comment on this write up about morale
comment on this write up about morale distress and resilience. End of life care is often a daunting task for many healthcare professionals. As nurses, easing the transition for clients and their loved ones is crucial. Research shows that clients are more comfortable transitioning in their home with familiar surroundings. Therefore, it is important for health care providers to allow as much nursing care in the home to promote a sense of comfort and normalcy while still ensuring that any medical needs are met. One end of life case from the Moral Distress Project details a struggle with a young patient with no prior medical history left in a vegetative state with a progressive decline (Rushton, C et al., 2023). The child was prevented from being taken home against the parents’ to pass due to a reluctance by medical staff to withdraw care. The key findings summarized in IOM’s Dying in America may have prevented this conflict (Pizzo, P et al., 2014). The findings support the idea that palliative care/ home based care can lead to an overall higher quality of life, provide emotional support to clients and their loved ones, and allow the client to transition comfortably in a familiar setting when the time comes. This particular case and position statement resonated with me because I am a homecare nurse myself. I have watched many clients with chronic conditions thrive in the home setting and recover faster from acute illness while maintaining a sense of normalcy. If the medical staff in the case detailed above had been more open to releasing the child to the parents and to the home so she could transition comfortably, it may have prevented extra stress on the family during an already difficult time. Moral resilience is a crucial quality to possess when working in the healthcare field. Moral resilience involves being able to make fair healthcare decisions in the face of adversity or emotional distress. The ANA’s strategies for promoting moral resilience among nurse leaders involves improving access to resources and screening tools to aid nurses in coping with the stressors of their job (Rushton, C et al., 2017). If I were a nurse leader, I would use evidence based practice to develop strategies to build the nursing staff’s resilience. A study reviewed the effects of something known as a Community of Practice on building moral resilience (Delgado, J et al., 2020). A CoP is a group of individuals with a shared interest who interact regularly and share their knowledge and experiences. CoPs offer healthcare providers a safe space to share their concerns and develop a feeling of mutual trust, resilience, and support. When workers feel 2 that they have a safe place to talk, the workers are more equipped to deal with the challenges they face, which leads to a greater amount overall of individual resilience and group resilience. Furthermore, the creation of CoPs supports the ANA’s emphasis on improving access to resources and developing ethics committees (ANA). If I were a nurse leader, I would implement a group similar to a CoP so my staff had resources and felt supported. I also believe that if a CoP was implemented for the caregivers of the end-of-life case described prior, the child may have been released to the home because the staff could have the support and expertise of one another on a difficult and highly emotional case. End of life care is a challenge for both nurses and their clients/ family members. As mentioned in the IOM article, patients deserve to be comfortable and transition in a place that is familiar to them, which is often the home. Caring for a dying client can take a tremendous toll on staff, so having resources available for them, such as a community group, can help them to build moral resilience and lead to better overall patient care. 3 References Delgado, J et al., (2020). Towards collective moral resilience: The potential of communities of practice during the covid-19 pandemic and beyond. Journal of medical ethics. Retrieved February 17, 2023, from https://pubmed.ncbi.nlm.nih.gov/33762300/ Pizzo, P et al.,(2014, September 17). Dying in america: Improving quality and honoring individual preferences near the end of life. Improving Quality and Honoring Individual Preferences Near the End of Life. The Institute of Medicine.. Retrieved February 17, 2023, from https://nap.nationalacademies.org/catalog/18748/dying-in-america-improving-quality-and-h onoring-individual-preferences-near Rushton, C et al., (2017). Exploring moral resilience toward a culture of ethical practice. Nursing World. Retrieved February 17, 2023, from https://www.nursingworld.org/~4907b6/globalassets/docs/ana/ana-call-to-action–exploring -moral-resilience-final.pdf Rushton, C et al,. (2023). Moral distress arising from end-of-life cases. UK HealthCare. University of Kentucky. Retrieved February 17, 2023, from https://ukhealthcare.uky.edu/bioethics-program/moral-distress-project/themes.
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