. Interpersonal communication post traumatic events: building trust & openness with persons impacted by critical incidents. Crisis, Stress, and Human Resilience: An International Journal. 2020; 2(3): 137-141.

Sumanen H. Experiences and impacts of the post critical incident seminar among rescue and emergency medical service personnel. Kotka: South-Eastern Finland University of Applied Sciences; 2020. 33 p.

Carvello M, Zanotti F, Rubbi, I, Bacchetti S, Artioli G, & Bonacaro A. Peer-support: a coping strategy for nurses working at the Emergency Ambulance Service. Acta Bio Medica: Atenei Parmensis. 2019; 90(11): 29-37.

Pearce T, Bugeja L, Wayland S, & Maple M. Effective elements for workplace responses to critical incidents and suicide: a rapid review. International journal of environmental research and public health. 2021; 18(9): 1-17. Web.

Brucia E, Cordova MJ, & Ruzek JI. Critical incident interventions: Crisis response and debriefing. In Police Science: Breakthroughs in Research and Practice (pp. 159-182). PA: IGI Global. 540 p.

Slivinski P C, & Hickey J V. Implementation of a Critical Incident Stress Management Program for Nurse Anesthetists. Journal of Nursing & Interprofessional Leadership in Quality & Safety. 2019: 2(2): 1-11.

Lee E, & Jang I. Nurses’ fatigue, job stress, organizational culture, and turnover intention: A culture–work–health model. Western journal of nursing research. 2020; 42(2): 108-116. Web.

Trus M, Galdikiene N, Balciunas S, Green P, Helminen M, & Suominen T. Connection between organizational culture and climate and empowerment: The perspective of nurse managers. Nursing & Health Sciences. 2019; 21(1): 54-62. Web.

Donaghy C, Doherty R, & Irwin T. Patient safety: A culture of openness and supporting staff. Surgery. 2018; 36(9): 509-514. Web.

Lee JY, Gowen III CR, & McFadden KL. An empirical study of US hospital quality: Readmission rates, organizational culture, patient satisfaction, and Facebook ratings. Quality Management Journal. 2018; 25(4): 158-170. Web.

Campione J, & Famolaro T. Promising practices for improving hospital patient safety culture. The Joint Commission Journal on Quality and Patient Safety. 2018; 44(1): 23-32. Web.

Corder E, & Ronnie L. The role of the psychological contract in the motivation of nurses. Leadership in Health Services. 2018; 31(1): 62-76. Web.

Arnetz JE, Sudan S, Fitzpatrick L, Cotten SR, Jodoin C, Chang CH, & Arnetz BB. Organizational determinants of bullying and work disengagement among hospital nurses. Journal of advanced nursing. 2019; 75(6): 1229-1238. Web.

Morrissey J & Higgins A. “Attenuating Anxieties”: A grounded theory study of mental health nurses’ responses to clients with suicidal behaviour. Journal of clinical nursing. 2019; 28(5-6): 947-958. Web.

Oliveira PSD, Couto TM, Gomes NP, Campos LM, Lima KTRDS, & Barral FE. Best practices in the delivery process: conceptions from nurse midwives. Revista Brasileira De Enfermagem. 2019; 72: 455-462. Web.

Callister LC. Now is the Time: Enhancing Access to Midwifery Care in the United States. MCN: The American Journal of Maternal/Child Nursing. 2020; 45(4): 243-264. Web.

Sanchez L, Young VB, & Baker M. Active shooter training in the emergency department: a safety initiative. Journal of Emergency Nursing. 2018; 44(6): 598-604. Web.

Watanabe N, Horikoshi M, Shinmei I, Oe Y, Narisawa T, Kumachi M, & Furukawa TA. Brief mindfulness-based stress management program for a better mental state in working populations-happy Nurse Project: a randomized controlled trial. Journal of affective disorders. 2019; 251: 186-194. Web.

Chesak SS, Cutshall SM, Bowe CL, Montanari KM, & Bhagra A. Stress management interventions for nurses: critical literature review. Journal of Holistic Nursing. 2019; 37(3): 288-295. Web.

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